Pruritus associated with malignancy may be one of the most bothersome
symptoms in advanced cancer. Its control is still difficult to achieve
and is a challenge to palliative medicine specialists. We describe fi
ve patients suffering from pruritus of different etiologies who respon
ded rapidly to administration of paroxetine, a serotonin reuptake inhi
bitor, in a dose-dependent manner. Two patients experienced transient
but severe nausea and vomiting. We suggest that paroxetine's antipruri
tic effect may be explained by rapid downregulation of the 5-HT3 recep
tors, which may have an important role In the generation of pruritus a
nd pain. J Pain Symptom Manage 1998;16:121-124. (C) U.S. Cancer Pain R
elief Committee, 1998.