Gabapentin and pregabalin are safe and efficacious options to treat older adults with chronic pruritus.

Prior to gabapentinoid initiation, the patient should be screened for: history of kidney disease; COPD or other lung disorders; current opioid medication use; history of falls, lightheadedness, or vertigo; history of mood disorders, including depression and suicidal ideation; history of recreational drug usage.

Common side effects of both gabapentin and pregabalin that should be screened for after initiation or dose change include: changes in mood or increased depression; anxiety, or suicidal ideation; dizziness, fatigue, or blurred vision; difficulty with balance or coordination; edema in extremities.

The goal of treatment is to control itch at night: start with 100 mg at 8:00 p.m. and then increase dose to 300 mg before adding a second evening dose at 5:00 p.m.