New Drug for Itching - Sertraline

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Sertraline as a first-line treatment for cholestatic

pruritus

Marlyn J. Mayo, Iorna Handem, Saldana, Heidi e,

Yonas Getachew, A.

Rush

Depart of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX

Depart of Dermatology, University of Texas Southwestern Medical CenterDallas, TX

Depart of Psychiatry, & Clinical Sciences, University of Texas Southwestern Medical Center Dallas, TX

Abstract

Pruritus is frequently the most debilitating symptom

of cholestatic liver diseases. Moreover,

existing therapies are often ineffective. Recent

small, retrospective case series reports suggest that serotonin reuptake

inhibitors can improve pruritus. This study was

undertaken to establish the dose of sertraline and

to evaluate its efficacy for cholestatic pruritus. Twenty one subjects with chronic pruritus due to liver

disease (including primary biliary cirrhosis, primary sclerosing

cholangitis, chronic hepatitis C, and postnecrotic cirrhosis) initially underwent an

open-label, dose escalation to determine the dose with optimal efficacy and

tolerability. After a washout period, 12 of the

subjects entered a randomized, double-blind, placebo-controlled trial. Participants quantified their pruritus using a 0-10

visual analog scale, and pruritus was assessed for distribution, timing,

degree of disability, and physical evidence of scratching. The optimum sertraline

dose (75-100 mg/day) was well tolerated. In the

controlled portion of the study, itch scores improved in patients taking sertraline, but worsened in patients taking placebo (P = 0.009). Changes

in itch distribution, duration, direction, and physical evidence of

scratching paralleled changes in the visual analog pruritus score. Conclusion:

Sertraline seems to be an effective, well-tolerated

treatment for pruritus due to chronic liver disease. These

results suggest that serotonergic pathways are

important in the perception of itch. (HEPATOLOGY 2007;45:666-674.)

In case anyone is interested, I did a little

research – Sertraline is marketed here in the

U.S. as Zoloft!

This is a small study, but who knows, it might be

worth a shot if your itching is out of control. Here is the drug info - http://www.nlm.nih.gov/medlineplus/druginfo/medmaster/a697048.html

Barb in Texas - Together in the Fight, Whatever it Takes!

Son Ken (32) UC 91 - PSC 99 Listed 7/21 @ Baylor Dallas

[Guest guest]

" In case anyone is interested, I did a little research – Sertraline is

marketed here in the U.S. as Zoloft! "

Wow. I can't wait to tell my brother this. He just started taking

Zoloft to help with the depression and mood swings. (Of course it

makes him really sleepy-and he doesn't like that). But to help with

the itch might just be an added bonus (hopefully) for him.

Brother, , 30, UC & PSC

[Guest guest]

> Sertraline as a first-line treatment for cholestatic pruritus

HOORAY - well found Barb - can I buy shares? ;o)

[Guest guest]

,

can be our own personal test trial. Please let us know if it works

for him. I will be anxious to hear.

Joanne (mom of Todd)

Re: New Drug for Itching - " Sertraline "

" In case anyone is interested, I did a little research - Sertraline is

marketed here in the U.S. as Zoloft! "

Wow. I can't wait to tell my brother this. He just started taking

Zoloft to help with the depression and mood swings. (Of course it

makes him really sleepy-and he doesn't like that). But to help with

the itch might just be an added bonus (hopefully) for him.

Brother, , 30, UC & PSC

[Guest guest]

I will certainly let you all know if he notices a difference. When I told him about the study today he said " yeah sure it helps stop the itch-you do nothing but sleep-so you don't scratch " . So, we obviously need to adjust to the medicine. But I will certainly keep my eyes open and check with him on it. I hope he could get some relief-it drives him crazy sometimes.

-

,

can be our own personal test trial. Please let us know if it works

for him. I will be anxious to hear.

Joanne (mom of Todd)

[Guest guest]

-----Original

Message-----

When I told him about the study today he said " yeah sure it

helps stop the itch-you do nothing but sleep-so you don't scratch " .

The pill Ken takes to help him sleep, (I keep forgetting the name) knocks him out

too, but he’s thrilled with it.

He prefers sleep rather than itch.

Unfortunately, Ken’s legs are already badly scarred.

Barb in Texas

[Guest guest]

WHEN I SLEEP IS THE TIME I SCRATCH...THEN I WAKE UP IN THE MORNING WITH BLACK AND BLUE ARMS...SOME TIMES I SCRATCH SO HARD I RIP MY SKIN..I HAD TO CUT MY NAILS WAY DOWN.. THE ITCHING IS WORST WHEN ASCITE STARTS TO ACT UP. JEANNE Crumbliss wrote: I will certainly let you all know if he notices a difference. When I told him about the study today he said "yeah sure it helps stop the itch-you do nothing but sleep-so you don't

scratch". So, we obviously need to adjust to the medicine. But I will certainly keep my eyes open and check with him on it. I hope he could get some relief-it drives him crazy sometimes. - On 3/7/07, Joanne Grieme <jgrieme (AT) zoominternet (DOT) net> wrote: , can be our own personal test trial. Please let us know if it worksfor him. I will be anxious to hear.Joanne (mom of Todd)

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I've placed a call to my doctor to see if he has heard

of the Zoloft usage. It sounds hopeful to me.

Cindy Baudoux-Northrup

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legs??? My whole body is scarred! Face, chest,

tummy, back, butt, legs, feet, arms....I prefer sleep

to itch as well.

I take 4 Benadryl a day, Ambien CR at night, Zofran,

Hydroxyzine 150 mgs a day...and all of these

supposedly cause drowsiness. Ambien CR certainly

does...but the others are like eating candy....3

Benadryl at time time does not affect me as far as

getting sleepy.

Cindy Baudoux-Northrup

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[Guest guest]

Sertraline just went generic and so the price will fall dramatically

and eventually be on the $4/month Walmart list. This study shows that

it is more effective than placebo at REDUCING itching scores. In other

words it may help but probably won't eliminate itching. It has a very

mild side effect profile and any help with itching is very much

appreciated.

[Guest guest]

Hi Von;

I've been taking Zoloft for a few years now for depression (not for

itching!). I did try switching to the generic sertraline, but found

that it dissolves much more rapidly than Zoloft on its way down. After

a few days on the generic I would experience a burning sensation in my

lower eosophagus. I suspect that may be because it is a HCl salt, and

it may have been releasing HCl (hydrochloric acid) before reaching my

stomach? I've never had this problem with the brand name Zoloft

pills ... perhaps they have a thicker coating and so dissolve less

easily than the generic tablets?

Hope that you are recovering well from your transplant!

Best regards,

Dave R.

>

> Sertraline just went generic and so the price will fall dramatically

> and eventually be on the $4/month Walmart list.