Ann Dermatol.  2016 Apr;28(2):159-163. 10.5021/ad.2016.28.2.159.

Clinical Efficacy and Safety of Naltrexone Combination Therapy in Older Patients with Severe Pruritus

• Lee J
• Shin JU
• Noh S
• Park CO
• Lee KH

• KMID: 2171371
• DOI: http://doi.org/10.5021/ad.2016.28.2.159

Abstract

BACKGROUND
Severe pruritus is a challenging condition, and it is more difficult to deal with in older patients due to their limitations in taking oral medication because of underlying diseases, possible interaction with concurrent medications, and poor general condition.
OBJECTIVE
We evaluated the efficacy and safety of naltrexone (Revia®), an opioid antagonist, in elderly patients with severe pruritus that was not easily controlled with conventional antipruritics.
METHODS
Eighteen patients were enrolled, with a mean age of 73 years. They additionally received 50 mg of naltrexone per day for an average of 2 months.
RESULTS
Using the visual analogue scale, 13 (72.2%) of 18 patients showed a "much improved" condition, reporting more than a 50% decrease in pruritus intensity. Sixteen (88.9%) showed symptomatic improvement, and only 2 (11.1%) had persistent pruritus. Five patients reported side effects including insomnia, fatigue, constipation, and anorexia. However, reactions were either limited to the first 2 weeks or well managed.
CONCLUSION
Naltrexone could be an effective and safe alternative treatment option to control severe pruritus in older patients.

Keyword

Elderly; Naltrexone; Pruritus

MeSH Terms

Aged
Anorexia
Antipruritics
Constipation
Fatigue
Humans
Naltrexone*
Pruritus*
Sleep Initiation and Maintenance Disorders
Antipruritics
Naltrexone

Figure

• 

  Fig. 1 Antipruritic effect of naltrexone according to the improvement of visual analoge scale (VAS) score was observed in sixteen patients (p<0.05).

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