{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T19:20:30Z","timestamp":1787772030910,"version":"build-2784847793"},"reference-count":26,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2024,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Chronic pruritus poses a significant challenge to treating physicians due to multitude of underlying causes and varying treatment strategies. Several topical, systemic, and physical modalities have been tried with variable success. Prescription practices in chronic pruritus are influenced by differential knowledge and experience of physicians, patient-related factors, and resource availability.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim:<\/jats:title>\n                    <jats:p>The purpose of this survey was to observe the current pattern of practice in Indian dermatologists in the management of chronic pruritus and to identify practice gaps particularly regarding the use of various systemic agents as antipruritics.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods:<\/jats:title>\n                    <jats:p>A previously validated questionnaire was sent to consultant dermatologists across India between January 2020 and July 2020. The questionnaire was comprised of six questions (multiple-choice questions as well as open-ended questions) regarding the use of antidepressants, cyclic gamma-aminobutyric acid (GABA) analogues, opioid antagonists, antihistamines, and alternate therapies in the management of chronic pruritus.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>A total of 700 dermatologists completed the questionnaire (response rate 70%). Overall, antihistamines were the most common drug prescribed in chronic pruritus (more than 95% respondents). Other systemic agents such as opioid antagonists, gabapentinoids, and antidepressants were prescribed by 22.42%, 71.85%, and 75.29% respondents, respectively, in chronic pruritus as either monotherapy or in combination with antihistamines in specific types of itches. Among antidepressants, tricyclic antidepressants (TCAs) (69.29%) were prescribed most often, followed by selective serotonin reuptake inhibitors (SSRIs) (32.29%) and serotonin and norepinephrine reuptake inhibitors (SNRIs) (9.14%). Other treatment options such as omalizumab, thalidomide, ondansetron, ursodeoxycholic acid (UDCA), and rifampicin were used by 10% respondents to alleviate pruritus in special situations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>This survey revealed the redundant practice of prescribing antihistamines in chronic pruritus irrespective of etiology among Indian dermatologists. It also revealed a differential approach regarding use of systemic agents such as gabapentinoids, opioid antagonists, and antidepressants, in academic and non-academic institutions. The survey emphasized a barrier in writing prescription of systemic agents such as opioid antagonist and SNRIs due to lack of knowledge and experience, fear of side effects, and inadequate available evidence.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/idoj.idoj_500_22","type":"journal-article","created":{"date-parts":[[2024,3,14]],"date-time":"2024-03-14T09:01:21Z","timestamp":1710406881000},"page":"33-38","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Prescription Practices Regarding the use of Systemic Drugs in the Management of Patients with Chronic Pruritus amongst Indian Dermatologists \u2013 A Questionnaire Based Survey"],"prefix":"10.4103","volume":"15","author":[{"given":"Kapil","family":"Vyas","sequence":"first","affiliation":[{"name":"Department of Dermatology, Venereology and Leprosy, Geetanjali Medical College and Hospital, Udaipur, Rajasthan, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kriti","family":"Maheshwari","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Venereology and Leprosy, Government Institute of Medical Sciences, Greater Noida, Uttar Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Praveen K. Shanmugam","family":"Reddy","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Venereology and Leprosy, Ramaiah Medical College, Bengaluru, Karnataka, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rajesh","family":"Verma","sequence":"additional","affiliation":[{"name":"Major