Update on the Treatment of the Pruritus of Cholestasis

The pruritus of cholestasis is a difficult clinical problem to manage. It can be severe and interfere with sleep. Clinical behavioral studies have confirmed that the pruritus is mediated at least in part by endogenous opioids. Other neurotransmitter systems may be involved in the mediation of pruritus. Work continues to identify the mechanisms that mediate the pruritus and to develop specific drugs to treat this often maddening symptom.