Comparison of gabapentin and hydroxyzine in the treatment of pruritus in patients on dialysis

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Pruritus is one of the most common problems in patients with chronic renal failure. Of all patients with end-stage renal disease (ESRD), 60-80% report pruritus during their life. To compare the effect of gabapentin (GBP) and hydroxyzine (HYDZ) in treating pruritus in patients on dialysis. In a double-blind, randomized, crossover clinical trial, 32 patients on dialysis who reported pruritus were assigned randomly to receive either GBP or HYDZ for 6weeks; the first group received GBP 100mg/day orally and the second group received HYDZ 25mg/day orally for 6weeks. After this 6-week period (Period 1) there was a washout period of 2weeks then patients were crossed over to the other drug (the first group receiving HYDZ and second group receiving GBP) and followed up for a further 6weeks (Period 2). A visual analogue scale was used to measure pruritus intensity in the groups before and after the first and second period. In Period 1, pruritus severity decreased from 7.1±1.46 at baseline to 2.17±1.82 at 6weeks in the GBP group (P=0.001) and from 6.83±2.11 to 2.86±1.67 in the HYDZ group (P=0.001). In Period 2, pruritus severity decreased from 5.1±1.61 at baseline to 1.56±0.82 at 6weeks in the GBP group (P<0.01) and from 5.23±2.11 to 2.1±1.87 in the HYDZ group (P=0.001). Results showed that both HYDZ and GBP significantly improved and controlled pruritus in patients on dialysis, with no significant difference observed between the two drugs.