In the 1990s, it was the first time that antidepressants were observed to relief itch. This includes mirtazapine, a norepinephrine reuptake inhibitor, tricyclic antidepressants and especially serotonin reuptake inhibitors (SSRIs) like paroxetine, fluoxetine and sertraline. They can be applied in somatoform itch, paraneoplastic itch, itch in cholestasis, itch of mixed and unknown origin. Mirtazapine is especially useful in night-time itch and can also be recommended in chronic itch in atopic dermatitis. Side-effect include nausea, weight gain, sleepiness as well as sleeplessness and agitation, sexual dysfunction, the latter mostly described in SSRIs. Patients report an improvement of their mood even though they were not previously thought to be depressed. The mechanisms of the antipruritic effects are still not understood.
KeywordsAntidepressant Itch Mirtazapine Paroxetine Pruritus Serotonin reuptake inhibitors Sertraline
- 12.Ständer S, Böckenholt B, Schürmeyer-Horst F, Weishaupt C, Heuft G, Luger TA, Schneider G. Treatment of chronic pruritus with the selective serotonin re-uptake inhibitors paroxetine and fluvoxamine: results of an open-labelled, two-arm proof-of-concept study. Acta Derm Venereol. 2009;89(1):45–51.CrossRefPubMedGoogle Scholar