Pruritus that is refractory to moisturizers and conservative measures can be treated with antihistamines or tricyclic antidepressants. Compared with the newer, nonsedating histamines, the older, sedating agents such as hydroxyzine (Atarax) and diphenhydramine (Benadryl) are more effective in controlling pruritus. 20 However, these agents can affect a child's ability to learn or an adult's ability to drive and work. 21 If drowsiness is a problem, a nonsedating antihistamine can be tried to see if it is effective. Tricyclic antidepressants such as doxepin (Sinequan) and amitriptyline (Elavil) also have an antihistaminic effect, induce sleep and reduce pruritus. 22
Just want to share some experience with you. You are an advocate for MW right? Well, after all that we have read about MW, my hubby decided to embark on his some 4 weeks ago. He has eczema but it has never been as bad as Darius’. He has been able to contain the flares by applying moisturizers on the skin right after showers, twice a day. Well, there are days when the skin acted up unexpectedly and he’ll just apply some topical steroid cream and voila, the eczema disappeared. This has been his vicious cycle for 20 years or more~..