The DOI matches its Crossref record; 17 of the 17 references it cites were found in a registry or an index.
N-Acetylcysteine, a Glutamate Modulator, in the Treatment of Trichotillomania: A Double-blind, Placebo-Controlled Study
Abstract
Context Trichotillomania is characterized by repetitive hair pulling that causes noticeable hair loss. Data on the pharmacologic treatment of trichotillomania are limited to conflicting studies of serotonergic medications. N-acetylcysteine, an amino acid, seems to restore the extracellular glutamate concentration in the nucleus accumbens and, therefore, offers promise in the reduction of compulsive behavior. Objective To determine the efficacy and tolerability of N-acetylcysteine in adults with trichotillomania. Design Twelve-week, double-blind, placebo-controlled trial. Setting Ambulatory care center. Patients Fifty individuals with trichotillomania (45 women and 5 men; mean [SD] age, 34.3 [12.1] years). Interventions N-acetylcysteine (dosing range, 1200-2400 mg/d) or placebo was administered for 12 weeks. Main outcome measures Patients were assessed using the Massachusetts General Hospital Hair Pulling Scale, the Clinical Global Impression scale, the Psychiatric Institute Trichotillomania Scale, and measures of depression, anxiety, and psychosocial functioning. Outcomes were examined using analysis of variance modeling analyses and linear regression in an intention-to-treat population. Results Patients assigned to receive N-acetylcysteine had significantly greater reductions in hair-pulling symptoms as measured using the Massachusetts General Hospital Hair Pulling Scale (P Conclusions This study, the first to our knowledge that examines the efficacy of a glutamatergic agent…
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“The glutamate modulator n‐acetyl cysteine has shown evidence of efficacy, in double‐blind placebo‐controlled studies, for OC‐related disorders trichotillomania and skin‐picking disorder”
From Obsessive-compulsive disorder: Etiology, neuropathology, and cognitive dysfunction (2023) · cites this paper as Grant et al., 2009
Citations
Cites
Hamilton, M. (1960) · Journal of Neurology, Neurosurgery & Psychiatry · doi:10.1136/jnnp.23.1.56 · Cited by 32,817
The assessment of anxiety states by rating
HAMILTON, M. (1959) · British Journal of Medical Psychology · doi:10.1111/j.2044-8341.1959.tb00467.x · Cited by 11,455
Jacobson, N. S., & Truax, P. (1991) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.59.1.12 · Cited by 7,770
Bootstrap Methods and their Application
Davison, A. C., & Hinkley, D. V. (1997) · doi:10.1017/cbo9780511802843 · Cited by 7,350
Frisch, M. B., Cornell, J., Villanueva, M., & Retzlaff, P. J. (1992) · Psychological Assessment · doi:10.1037/1040-3590.4.1.92 · Cited by 1,075
Characteristics of 60 adult chronic hair pullers
(1991) · American Journal of Psychiatry · doi:10.1176/ajp.148.3.365 · Cited by 570 · cited 1×
“and include significantly reduced quality of life, reduced work productivity, and impaired social functioning.(2,3)”
BackgroundThe Massachusetts General Hospital (MGH) Hairpulling Scale: 1. Development and Factor Analyses
Keuthen, N. J., O’Sullivan, R. L., Ricciardi, J. N., Shera, D., Savage, C. R., Borgmann, A. S., Jenike, M. A., & Baer, L. (2010) · Psychotherapy and Psychosomatics · doi:10.1159/000289003 · Cited by 444 · cited 3×
“Patients reported the severity of trichotillomania symptoms using the self-rated Massachusetts General Hospital Hair Pulling Scale (MGH-HPS).(33) Investigators assessed trichotillomania symptoms by the use of the physician-administered Psychiatric Institute Trichotillomania Scale (PITS).”
BackgroundMethodInfluentialWoods, D. W., Wetterneck, C. T., & Flessner, C. A. (2006) · Behaviour Research and Therapy · doi:10.1016/j.brat.2005.05.006 · Cited by 381 · cited 1×
“4% reduction in the MGHHPS score).(49,50,57) These findings suggest that Nacetylcysteine compares favorably with existing treatment options available to physicians.”
