Treatment of Pruritus in a Palliative Care Patient With Low-dose Paroxetine

A Case Report

Roni Y. Kraut

Disclosures

J Med Case Reports. 2017;11(280) 

In This Article

Abstract and Introduction

Abstract

Background Pruritus is a distressing symptom seen in palliative care. There is limited high-quality evidence of pharmaceutical treatments for pruritus in palliative care, including the use of paroxetine.

Case presentation I present a case of a 70-year-old caucasian woman with metastatic ovarian cancer who presented with severe pruritus. She had been diagnosed with bile duct obstruction 1 month earlier. Antihistamines and over-the-counter skin creams were first trialed, to no effect. Paroxetine was started at 5 mg in the evening, with the intention of titrating up. However, 5 mg of paroxetine was effective, and the patient's pruritus fully resolved after the second day.

Conclusions This case supports the use of paroxetine as a therapy for pruritus in palliative care patients and suggests that paroxetine may be effective at a very low dose.

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