Medications are not available for the direct treatment of trichotillomania. However, medications that alleviate conditions or symptoms associated with the condition may help reduce hair pulling.
Memantine, a medication commonly prescribed for Alzheimer’s disease, significantly reduced symptoms in adults with both trichotillomania and skin-picking disorder, according to new research. This type of medication modulates the glutamate neurotransmitter.
Trichotillomania is a compulsive behavior that involves pulling out your own hair. It can have a negative impact on your life, and may cause noticeable bald spots that affect your self-image. People who have trichotillomania often feel shame about their disorder and might attempt to hide their condition by wearing hats or wigs. In some cases, trichotillomania can lead to depression or anxiety. A psychiatric doctor can prescribe medications that can help you control the urges and symptoms of this condition.
Behavioral therapy is generally regarded as the first-line treatment, but it can be difficult to find therapists trained in trichotillomania treatment. In a recent survey, 55% of people with trichotillomania reported that their clinicians were not well-versed in the disorder. Medications that have been shown to be effective include antidepressants, such as clomipramine (Anafranil), and atypical antipsychotics, such as olanzapine (Zyprexa).
The medication memantine targets an area of the brain involved in motor habits. Research has also shown that people with trichotillomania and skin-picking disorder have disorganized areas of white matter in the regions of the brain controlling these behaviors. The study Grant is conducting uses diffusion tensor imaging to track changes in the brain as participants take memantine or a placebo for eight weeks. He has found that 26 out of the 43 participants who took memantine experienced a great deal or very much of an improvement in their pulling and picking. In comparison, three of the 36 people taking a placebo showed such improvements.
There are other trichotillomania medications that target the skin, such as astringents and topical anesthetics. These are used to reduce the itching that can trigger a compulsion to pull the hair. Antihistamines and lubricants are also sometimes prescribed to prevent the skin from becoming dry, scaly or flaky, which could trigger an urge to pull.
Another potential option is a newer class of drugs known as NMDA antagonists, which work by inhibiting the action of the neurotransmitter glutamate. A recent study found that the drug aripiprazole (ah-rip-IPRAH-zol) was successful in helping to reduce trichotillomania urges. It is currently being studied in a larger open-label study.
As Needed Medications
Trichotillomania is a mental health disorder that causes recurrent, irresistible urges to pull out your own hair, often resulting in patchy bald spots. It affects both men and women of all ages. It can cause emotional distress and interfere with work or social functioning. It is sometimes accompanied by other mental health conditions, such as depression and anxiety. It tends to be long-term, lasting for weeks, months or even years. Trichotillomania symptoms may be lessened by treating the underlying anxiety or depression.
While no medication has been approved by the Food and Drug Administration (FDA) for the treatment of trichotillomania, some medications have shown promise in helping control symptoms. These include tricyclic antidepressants, such as clomipramine (Anafranil), and selective serotonin reuptake inhibitors (SSRIs), including Prozac. Some atypical antipsychotics, such as olanzapine (Zyprexa) and clonazepam (Klonopin), are also used to help control impulsivity and reduce other feelings of anxiety and depression.
In addition to these medications, a number of herbal remedies or supplements have been reported to reduce the severity of trichotillomania symptoms. These herbal treatments or supplements are not considered scientifically proven and should only be tried under the care of a trained healthcare professional. They should never be used in combination with prescribed medications, as some herbs or supplements can interact negatively with certain medications and increase their side effects.
Cognitive behavioral therapy, or CBT, has been shown to be effective in the treatment of trichotillomania. Habit reversal training, a form of CBT, is regarded as the first-line method for treating compulsive hair pulling. This treatment involves learning to recognize and then overcome triggers, such as stress or negative self-talk, that can lead to the urge to pull. It also includes in-the-moment recording of the behavior to identify any patterns.
