Jacob Bell
New Member
Preliminary observation with dronabinol in patients with intractable pruritus secondary to cholestatic liver disease
Author(s) Neff GW, O'Brien CB, Reddy KR, Bergasa NV, Regev A, Molina E, Amaro R, Rodriguez MJ, Chase V, Jeffers L, Schiff E.
Journal, Volume, Issue Am J Gastroenterol 2002;97(8):2117-9
Major outcome(s) THC signficantly reduced intractable cholestatic related pruritus
Medication Delta-9-THC
Route(s) Oral
Dose(s) 2.5 - 5 mg THC
Duration (days)
Participants 3 patients with pruritus
Design Open study
Type of publication Medical journal
Address of author(s) Department of Medicine, University of Miami, Florida, USA
Abstract
Pruritus due to cholestatic liver disease can be particularly difficult to
manage and frequently is intractable to a variety of medical therapies. The aim
of our study is to evaluate the efficacy of delta-9-tetrahydrocannabinol
(delta-9-THC) for intractable cholestatic related pruritus (ICRP) that has
failed conventional (and unconventional) remedies. Three patients were evaluated
for plasmapheresis because of ICRP. All 3 patients had previously been
extensively treated with standard therapies for ICRP including: diphenhydramine,
chlorpheniramine, cholestyramine, rifampicin, phenobarbital, doxepin,
naltrexone, UV therapy, and topical lotions. Even multiple courses of
plasmapheresis were performed without any benefit for the intractable pruritus.
All patients reported significant decreases in their quality of life, including
lack of sleep, depression, inability to work, and suicidal ideations. All
patients were started on 5 mg of delta-9-THC (Marinol) at bedtime. All 3
patients reported a decrease in pruritus, marked improvement in sleep, and
eventually were able to return to work. Resolution of depression occurred in two
of three. Side effects related to the drug include one patient experiencing a
disturbance in coordination. Marinol dosage was decreased to 2.5 mg in this
patient with resolution of symptoms. The duration of antipruritic effect is
approximately 4-6 hrs in all three patients suggesting the need for more
frequent dosing. Delta-9-tetrahydrocannabinol may be an effective alternative in
patients with intractable cholestatic pruritus.
Source: Preliminary observation with dronabinol in patients with intractable pruritus secondary to cholestatic liver disease
Author(s) Neff GW, O'Brien CB, Reddy KR, Bergasa NV, Regev A, Molina E, Amaro R, Rodriguez MJ, Chase V, Jeffers L, Schiff E.
Journal, Volume, Issue Am J Gastroenterol 2002;97(8):2117-9
Major outcome(s) THC signficantly reduced intractable cholestatic related pruritus
Medication Delta-9-THC
Route(s) Oral
Dose(s) 2.5 - 5 mg THC
Duration (days)
Participants 3 patients with pruritus
Design Open study
Type of publication Medical journal
Address of author(s) Department of Medicine, University of Miami, Florida, USA
Abstract
Pruritus due to cholestatic liver disease can be particularly difficult to
manage and frequently is intractable to a variety of medical therapies. The aim
of our study is to evaluate the efficacy of delta-9-tetrahydrocannabinol
(delta-9-THC) for intractable cholestatic related pruritus (ICRP) that has
failed conventional (and unconventional) remedies. Three patients were evaluated
for plasmapheresis because of ICRP. All 3 patients had previously been
extensively treated with standard therapies for ICRP including: diphenhydramine,
chlorpheniramine, cholestyramine, rifampicin, phenobarbital, doxepin,
naltrexone, UV therapy, and topical lotions. Even multiple courses of
plasmapheresis were performed without any benefit for the intractable pruritus.
All patients reported significant decreases in their quality of life, including
lack of sleep, depression, inability to work, and suicidal ideations. All
patients were started on 5 mg of delta-9-THC (Marinol) at bedtime. All 3
patients reported a decrease in pruritus, marked improvement in sleep, and
eventually were able to return to work. Resolution of depression occurred in two
of three. Side effects related to the drug include one patient experiencing a
disturbance in coordination. Marinol dosage was decreased to 2.5 mg in this
patient with resolution of symptoms. The duration of antipruritic effect is
approximately 4-6 hrs in all three patients suggesting the need for more
frequent dosing. Delta-9-tetrahydrocannabinol may be an effective alternative in
patients with intractable cholestatic pruritus.
Source: Preliminary observation with dronabinol in patients with intractable pruritus secondary to cholestatic liver disease
