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Abstract
Introduction: Pruritus is an uncomfortable cutaneous symptom with various etiologies, that leads to the urge to scratch. Pruritus greatly impacts patient quality of life, and an effective and global treatment has not been universally established due to its complex pathophysiology. Gabapentin, an anticonvulsant, binds to the alpha-2-delta subunit of voltage-gated calcium channels in the central nervous system, reducing neuronal excitability. Recently, neuronal theories of pruritus and neuromodulators have gained traction as a therapeutic approach. This systematic review examines the current literature on Gabapentin’s therapeutic effects on all forms of pruritus and compares its efficacy based on etiology, demographics, and dosages. A thorough investigation of the current literature of Gabapentin’s effects for pruritus is crucial in advancing and consolidating the understanding of pruritus management.
Methods: A comprehensive literature search was conducted in PubMed using relevant keywords and MeSH terms. Inclusion criteria included manuscripts published in the English language and must include a control group. Studies encompassed research on the association between pruritus and gabapentin treatment. Two independent reviewers will assess study eligibility based on predetermined criteria. Data extraction will cover study characteristics, participant demographics, etiology of pruritus, treatment outcomes, and relevant findings.
Results: 24 articles were identified in the literature that investigated gabapentin’s efficacy as a treatment modality for pruritus. These studies investigated the use in uremic, opioid induced, post-burn pruritus, and atypical pruritus. Gabapentin was shown to be an effective treatment modality for a wide range of pruritic etiologies and had synergistic effects when combined with other antipruritic medications. Its versatility and dose dependent response make it an attractive choice for patients with pruritus, especially those with resistant chronic pruritus.
Conclusion: This systematic review discusses the effects of gabapentin as a treatment for various forms of pruritus. Overall gabapentin was an effective treatment for uremic, opioid induced, and post-burn pruritus in comparison to traditional antihistamines and placebo. Further studies investigating the dose dependent responses and synergistic effects with other antipruritic drugs is essential in clarifying the landscape of gabapentin’s use cases.