D J Stein1, E Hollander. 1. Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, NY.
Abstract
BACKGROUND: There is some overlap in the phenomenology and treatment response of trichotillomania, Gilles de la Tourette's syndrome (TS), and obsessive compulsive disorder (OCD). Neuroleptics may play a role in the treatment of TS as well as refractory OCD, and the question arises whether this also holds for trichotillomania. METHOD: Patients with trichotillomania were treated in open clinical practice with serotonin reuptake blockers. When symptom resolution was incomplete or symptom relapse occurred, low-dose pimozide was added. RESULTS: In six out of seven patients, the addition of pimozide to a serotonin reuptake blocker led to an improvement in hair pulling. In patients who were able to tolerate their medication, this response was sustained. CONCLUSION: Augmentation of serotonergic agents with dopamine blockers may play a role in the treatment of trichotillomania. Further controlled trials of pimozide augmentation in trichotillomania are needed.
BACKGROUND: There is some overlap in the phenomenology and treatment response of trichotillomania, Gilles de la Tourette's syndrome (TS), and obsessive compulsive disorder (OCD). Neuroleptics may play a role in the treatment of TS as well as refractory OCD, and the question arises whether this also holds for trichotillomania. METHOD:Patients with trichotillomania were treated in open clinical practice with serotonin reuptake blockers. When symptom resolution was incomplete or symptom relapse occurred, low-dose pimozide was added. RESULTS: In six out of seven patients, the addition of pimozide to a serotonin reuptake blocker led to an improvement in hair pulling. In patients who were able to tolerate their medication, this response was sustained. CONCLUSION: Augmentation of serotonergic agents with dopamine blockers may play a role in the treatment of trichotillomania. Further controlled trials of pimozide augmentation in trichotillomania are needed.
Authors: Katharine A Phillips; Dan J Stein; Scott L Rauch; Eric Hollander; Brian A Fallon; Arthur Barsky; Naomi Fineberg; David Mataix-Cols; Ygor Arzeno Ferrão; Sanjaya Saxena; Sabine Wilhelm; Megan M Kelly; Lee Anna Clark; Anthony Pinto; O Joseph Bienvenu; Joanne Farrow; James Leckman Journal: Depress Anxiety Date: 2010-06 Impact factor: 6.505