Research has also identified that the brain chemicals glutamate and dopamine are involved in trichotillomania and other body-focused repetitive behaviors, such as skin picking. The medication memantine, which blocks the actions of these two chemicals, has shown promising results in improving the severity of trichotillomania and skin picking. A recent study found that people who took the drug showed a significant improvement in their symptoms compared to those taking placebo.
Trichotillomania patients who also suffer from depression may benefit from medications that help control the symptoms of depression. Some examples of these types of medication are SSRI antidepressants like citalopram (Celexa), selective serotonin reuptake inhibitors (SSRIs) such as sertraline (Zoloft) and fluoxetine, and trichotillomania-specific medications that have been shown to be effective, such as clomipramine (Anafranil), N-acetylcysteine (NA-acetyl-SCH-EH-tee-ne), an amino acid that influences neurotransmitters related to mood, and olanzapine (Zyprexa).
Medications can also be used to help control other symptoms that commonly occur along with trichotillomania. For example, many people who struggle with the condition also experience anxiety. In these cases, the use of antianxiety medications such as clonazepam (Klonopin) and alprazolam (Xanax) can be useful in helping to alleviate those symptoms. Other medications that have been found to be helpful in controlling other symptoms associated with trichotillomania include antipsychotics such as clozapine (Zyprexa) and olanzapine, as well as antiseizure medicines such as lamotrigine (Lamictal).
Therapy is a key component of trichotillomania treatment. Research has proven that cognitive-behavioral therapy is highly effective for those with the disorder. This therapy often involves habit reversal training, which is a form of behavior therapy that helps you learn to recognize the urge to pull your hair and to substitute other behaviors, such as clenching your fists. It also includes cognitive therapy, which helps you examine and address distorted beliefs that might be contributing to your trichotillomania.
If you decide to use medication as part of your trichotillomania treatment, be sure to discuss the risks and benefits with your doctor. Regardless of the type of medication you use, it’s important to seek treatment so that your doctor can monitor your progress and ensure that the medication is having its intended effect. In addition, be sure to keep a close eye on any other symptoms that you might have, including depression or anxiety.
Medications used to treat other mental health conditions can also help people with trichotillomania. For example, a drug used to treat bipolar disorder, lithium, may be beneficial in some people with trichotillomania. Lithium helps regulate certain chemical imbalances in the brain that can contribute to impulsive behaviors like hair pulling. It also reduces the severity of mood swings.
Other medications that have been effective in reducing trichotillomania symptoms include antidepressants, such as paroxetine (Paxil) and sertraline (Zoloft). A medication used to treat anxiety, called buspirone, has also shown promise. It is believed to work by blocking serotonin receptors in the brain.
Trichotillomania is often misdiagnosed or underreported. However, many people who live with this condition can benefit from treatment. The key is to find a mental health professional who is familiar with the disorder. People with trichotillomania should explain all of their symptoms, including other behavioral or emotional responses. They should also share all of their current medications, including vitamins and herbal supplements.
Although the causes of trichotillomania vary, most people experience a strong urge to pull their hair or eyelashes and eyebrows. It can be compulsive or automatic, and it is most common in women. It can lead to bald patches or thinning hair. It can also co-occur with other repetitive behavior disorders, such as nail biting and skin picking.
Some trichotillomania patients have found that taking oral vitamin D, or cholecalciferol, can help reduce the urge to pull. The amount of vitamin D needed varies from person to person, but a physician can recommend an appropriate dose. Research has also linked low levels of vitamin D to a predisposition to develop trichotillomania and other psychiatric illnesses.
A type of dopamine-blocking neuroleptic, naltrexone, has been tested in two controlled studies of trichotillomania and has shown some potential to improve the symptoms. It is important to note that naltrexone can cause extrapyramidal side effects, such as Parkinson-like tremors, rigidity, and bradykinesia. It can also cause nausea, insomnia, muscle aches, and liver enzyme elevations.
Other medications that have been examined for the treatment of trichotillomania are clonazepam, alprazolam, and ziprasidone. None of these medications have been approved by the Food and Drug Administration for use in treating trichotillomania.