Evaluation of the Efficacy and Safety of Mirtazapine in the Treatment of Uremic Pruritus in Hemodialysis Patients: A Randomized, Double-blind, Placebo-controlled Clinical Trial
Objective: Uremic pruritus (UP) is a prevalent and debilitating condition experienced by patients undergoing hemodialysis, influenced by multiple underlying mechanisms. Despite the availability of various treatment options, many patients still endure significant pruritus. This double-blind, placebo-...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2024-10-01
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| Series: | Journal of Research in Pharmacy Practice |
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| Online Access: | https://journals.lww.com/10.4103/jrpp.jrpp_16_25 |
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| author | Hamidreza Namvar Fatemeh Espahbodi Mahmood Moosazadeh Seyyed Mobin Rahimnia Narjes Hendouei |
| author_facet | Hamidreza Namvar Fatemeh Espahbodi Mahmood Moosazadeh Seyyed Mobin Rahimnia Narjes Hendouei |
| author_sort | Hamidreza Namvar |
| collection | DOAJ |
| description | Objective:
Uremic pruritus (UP) is a prevalent and debilitating condition experienced by patients undergoing hemodialysis, influenced by multiple underlying mechanisms. Despite the availability of various treatment options, many patients still endure significant pruritus. This double-blind, placebo-controlled clinical trial aims to assess and compare the safety and efficacy of mirtazapine and hydroxyzine in treating UP and improving sleep quality in hemodialysis patients.
Methods:
Twenty-seven patients in the mirtazapine group received 15 mg/night (7.5 mg for the first two nights) with a hydroxyzine placebo, while 28 patients in the hydroxyzine group received 25 mg/night (12.5 mg for the first two nights) with a mirtazapine placebo for 2 weeks. UP was assessed using the 5D-itch scale, and sleep quality was measured with the Pittsburgh Sleep Quality Index (PSQI) at baseline, weeks 2, 3, and 4. Adverse effects were recorded using the Antidepressant Side Effect Checklist at each visit from baseline to week 2.
Findings:
UP ratings based on the 5D-itch scale decreased for both groups, with a more significant reduction in the mirtazapine group (P = 0.04). The mirtazapine group also showed a significant improvement in the PSQI compared to hydroxyzine (P = 0.01). Dry mouth was the only notable adverse effect, occurring more frequently in the mirtazapine group (P = 0.02).
Conclusion:
This study suggests that short-term treatment with mirtazapine is more effective than hydroxyzine in reducing the severity of UP and improving sleep quality for patients undergoing hemodialysis. |
| format | Article |
| id | doaj-art-6d3d96521e24476f89037a99f8da8232 |
| institution | Kabale University |
| issn | 2319-9644 2279-042X |
| language | English |
| publishDate | 2024-10-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Journal of Research in Pharmacy Practice |
| spelling | doaj-art-6d3d96521e24476f89037a99f8da82322025-08-20T03:48:43ZengWolters Kluwer Medknow PublicationsJournal of Research in Pharmacy Practice2319-96442279-042X2024-10-0113412713610.4103/jrpp.jrpp_16_25Evaluation of the Efficacy and Safety of Mirtazapine in the Treatment of Uremic Pruritus in Hemodialysis Patients: A Randomized, Double-blind, Placebo-controlled Clinical TrialHamidreza NamvarFatemeh EspahbodiMahmood MoosazadehSeyyed Mobin RahimniaNarjes HendoueiObjective: Uremic pruritus (UP) is a prevalent and debilitating condition experienced by patients undergoing hemodialysis, influenced by multiple underlying mechanisms. Despite the availability of various treatment options, many patients still endure significant pruritus. This double-blind, placebo-controlled clinical trial aims to assess and compare the safety and efficacy of mirtazapine and hydroxyzine in treating UP and improving sleep quality in hemodialysis patients. Methods: Twenty-seven patients in the mirtazapine group received 15 mg/night (7.5 mg for the first two nights) with a hydroxyzine placebo, while 28 patients in the hydroxyzine group received 25 mg/night (12.5 mg for the first two nights) with a mirtazapine placebo for 2 weeks. UP was assessed using the 5D-itch scale, and sleep quality was measured with the Pittsburgh Sleep Quality Index (PSQI) at baseline, weeks 2, 3, and 4. Adverse effects were recorded using the Antidepressant Side Effect Checklist at each visit from baseline to week 2. Findings: UP ratings based on the 5D-itch scale decreased for both groups, with a more significant reduction in the mirtazapine group (P = 0.04). The mirtazapine group also showed a significant improvement in the PSQI compared to hydroxyzine (P = 0.01). Dry mouth was the only notable adverse effect, occurring more frequently in the mirtazapine group (P = 0.02). Conclusion: This study suggests that short-term treatment with mirtazapine is more effective than hydroxyzine in reducing the severity of UP and improving sleep quality for patients undergoing hemodialysis.https://journals.lww.com/10.4103/jrpp.jrpp_16_25hemodialysis patientshydroxyzinemirtazapineuremic pruritus |
| spellingShingle | Hamidreza Namvar Fatemeh Espahbodi Mahmood Moosazadeh Seyyed Mobin Rahimnia Narjes Hendouei Evaluation of the Efficacy and Safety of Mirtazapine in the Treatment of Uremic Pruritus in Hemodialysis Patients: A Randomized, Double-blind, Placebo-controlled Clinical Trial Journal of Research in Pharmacy Practice hemodialysis patients hydroxyzine mirtazapine uremic pruritus |
| title | Evaluation of the Efficacy and Safety of Mirtazapine in the Treatment of Uremic Pruritus in Hemodialysis Patients: A Randomized, Double-blind, Placebo-controlled Clinical Trial |
| title_full | Evaluation of the Efficacy and Safety of Mirtazapine in the Treatment of Uremic Pruritus in Hemodialysis Patients: A Randomized, Double-blind, Placebo-controlled Clinical Trial |
| title_fullStr | Evaluation of the Efficacy and Safety of Mirtazapine in the Treatment of Uremic Pruritus in Hemodialysis Patients: A Randomized, Double-blind, Placebo-controlled Clinical Trial |
| title_full_unstemmed | Evaluation of the Efficacy and Safety of Mirtazapine in the Treatment of Uremic Pruritus in Hemodialysis Patients: A Randomized, Double-blind, Placebo-controlled Clinical Trial |
| title_short | Evaluation of the Efficacy and Safety of Mirtazapine in the Treatment of Uremic Pruritus in Hemodialysis Patients: A Randomized, Double-blind, Placebo-controlled Clinical Trial |
| title_sort | evaluation of the efficacy and safety of mirtazapine in the treatment of uremic pruritus in hemodialysis patients a randomized double blind placebo controlled clinical trial |
| topic | hemodialysis patients hydroxyzine mirtazapine uremic pruritus |
| url | https://journals.lww.com/10.4103/jrpp.jrpp_16_25 |
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