The cause of generalized pruritus should be sought and corrected. If no skin disease is apparent, a systemic disorder or drug-related cause should be sought. If feasible, all drugs should be stopped or replaced with chemically unrelated drugs. Ultraviolet B to the skin and oral cholestyramine can be helpful in uremia and cholestasis and at times in undiagnosed cases. If antihistamines are helpful, their sedative effect may be the reason.
Antihistamines are more likely to cause intolerable side effects in the elderly.
In the past decade, several newer low-sedating antihistamines have become available, including astemizole, loratadine, and cetirizine. These drugs have been used with limited success in the treatment of pruritus. All rights reserved.