Chemistry of compulsive hair pulling
A preliminary study suggests women driven by an irresistible impulse to pull out their own hair can often resist the strange urge when given an antidepressant drug already shown to ease the symptoms of obsessive-compulsive disorder. The finding, reported in the Aug. 24 NEW ENGLAND JOURNAL OF MEDICINE, suggests excessive hair pulling--or trichotillomania--is related to the uncontrollable thoughts and repeated rituals that characterize obsessive-compulsive disorder.
Trichotillomania's prevalence is unclear. Sufferers recognize the bizarre nature of their impulses but still pull out hair from their scalps, arms, eyebrows and eyelashes. No standard treatment exists for the disorder, which mainly afflicts females.
Psychiatrist Susan E. Swedo of the National Institute of Mental Health and her colleagues compared two antidepressants, clomipramine and desipramine, in 13 women with severe trichotillomania. Subjects first took a placebo pill for two weeks. Next, each received one of the antidepressants for five weeks, then switched to the other for five weeks.
Evaluations by patients and their physicians, none of whom knew which drug was being taken, indicated only clomipramine was effective. Three clomipramine patients stopped pulling their hair, and nine had a reduction of at least 50 percent in the severity of their symptoms.
Clomipramine may work by increasing the availability of serotonin, a chemical messenger in the brain (SN: 5/21/88, p.324). The researchers also recommend behavior therapy for patients who partially respond to the drug.
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