Pharmacotherapy of trichotillomania (hair pulling disorder): an updated systematic review.

INTRODUCTION: Individuals affected by trichotillomania (TTM) (hair-pulling disorder) consciously or non-consciously pull out their own body hair. The disorder has recently been incorporated into a chapter entitled, 'Obsessive-Compulsive and Related Disorders' in the diagnostic and statistical manual of mental disorders, fifth edition. AREAS COVERED: The review describes the literature currently available on the pharmacotherapy for TTM, including both randomized controlled trials and open-label trials of pharmacotherapy for TTM in adults or children. EXPERT OPINION: Early work focused on the serotonin reuptake inhibitors; however, the majority of the trials have been negative. There is a small body of evidence focused on pharmacotherapy for TTM. In future, larger trials are required to expand on the preliminary evidence available for N-acetylcysteine, olanzapine and dronabinol in recent trials.