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Paroxetine Appears Effective in Treating Severe Non-Dermatological Pruritus
A DGReview of :"Paroxetine in the treatment of severe non-dermatological pruritus: a randomized, controlled trial"
Journal of Pain and Symptom Management
12/16/2003
By Mary Beth Nierengarten
Paroxetine appears to relieve severe non-dermatological pruritus associated with advanced cancer or other systemic diseases, reports a European study.
Severe pruritus, associated with advanced systemic disease or of idiopathic origin, is difficult to treat. However, data from uncontrolled studies indicate that paroxetine may provide rapid relief of symptoms associated with the condition.
To evaluate the clinical efficacy of paroxetine in this setting, Zbigniew Zylicz, MD, PhD, Hospice Rozenheuvel, the Netherlands, and colleagues conducted a prospective double-blind randomised trial comparing paroxetine to placebo in 17 patients with solid tumours, 4 with haematological malignancies, and 5 with nonmalignant or idiopathic conditions. After 7 days of randomisation to either paroxetine (20 mg) or placebo, patients were then crossed over to receive the alternate treatment. The primary outcome evaluated was the mean intensity score of pruritus after the 7 days of randomisation or crossover. Individual global response to treatment (defined as at least 50% reduction in intensity of pruritus during last 3 days of treatment compared to baseline) was the secondary outcome measured.
Of the 24 evaluable patients, treatment with paroxetine conferred lower pruritus intensity scores than did placebo (5.2 vs. 6.0, respectively), with a mean difference of 0.78. The average difference between paroxetine and placebo groups was even greater on the last 3 days of treatment. These differences were found irrespective of the order of treatment, and no significant effect on results was found based on a carry-over effect.
In terms of response, paroxetine was associated with significantly higher proportion of responses compared to placebo (37.5% vs. 4.2%, respectively). Overall, patients reported higher satisfaction when treated with paroxetine than when on placebo.
The authors conclude that paroxetine appears to be effective in treating intractable severe pruritus of non-dermatological origin in patients with advanced cancer or other systemic diseases.
J Pain Symptom Manage 2003;26:6:1105-1111.
"Paroxetine in the treatment of severe non-dermatological pruritus: a randomized, controlled trial"
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