title: Clinical Efficacy and Safety of Naltrexone Combination Therapy in Older Patients with Severe Pruritus.
abstract: BACKGROUND
  Severe pruritus is a challenging condition, and it is more difficult to deal with in older patients due to their limitations in taking oral medication because of underlying diseases, possible interaction with concurrent medications, and poor general condition.
  
  
  OBJECTIVE
  We evaluated the efficacy and safety of naltrexone (Revia®), an opioid antagonist, in elderly patients with severe pruritus that was not easily controlled with conventional antipruritics.
  
  
  METHODS
  Eighteen patients were enrolled, with a mean age of 73 years. They additionally received 50 mg of naltrexone per day for an average of 2 months.
  
  
  RESULTS
  Using the visual analogue scale, 13 (72.2%) of 18 patients showed a "much improved" condition, reporting more than a 50% decrease in pruritus intensity. Sixteen (88.9%) showed symptomatic improvement, and only 2 (11.1%) had persistent pruritus. Five patients reported side effects including insomnia, fatigue, constipation, and anorexia. However, reactions were either limited to the first 2 weeks or well managed.
  
  
  CONCLUSIONS
  Naltrexone could be an effective and safe alternative treatment option to control severe pruritus in older patients.
authors.affiliation: Department of Dermatology and Cutaneous Biology Research Institute, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Jungsoo
authors.initials: J
authors.lastname: Lee
authors.affiliation: Department of Dermatology and Cutaneous Biology Research Institute, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Jung U
authors.initials: JU
authors.lastname: Shin
authors.affiliation: Department of Dermatology and Cutaneous Biology Research Institute, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Seongmin
authors.initials: S
authors.lastname: Noh
authors.affiliation: Department of Dermatology and Cutaneous Biology Research Institute, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Chang Ook
authors.initials: CO
authors.lastname: Park
authors.affiliation: Department of Dermatology and Cutaneous Biology Research Institute, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Kwang Hoon
authors.initials: KH
authors.lastname: Lee
keywords: Elderly; Naltrexone; Pruritus