BackgroundWoods, D. W., Flessner, C. A., Franklin, M. E., Keuthen, N. J., Goodwin, R. D., Stein, D. J., Walther, M. R., & Trichotillomania Learning Center-Scientific Advisory Board (2006) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.v67n1207 · Cited by 317 · cited 2×
“and include significantly reduced quality of life, reduced work productivity, and impaired social functioning.(2,3)”
BackgroundResultRiluzole augmentation in treatment-resistant obsessive-compulsive disorder: An open-label trial
Coric, V., Taskiran, S., Pittenger, C., Wasylink, S., Mathalon, D. H., Valentine, G., Saksa, J., Wu, Y.-T., Gueorguieva, R., Sanacora, G., et al. (2005) · Biological Psychiatry · doi:10.1016/j.biopsych.2005.04.043 · Cited by 314
Cited by
Sorted by citations
Items 101–200 of 359
Trichotillomania across the life span.
Kratochvil, C., & Bloch, M. (2009) · Journal of the American Academy of Child and Adolescent Psychiatry · doi:10.1097/chi.0b013e3181ae09f3 · Cited by 42
Obesity-induced astrocyte dysfunction impairs heterosynaptic plasticity in the orbitofrontal cortexPreprint
Lau, B. K., Murphy‐Royal, C., Kaur, M., Qiao, M., Bains, J. S., Gordon, G. R., & Borgland, S. L. (2020) · bioRxiv (Cold Spring Harbor Laboratory) · doi:10.1101/2020.05.01.073205 · Cited by 6
“…and inhibitory plasticity There is an increasing body of work indicating that NAC has efficacy in the treatment of neuropsychiatric conditions, including substance use disorder and compulsive behaviours (Baker et al., 2003; Brown et al., 2013; Grant et al., 2009, 2016; Moussawi et al., 2009).”
BackgroundTrichotillomania and Trichophagia: Modern Diagnostic and Therapeutic Methods
Cisoń, H., Kuś, A., Popowicz, E., Szyca, M., & Reich, A. (2018) · Dermatologic Therapy · doi:10.1007/s13555-018-0256-z · Cited by 38
Self-induced dermatoses: A great imitator.
Gupta, M., & Gupta, A. (2019) · Clinical Dermatology · doi:10.1016/j.clindermatol.2019.01.006 · Cited by 37
Corticostriatal circuitry in regulating diseases characterized by intrusive thinking
Kalivas, B. C., & Kalivas, P. W. (2016) · Dialogues in Clinical Neuroscience · doi:10.31887/dcns.2016.18.1/pkalivas · Cited by 43
Johnson, J., & El‐Alfy, A. T. (2015) · Journal of Advanced Research · doi:10.1016/j.jare.2015.05.001 · Cited by 40
“in patients with OCD, a disorder that may be linked to TTM, researchers believe that using glutamate modulators, such as N-acetylcysteine (NAC), may help restore glutamate concentrations in the brain to a lower level [22].”
BackgroundMethodInfluentialN-Acetyl-Cysteine: Modulating the Cysteine Redox Proteome in Neurodegenerative Diseases
Martínez, M. (2022) · Antioxidants · doi:10.3390/antiox11020416 · Cited by 46
Bloch, M. H., Panza, K. E., Yaffa, A., de Alvarenga, P. G., Jakubovski, E., Mulqueen, J. M., Landeros‐Weisenberger, A., & Leckman, J. F. (2016) · Journal of Child and Adolescent Psychopharmacology · doi:10.1089/cap.2015.0109 · Cited by 37
“It seems that our negative results of NAC treatment to pediatric TTM (Leckman et al. 1989) and pediatric TS are both accurate and reliable.”
InfluentialTrichotillomania (hair pulling disorder)
Grant, J. (2019) · Indian Journal of Psychiatry · doi:10.4103/psychiatry.indianjpsychiatry_529_18 · Cited by 35
“The study in adults demonstrated greater efficacy than placebo, whereas the same study in children did not.[35,36] The studies raise the question of whether the disorder may”
Self-citationDouble-Blind Placebo-Controlled Study of Memantine in Trichotillomania and Skin-Picking Disorder
Grant, J. E., Chesivoir, E. K., Valle, S., Ehsan, D. A., & Chamberlain, S. R. (2023) · American Journal of Psychiatry · doi:10.1176/appi.ajp.20220737 · Cited by 50
Self-citationUnderstanding the impact of diet and nutrition on symptoms of Tourette syndrome: A scoping review
Ludlow, A., & Rogers, S. L. (2018) · Journal of Child Health Care · doi:10.1177/1367493517748373 · Cited by 35
“In addition to showing few side effects, NAC has been found to be effective in the treatment of a range of clinical disorders including OCD and adult trichotillomania (Grant et al., 2009).”