General, Western Command, Chandimandir, Panchkula, Haryana, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Iffat","family":"Hasan","sequence":"additional","affiliation":[{"name":"Department of Dermatology Venereology and Leprosy, Government Medical College Srinagar, University of Kashmir, Jammu and Kashmir, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Asit","family":"Mittal","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Venereology and Leprosy, Ravindra Nath Tagore Medical College, Udaipur, Rajasthan, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2023,12,1]]},"reference":[{"key":"R1-20240828","doi-asserted-by":"crossref","first-page":"291","DOI":"10.1586\/edm.13.25","article-title":"Pruritus intensity assessment: Challenge for clinicians","volume":"8","author":"Reich","year":"2013","journal-title":"Expert Rev Dermatol"},{"key":"R2-20240828","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1172\/JCI102414","article-title":"Neural mechanisms involved in itch, \u201citchy skin\u201d and tickle sensations","volume":"30","author":"Graham DT Goodell","year":"1951","journal-title":"J Clin Invest"},{"key":"R3-20240828","first-page":"1135","article-title":"Pruritus","volume":"68","author":"Moses","year":"2003","journal-title":"Am Fam Physician"},{"key":"R4-20240828","doi-asserted-by":"crossref","first-page":"550","DOI":"10.1016\/j.tins.2010.09.002","article-title":"The multiple pathways for itch and their interactions with pain","volume":"33","author":"Davidson","year":"2010","journal-title":"Trends Neurosci"},{"key":"R5-20240828","first-page":"669","article-title":"Tricyclic antidepressants and histamine H1-receptors","volume":"54","author":"Richelson","year":"1979","journal-title":"Mayo Clin Proc"},{"key":"R6-20240828","doi-asserted-by":"crossref","first-page":"613","DOI":"10.1016\/S0190-9622(94)70225-X","article-title":"Relief of pruritus inpatients with atopic dermatitis after treatment with topical doxepin cream","volume":"31","author":"Drake","year":"1994","journal-title":"J Am Acad Dermatol"},{"key":"R7-20240828","doi-asserted-by":"crossref","first-page":"110","DOI":"10.1034\/j.1600-0625.2001.010002110.x","article-title":"Doxepin affects acetylcholine induced cutaneous reactions in atopic eczema","volume":"10","author":"Groene","year":"2001","journal-title":"Exp Dermatol"},{"key":"R8-20240828","first-page":"34","article-title":"Low-dose doxepin for treatment of pruritus in patients on hemodialysis","volume":"1","author":"Pour-Reza-Gholi","year":"2007","journal-title":"Iran J Kidney Dis"},{"key":"R9-20240828","doi-asserted-by":"crossref","first-page":"867","DOI":"10.1016\/0091-6749(86)90232-0","article-title":"Efficacy of doxepin in the treatment of chronic idiopathic urticaria","volume":"78","author":"Goldsobel","year":"1986","journal-title":"J Allergy Clin Immunol"},{"key":"R10-20240828","doi-asserted-by":"crossref","first-page":"970","DOI":"10.1097\/PSY.0b013e3181572799","article-title":"Psychiatric medications for the treatment of pruritus","volume":"69","author":"Shaw","year":"2007","journal-title":"Psychosom Med"},{"key":"R11-20240828","doi-asserted-by":"crossref","first-page":"505","DOI":"10.1111\/1346-8138.12154","article-title":"Effective treatment of notalgia paresthetica with amitriptyline","volume":"40","author":"Yeo","year":"2013","journal-title":"J Dermatol"},{"key":"R12-20240828","doi-asserted-by":"crossref","first-page":"124","DOI":"10.1080\/09546634.2019.1623369","article-title":"Tricyclic antidepressants for the treatment of chronic pruritus","volume":"32","author":"Boozalis","year":"2021","journal-title":"J Dermatolog Treat"},{"key":"R13-20240828","first-page":"5","article-title":"Problems with currently available antidepressants","volume":"61","author":"Gumnick","year":"2000","journal-title":"J Clin Psychiatry"},{"key":"R14-20240828","first-page":"674","article-title":"By the 2019 American Geriatrics Society Beers Criteria\u00aeUpdate Expert Panel. American geriatrics society 2019 updated AGS beers criteria\u00aefor potentially inappropriate medication use in older adults","volume":"67","year":"2019","journal-title":"J Am Geriatr