title: Comparison of pregabalin with doxepin in the management of uremic pruritus: a randomized single blind clinical trial.
abstract: Pruritus is one of the frustrating skin manifestations of advanced renal failure. Many options have been used for the management of uremic pruritus (UP) such as pregabalin. There are some studies that reported beneficial effects of pregabalin in reducing UP; however, most of them did not have a comparator arm. Therefore, we designed this study to compare antipruritic effects of pregabalin with doxepin in the management of pruritus in hemodialysis patients.
  
  
  
  Seventy-two patients suffering from UP were randomly assigned to receive pregabalin (50 mg every other day) or doxepin (10 mg per day) for 4 weeks. Severity of pruritus and its effect on quality of life were assessed by visual analog scale (VAS), 5-D itch scale and dermatology life quality index (DLQI) at baseline and after 1 week, 2 weeks and 4 weeks of the treatment.
  
  
  
  Mean scores of the VAS decreased from 7.5± 1.4 and 7.1 ± 1.3 at baseline to 2.1 ± 2.6 and 4.2 ± 2.6 at the end of the study (P < 0.001) in the pregabalin and doxepin groups, respectively. Similarly, pregabalin significantly reduced mean scores of the 5-D itch scale and the DLQI compared to doxepin. The most reported side effect in each group was somnolence which occurred in similar rates in the both groups.
  
  
  
  Pregabalin was more effective than doxepin in reducing the severity of uremic pruritus and improving the quality of life of patients in this study, so we suggest that clinician can consider pregabalin prior to using antihistamine drugs in the management of severe itch in hemodialysis patients.
authors.affiliation: Faculty of Pharmacy and Pharmaceutical Sciences, Kerman University of Medical Sciences, Kerman, Iran.
authors.forename: Nazanin
authors.initials: N
authors.lastname: Foroutan
authors.affiliation: Department of Nephrology, Shafa Hospital, Kerman University of Medical Sciences, Kerman, Iran.
authors.forename: Abbas
authors.initials: A
authors.lastname: Etminan
authors.affiliation: Faculty of Pharmacy and Pharmaceutical Sciences, and Department of Nephrology, Shafa Hospital, Kerman University of Medical Sciences, Kerman, Iran.
authors.forename: Naemeh
authors.initials: N
authors.lastname: Nikvarz
authors.affiliation: Biostatistics Department, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran.
authors.forename: Mohadese
authors.initials: M
authors.lastname: Shojai Shahrokh Abadi
mesh_terms: D000700:Analgesics / Q000627:therapeutic use*; D004316:Doxepin / Q000627:therapeutic use*; D005260:Female; D006633:Histamine Antagonists / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D000069583:Pregabalin / Q000627:therapeutic use*; D011537:Pruritus / Q000188:drug therapy* / Q000209:etiology; D011788:Quality of Life; D006435:Renal Dialysis / Q000009:adverse effects*; D016037:Single-Blind Method; D014511:Uremia / Q000150:complications*
chemical_list: D000700:Analgesics; D006633:Histamine Antagonists; D004316:Doxepin; D000069583:Pregabalin
keywords: Uremic pruritus; doxepin; hemodialysis; neuropathy; pregabalin