BackgroundNordstrom, E. J., Bittner, K. C., McGrath, M. J., Parks, C. R., & Burton, F. H. (2015) · Brain Research · doi:10.1016/j.brainres.2015.09.032 · Cited by 37
Mohseni, G. K., Hosseini, S. A., Majdinasab, N., & Cheraghian, B. (2023) · Neuropsychopharmacology Reports · doi:10.1002/npr2.12360 · Cited by 40
Comprehensive Behavioral Treatment of Trichotillomania
Falkenstein, M. J., Mouton‐Odum, S., Mansueto, C. S., Golomb, R. G., & Haaga, D. A. F. (2015) · Behavior Modification · doi:10.1177/0145445515616369 · Cited by 41
“Our findings were also comparable with the Grant, Odlaug, and Kim (2009) N-acetylcysteine (NAC) versus placebo study, which showed a reduction in the MGH-HPS from 17.6 at baseline to 10.4 at study endpoint.”
ResultInfluentialLong-Term Outcome in Pediatric Trichotillomania
Schumer, M. C., Panza, K. E., Mulqueen, J. M., Jakubovski, E., & Bloch, M. (2015) · Depression and Anxiety · doi:10.1002/da.22390 · Cited by 34
Acceptance-Enhanced Behavior Therapy for Trichotillomania in Adolescents
Fine, K. M., Walther, M. R., Joseph, J. M., Robinson, J. S., Ricketts, E., Bowe, W. E., & Woods, D. W. (2012) · Cognitive and Behavioral Practice · doi:10.1016/j.cbpra.2011.10.002 · Cited by 34
Open-Label Trial of Aripiprazole in the Treatment of Trichotillomania
White, M. P., & Koran, L. (2011) · Journal of Clinical Psychopharmacology · doi:10.1097/jcp.0b013e318221b1ba · Cited by 34
“003).(8) The authors speculated that the benefit of N-acetylcysteine may be due to the regulation of reward centers in the brain, such as the nucleus accumbens, a region characterized by significant dopaminergic neurotransmitter activity.”
BackgroundSchiavone, S., & Trabace, L. (2016) · Pharmacological Research · doi:10.1016/j.phrs.2016.03.019 · Cited by 36
Recent Advances in the Understanding and Treatment of Trichotillomania
Walther, M. R., Ricketts, E. J., Conelea, C. A., & Woods, D. W. (2010) · Journal of Cognitive Psychotherapy · doi:10.1891/0889-8391.24.1.46 · Cited by 34
“A number of uncontrolled case studies (Rosenbaum & Ayllon, 1981), controlled single-subject designs (e.g., Rapp et al., 1998; Tarnowski, Rosen, McGrath, & Drabman, 1987), and uncontrolled group designs (Lerner, Franklin, Meadows, Hembree, & Foa, 1998; Mouton & Stanley, 1996) provide preliminary support for the efficac…”
BackgroundInfluentialIdentifying standardized definitions of treatment response in trichotillomania: A meta-analysis
Farhat, L. C., Olfson, E., Li, F., Telang, S., & Bloch, M. H. (2019) · Progress in Neuro-Psychopharmacology and Biological Psychiatry · doi:10.1016/j.pnpbp.2018.10.009 · Cited by 32
“Data from 7 additional potentially eligible trials was unavailable due to IRB limitations (Gadde et al. 2007; Grant et al. 2009; Grant et al. 2014; Leppink et al. 2017), lack of access to data (Diefenbach et al.”
