Relief of cholestatic pruritus by a novel class of drugs: 5-hydroxytryptamine type 3 (5-HT3) receptor antagonists: effectiveness of ondansetron.
The objective of the present study was to determine whether ondansetron, a specific serotonin type 3 receptor antagonist (5-HT3), relieves cholestatic pruritus in patients resistant to conventional antipruritic therapy (antihistamines and cholestyramine). In a placebo-controlled study the acute effect of an intravenous injection of ondansetron (4 mg, 8 mg) or placebo (NaCl solution) was tested in 10 patients (41-66 years of age; 4 men, 6 women) with cholestatic itch. A successful treatment was assessed when the intensity of itch was reduced by 50% or more within 2 h after injection of ondansetron. Intensity of itch was determined by the patients on a visual rating scale from 0 to 10. Ondansetron reduced or abolished pruritus within 30-60 min after injection. A 50% reduction of the intensity of itch was observed up to 6 h after injection of 8 mg. The effect was reproducible in the same patient. In conclusion ondansetron is effective in the treatment of cholestatic itch. Serotonin may participate in the generation and/or sensation of cholestatic pruritus.
Schwörer
Harald
H
Department of Medicine, Division of Gastroenterology and Endocrinology, University of Göttingen, 37075 Göttingen, Germany.
Hartmann
Heinz
H
Ramadori
Giuliano
G
D000328:Adult; D000368:Aged; D015209:Cholangitis, Sclerosing / Q000150:complications; D002779:Cholestasis / Q000150:complications*; D005260:Female; D006801:Humans; D008105:Liver Cirrhosis, Biliary / Q000150:complications; D008297:Male; D008875:Middle Aged; D017294:Ondansetron / Q000627:therapeutic use*; D011537:Pruritus / Q000188:drug therapy* / Q000209:etiology; D012702:Serotonin Antagonists / Q000627:therapeutic use*
D012702:Serotonin Antagonists; D017294:Ondansetron