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Pruritus pp 379-388 | Cite as

Anticonvulsants

  • Simone GarcovichEmail author
Chapter

Abstract

Anticonvulsants are a class of neuronally active medications first licensed to treat epilepsy and neuropathic pain. Among these, the gabapentinoids, the GABA-derivatives gabapentin and pregabalin, have been used with success to treat post-herpetic neuralgia, a chronic neuropathic condition characterized by pain, itch and dysesthesia. The preliminary report of efficacy of gabapentin in brachioradial pruritus and the common pathophysiology of neuropathic pain and itch opened a new therapeutic option in chronic pruritic conditions. In animal and human models, gabapentinoids are effective in reducing neuropathic pain and related manifestations of allodynia and hyperalgesia, key features of a central sensitization process to pain. A similar pattern of central sensitization has also been characterized in chronic pruritus, representing the rationale for antipruritic treatment with anticonvulsants. Currently available clinical studies support the use of the gabapentin and pregabalin as second-line systemic agents in neuropathic itch conditions, uremic itch, post-burn itch and prurigo nodularis. Antipruritic anticonvulsants present a predictable safety profile and are useful in combination with other central and peripheral-acting medications in a multimodal, patient-oriented treatment strategy.

Keywords

Pruritus, prurigo, anticonvulsants Analgesics Gabapentin Pregabalin Calcium channel blockers Neuralgia Central sensitization Antipruritics 

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Copyright information

© Springer-Verlag London 2016

Authors and Affiliations

  1. 1.Institute of DermatologyPoliclinico Agostino Gemelli University Hospital, Università Cattolica del Sacro CuoreRomeItaly

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