BackgroundSantos, P. C. D., Herrmann, A. P., Elisabetsky, E., & Piato, Â. (2018) · Brazilian Journal of Psychiatry · doi:10.1590/1516-4446-2018-0005 · Cited by 33
Lower Posterior Cingulate Cortex Glutathione Levels in Obsessive-Compulsive Disorder
Brennan, B. P., Jensen, J. E., Perriello, C., Pope, H. G., Jenike, M. A., Hudson, J. I., Rauch, S. L., & Kaufman, M. J. (2015) · Biological Psychiatry Cognitive Neuroscience and Neuroimaging · doi:10.1016/j.bpsc.2015.12.003 · Cited by 34
“While others have theorized that the beneficial effects of NAC in OCRD result from its ability to modulate glutamatergic neurotransmission (68), we propose that NAC’s capacity to increase GSH synthesis may also play a significant role.”
BackgroundProgress in Developing Pharmacologic Agents to Treat Bulimia Nervosa
McElroy, S. L., Guerdjikova, A. I., Mori, N. N., & Romo‐Nava, F. (2018) · CNS Drugs · doi:10.1007/s40263-018-0594-5 · Cited by 45
Morley, K. C., Baillie, A., van den Brink, W., Chitty, K. M., Brady, K. T., Back, S. E., Seth, D., Sutherland, G. T., Leggio, L., & Haber, P. (2018) · Expert Opinion on Investigational Drugs · doi:10.1080/13543784.2018.1501471 · Cited by 29
Nutrients for Prevention and Treatment of Mental Health Disorders
Akhondzadeh, S., Gerbarg, P. L., & Brown, R. P. (2013) · Psychiatric Clinics of North America · doi:10.1016/j.psc.2012.12.003 · Cited by 29
Emerging Treatment Strategies in Tourette Syndrome
Termine, C., Selvini, C., Rossi, G., & Balottin, U. (2013) · International review of neurobiology · doi:10.1016/b978-0-12-411546-0.00015-9 · Cited by 36
Developing Medications Targeting Glutamatergic Dysfunction in Autism: Progress to Date
Fung, L. K., & Hardan, A. Y. (2015) · CNS Drugs · doi:10.1007/s40263-015-0252-0 · Cited by 28
Asevedo, E., Cunha, G., Zugman, A., Mansur, R., & Brietzke, E. (2012) · Reviews in the Neurosciences · doi:10.1515/revneuro-2012-0039 · Cited by 30
N-Acetylcysteine amide protects against methamphetamine-induced tissue damage in CD-1 mice
Zhang, X., Tobwala, S., & Ercal, N. (2012) · Human and Experimental Toxicology · doi:10.1177/0960327112438287 · Cited by 30
Interoception and Obsessive-Compulsive Disorder: A Review of Current Evidence and Future Directions
Bragdon, L. B., Eng, G. K., Belanger, A., Collins, K. A., & Stern, E. R. (2021) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2021.686482 · Cited by 38
Snorrason, Í., Beard, C., Peckham, A., & Björgvinsson, Þ. (2020) · Psychological Medicine · doi:10.1017/s0033291720000380 · Cited by 30
“…randomized-controlled trials have shown that glutamatergic medications (e.g. N-acetylcysteine), which are known for reducing cravings across psychiatric and addictive disorders (Duailibi et al., 2017), significantly reduce symptoms of SPD (Grant et al., 2016) and HPD (Grant et al., 2009).”
BackgroundSmith, L., Tracy, D. K., & Giaroli, G. (2015) · Journal of Clinical Psychopharmacology · doi:10.1097/jcp.0000000000000431 · Cited by 26
N -Acetylcysteine as Treatment for Self-Injurious Behavior in a Child with Autism
Marler, S., Sanders, K. B., & Veenstra-VanderWeele, J. M. (2014) · Journal of Child and Adolescent Psychopharmacology · doi:10.1089/cap.2013.0137 · Cited by 22
“In addition to these uses, NAC is also considered an emergent treatment for trichotillomania (repetitive hair pulling), with one positive RCT of a dissolving preparation (PharmaNAC) in adults (Grant et al. 2009) and one negative trial of a different NAC preparation in children (Bloch et al. 2013).”
Psychocutaneous disease: Pharmacotherapy and psychotherapy.