Soc"},{"key":"R15-20240828","doi-asserted-by":"crossref","first-page":"73","DOI":"10.3390\/medicines6030073","article-title":"Mirtazapine for the treatment of chronic pruritus","volume":"6","author":"Khanna","year":"2019","journal-title":"Medicines (Basel)"},{"key":"R16-20240828","doi-asserted-by":"crossref","first-page":"1105","DOI":"10.1016\/j.jpainsymman.2003.05.004","article-title":"Paroxetine in the treatment of severe non-dermatological pruritus: A randomized, controlled trial","volume":"26","author":"Zylicz","year":"2003","journal-title":"J Pain Symptom Manage"},{"key":"R17-20240828","doi-asserted-by":"crossref","first-page":"666","DOI":"10.1002\/hep.21553","article-title":"Sertraline as a first line treatment for cholestatic pruritus","volume":"45","author":"Mayo","year":"2007","journal-title":"Hepatology"},{"key":"R18-20240828","doi-asserted-by":"crossref","first-page":"351","DOI":"10.7861\/clinmedicine.15-4-351","article-title":"Drug treatment of pruritus in liver diseases","volume":"15","author":"Hegade","year":"2015","journal-title":"Clin Med (Lond)"},{"key":"R19-20240828","doi-asserted-by":"crossref","first-page":"217","DOI":"10.2174\/1574887114666190328130720","article-title":"Comparison of sertraline with rifampin in the treatment of cholestatic pruritus: A randomized clinical trial","volume":"14","author":"Ataei","year":"2019","journal-title":"Rev Recent Clin Trials"},{"key":"R20-20240828","doi-asserted-by":"crossref","first-page":"1507","DOI":"10.1001\/archderm.141.12.1507","article-title":"Efficacy of gabapentin in the management of pruritus of unknown origin","volume":"141","author":"Yesudian","year":"2005","journal-title":"Arch Dermatol"},{"key":"R21-20240828","doi-asserted-by":"crossref","first-page":"93","DOI":"10.4103\/ijdd.ijdd_14_20","article-title":"Efficacy and safety of a sustained-release preparation of pregabalin in chronic pruritus","volume":"6","author":"Meena","year":"2020","journal-title":"Indian J Drugs Dermatol"},{"key":"R22-20240828","doi-asserted-by":"crossref","first-page":"669","DOI":"10.1007\/s13555-021-00513-z","article-title":"Gabapentinoids for pruritus in older adults: A narrative review","volume":"11","author":"Sreekantaswamy","year":"2021","journal-title":"Dermatol Ther (Heidelb)"},{"key":"R23-20240828","doi-asserted-by":"crossref","first-page":"1125","DOI":"10.3748\/wjg.v12.i7.1125","article-title":"Effect of oral naltrexone on pruritus in cholestatic patients","volume":"12","author":"Mansour-Ghanaei","year":"2006","journal-title":"World J Gastroenterol"},{"key":"R24-20240828","doi-asserted-by":"crossref","first-page":"979","DOI":"10.1016\/j.jaad.2007.01.007","article-title":"Treatment of pruritus with topically applied opiate receptor antagonist","volume":"56","author":"Bigliardi","year":"2007","journal-title":"J Am Acad Dermatol"},{"key":"R25-20240828","first-page":"533","article-title":"Efficacy and safety of naltrexone, an oral opiate receptor antagonist, in the treatment of pruritus in internal and dermatological diseases","volume":"41","author":"Metze","year":"1999","journal-title":"J Am Acad Dermatol"},{"key":"R26-20240828","doi-asserted-by":"crossref","first-page":"304","DOI":"10.2340\/00015555-3101","article-title":"Use of systemic treatment in patients with chronic pruritus: A survey of dermatologists in the Netherlands","volume":"99","author":"Kouwenhoven","year":"2019","journal-title":"Acta Derm Venereol"}],"container-title":["Indian Dermatology Online Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/idoj.idoj_500_22","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T18:26:43Z","timestamp":1787768803000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/idoj.idoj_500_22"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,12,1]]},"references-count":26,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2024]]}},"URL":"https:\/\/doi.org\/10.4103\/idoj.idoj_500_22","relation":{},"ISSN":["2229-5178","2249-5673"],"issn-type":[{"value":"2229-5178","type":"print"},{"value":"2249-5673","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,12,1]]},"assertion":[{"value":"2022-09-21","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-12-31","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}