Q; Which of the following  anticonvulsants is effective in uremic pruritus patients on hemodialysis?

A) Gabapentin
B) Phenytoin
C) levetiracetam
D) Fosphenytoin
E) Carbamazepine


Answer:  A

Gabapentin is shown to be effective in uremic pruritus. For patients who don't respond to pruritus despite emollients and/or topical analgesics, and oral antihistamines - gabapentin is an effective choice. The starting dose is 100 mg and maximum dose is 350 mg given after each hemodialysis session. Another effective drug on same line is pregabalin (lyrica).



Reference: 

1. Gunal AI, Ozalp G, Yoldas TK, et al. Gabapentin therapy for pruritus in haemodialysis patients: a randomized, placebo-controlled, double-blind trial. Nephrol Dial Transplant 2004; 19:3137. 

2. Naini AE, Harandi AA, Khanbabapour S, et al. Gabapentin: a promising drug for the treatment of uremic pruritus. Saudi J Kidney Dis Transpl 2007; 18:378. 

3. Shavit L, Grenader T, Lifschitz M, Slotki I. Use of pregabalin in the management of chronic uremic pruritus. J Pain Symptom Manage 2013; 45:776.