Kuhn, H., Mennella, C., Magid, M., Stamu‐O'Brien, C., & Kroumpouzos, G. (2017) · Journal of American Academy of Dermatology · doi:10.1016/j.jaad.2016.11.021 · Cited by 27
Defining treatment response in trichotillomania: a signal detection analysis
Houghton, D. C., Capriotti, M. R., Nadai, A. S. D., Compton, S. N., Twohig, M. P., Neal-Barnett, A. M., Saunders, S. M., Franklin, M. E., & Woods, D. W. (2015) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2015.09.008 · Cited by 50
“Such studies typically utilize psychometrically-validated measures of pulling severity (Grant et al., 2009, Keuthen et al., 2012 and Woods et al., 2006), the most common of which are the Massachusetts General Hospital Hairpulling Scale (MGH-HPS; Keuthen et al., 1995) and the National Institutes of…”
Strawn, J. R., & Saldaña, S. N. (2012) · Journal of Child and Adolescent Psychopharmacology · doi:10.1089/cap.2012.0066 · Cited by 26
“…as has been the case in children with autism (Hardan et al. 2012), in adolescents with cannabis dependence (Gray et al. 2012), in adults with trichotillomania (Grant et al. 2009), and when used adjunc-tively with SSRIs, in adults with SSRI-resistant anxiety disorders (Lafleur et al. 2006).”
N‐Acetylcysteine in psychodermatological disorders
Nwankwo, C., & Jafferany, M. (2019) · Dermatologic Therapy · doi:10.1111/dth.13073 · Cited by 26
Slikboer, R., Nedeljkovic, M., Bowe, S. J., & Moulding, R. (2015) · Clinical Psychologist · doi:10.1111/cp.12074 · Cited by 30
“…Society 7 Slikboer et al. 26 © 2015 The Australian Psychological Society NAcetylcysteine (n = 1) Olanzapine (n = 1) Clomipramine (n = 2) Fluoxetine (n = 3) -1 0 1 2 3 4 5 Summary effect size study each comparing the medication to a placebo condition (Grant et al., 2009; Van Ameringen et al., 2010).”
BackgroundInfluentialN‐acetylcysteine in trichotillomania: a panacea for compulsive skin disorders?
Taylor, M., & Bhagwandas, K. (2014) · British Journal of Dermatology · doi:10.1111/bjd.13080 · Cited by 26
Bellia, F., Vismara, M. E. M., Annunzi, E., Cifani, C., Benatti, B., Dell’Osso, B. M., & D’Addario, C. (2020) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2020.10.040 · Cited by 33
Current and up-and-coming pharmacotherapy for obsessive-compulsive disorder in adults
Grassi, G., & Pallanti, S. (2018) · Expert Opinion on Pharmacotherapy · doi:10.1080/14656566.2018.1528230 · Cited by 27
Harrison, J. P., & Franklin, M. E. (2012) · Current Psychiatry Reports · doi:10.1007/s11920-012-0269-8 · Cited by 25
N‐Acetylcysteine in the treatment of trichotillomania: remarkable results in two patients
Özcan, D., & Seçkin, D. (2016) · Journal of the European Academy of Dermatology and Venereology · doi:10.1111/jdv.13690 · Cited by 24
The psychiatric aspects of skin disorders
Osman, O. T., Mufaddel, A. A., Mugaddam, F. A., & Augusterfer, E. F. (2011) · Expert Review of Dermatology · doi:10.1586/edm.11.10 · Cited by 27
Back to the Future: Circuit-testing TS & OCD
Burton, F. H. (2017) · Journal of Neuroscience Methods · doi:10.1016/j.jneumeth.2017.07.025 · Cited by 26
Vieira, G. D. L. T., Lossie, A. C., Lay, D. C., Jr., Radcliffe, J. S., & Garner, J. P. (2017) · PLoS ONE · doi:10.1371/journal.pone.0175222 · Cited by 26
A double-blind, placebo-controlled study of inositol in trichotillomania
Leppink, E. W., Redden, S., & Grant, J. (2017) · International Clinical Psychopharmacology · doi:10.1097/yic.0000000000000156 · Cited by 23
“It is also important to consider that the placebo response based on the CGI-Improvement Scale in this study (35% last observation carried forward; 50% completer) was higher than that in previous positive pharmacological studies of trichotillomania (17–19%) (Grant et al., 2009; van Ameringen et al., 2010).”
BackgroundResultInfluentialSelf-citationPerçinel, İ., & Yazıcı, K. (2014) · Journal of Clinical Psychopharmacology · doi:10.1097/jcp.0000000000000210 · Cited by 23
“A double-blinded, randomized, and placebo-controlled study conducted on adult patients with TTM revealed that NAC was significantly superior to placebo.(13) In addition, adult case reports in the literature show that NAC is an effective treatment for TTM, NB, and SPD.”
BackgroundUpdate on pharmacotherapy in psychodermatological disorders
Munoli, R. N., Shenoi, S. D., Soman, S., & Prabhu, S. S. (2020) · Indian Dermatology Online Journal · doi:10.4103/idoj.idoj_330_19 · Cited by 25
Trichoteiromania: Good Response to Treatment with N-Acetylcysteine
Salas-Callo, C. I., & Pirmez, R. (2019) · Skin Appendage Disorders · doi:10.1159/000497167 · Cited by 22
Lin, S. (2013) · British Journal of Clinical Pharmacology · doi:10.1111/bcp.12163 · Cited by 22
N-acetylcysteine augmentation in treatment resistant obsessive compulsive disorder: A case series
Ameringen, M. V., Patterson, B. A., Simpson, W. S., & Turna, J. (2012) · Journal of Obsessive-Compulsive and Related Disorders · doi:10.1016/j.jocrd.2012.10.003 · Cited by 24
Diuzheva, A., Balogh, J., Studenyak, Y., Cziáky, Z., & Jekő, J. (2019) · Talanta: The International Journal of Pure and Applied Analytical Chemistry · doi:10.1016/j.talanta.2018.10.026 · Cited by 21
Krooks, J., Weatherall, A. G., & Holland, P. J. (2017) · Journal of Dermatological Treatment · doi:10.1080/09546634.2017.1395389 · Cited by 27
“Disorders in this category that most commonly present to dermatologists include olfactory reference syndrome (ORS); BDD; and BFRBD ’ s, particularly excoriation disorder (ExD), and trichotillomania (TTM).”
BackgroundInfluentialGlutamatergic Medications for Obsessive-Compulsive and Related Disorders
Coelho, D. R. A., Yang, C., Suriaga, A. A., Manasa, J., Bain, P. A., Vieira, W., Papatheodorou, S., & Salvi, J. D. (2025) · JAMA Network Open · doi:10.1001/jamanetworkopen.2024.52963 · Cited by 20
Mechler, K., Häge, A., Schweinfurth, N., Glennon, J. C., Dijkhuizen, R. M., Murphy, D., Durston, S., Williams, S., Buitelaar, J. K., Banaschewski, T., et al. (2017) · Zeitschrift für Kinder- und Jugendpsychiatrie und Psychotherapie · doi:10.1024/1422-4917/a000546 · Cited by 22
“84 (Lafl eur et al., 2006; Grant, Odlaug, & Kim, 2009; Dean et al., 2011; Pittenger et al., 2011; Berk et al., 2013).”
N-acetylcysteine (NAC) decreases binge eating in a rodent model
Hurley, M. M., Resch, J., Maunze, B., Frenkel, M., Baker, D., & Choi, S. (2016) · International Journal of Obesity · doi:10.1038/ijo.2016.31 · Cited by 20
“9, 10, 22 Pursuing effective treatments for compulsive eating disorders will require further understanding of the neural mechanisms that underlie hedonic drive.”
BackgroundPharmacologic treatment of obsessive-compulsive disorder comorbidity
Pallanti, S., & Grassi, G. (2014) · Expert Opinion on Pharmacotherapy · doi:10.1517/14656566.2014.964208 · Cited by 23
Hair‐pulling disorder (Trichotillomania): Etiopathogenesis, diagnosis and treatment in a nutshell
Torales, J. C., Ruíz-Díaz, N., Ventriglio, A., Castaldelli-Maia, J. M., Barrios, I., García, Ó., Navarro, R. E., González, I., O’Higgins, M. G., & Jafferany, M. (2020) · Dermatologic Therapy · doi:10.1111/dth.14366 · Cited by 33
“Table 3 summarizes possible psychopharmacological treatments of trichotillomania.(3,4,51-61) Finally, some researchers have emphasized the neurobiological and phenomenological overlap between trichotillomania and some addictive behaviors.”
BackgroundTreatment of obsessive-compulsive disorders (OCD) and obsessive-compulsive-related disorders (OCRD)
Krzyszkowiak, W., Kuleta-Krzyszkowiak, M., & Krzanowska, E. (2019) · Psychiatria Polska · doi:10.12740/pp/105130 · Cited by 28
“There have been attempts to use NAC in treating trichotillomania, body dysmorphic disorder and nail-biting disorder [10, 31, 49].”
MethodAntioxidant Therapies for Ulcerative Dermatitis: A Potential Model for Skin Picking Disorder
George, N. M., Whitaker, J. W., Vieira, G., Geronimo, J. T., Bellinger, D., Fletcher, C. A., & Garner, J. (2015) · PLoS ONE · doi:10.1371/journal.pone.0132092 · Cited by 19
“Although the mode of action is unclear, trichotillomania [10] and Skin Picking Disorder [11] both respond to N-Acetylcysteine (NAC).”
BackgroundInfluentialYazıcı, K., & Perçinel, İ. (2015) · Journal of Clinical Psychopharmacology · doi:10.1097/jcp.0000000000000362 · Cited by 19
Silymarin Treatment of Obsessive-Compulsive Spectrum Disorders
Grant, J., & Odlaug, B. (2015) · Journal of Clinical Psychopharmacology · doi:10.1097/jcp.0000000000000327 · Cited by 19
Self-citationA review of N‐acetylcysteine in the treatment of grooming disorders
Braun, T. L., Patel, V., DeBord, L., & Rosen, T. (2019) · International Journal of Dermatology · doi:10.1111/ijd.14371 · Cited by 18
Repetitive Behaviors Treated With N-Acetylcysteine: Case Series.
Kılıç, F., & Keleş, S. (2019) · Clinical neuropharmacology · doi:10.1097/wnf.0000000000000352 · Cited by 17
“Copyright © 2019 Wolters Kluwer the NAC group compared with the placebo group.(8,12) In an open-label prospective study, 35 patients with Prader-Willi syndrome were treated with NAC for their skin-picking habits, and significant improvements were seen after 12 weeks.”
BackgroundTreating Nonsuicidal Self-Injury
Guerdjikova, A. I., Gwizdowski, I. S., McElroy, S. L., McCullumsmith, C. B., & Suppes, P. (2014) · Current Treatment Options in Psychiatry · doi:10.1007/s40501-014-0028-z · Cited by 18
Schiavi, S., Rosa, P. L., Petrillo, S., Carbone, E., D’Amico, J., Piemonte, F., & Trezza, V. (2022) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2022.851679 · Cited by 19
Psychocutaneous disease: Clinical perspectives.
Kuhn, H., Mennella, C., Magid, M., Stamu‐O'Brien, C., & Kroumpouzos, G. (2017) · Journal of American Academy of Dermatology · doi:10.1016/j.jaad.2016.11.013 · Cited by 16
Pharmacotherapy of trichotillomania (hair pulling disorder): an updated systematic review
Rothbart, R., & Stein, D. J. (2014) · Expert Opinion on Pharmacotherapy · doi:10.1517/14656566.2014.972936 · Cited by 16
Recurrent trichobezoar due to trichophagia: a case report.
Kırpınar, I., Kocacenk, T., Koçer, E., & Memmi, N. (2013) · General Hospital Psychiatry · doi:10.1016/j.genhosppsych.2013.01.013 · Cited by 16
“N-acetylcysteine has emerged as a useful agent in a large double-blind study and significantly reduced the TTM compared to the placebo [28].”
BackgroundGrant, J., Valle, S., Chesivoir, E. K., & Ehsan, D. (2021) · International Clinical Psychopharmacology · doi:10.1097/yic.0000000000000382 · Cited by 15
“The glutamate system has been theorized to play some role in BFRBs (Bienvenu et al., 2009; Grant et al., 2009) and therefore perhaps medications that target the cannabinoid system might also influence the glutamate system and improve the symptoms of BFRBs.”
BackgroundSelf-citationTurk, T., Liu, C., Fujiwara, E., Straube, S., Hagtvedt, R., Dennett, L., Abba‐Aji, A., & Dytoc, M. T. (2023) · Journal of Cutaneous Medicine and Surgery · doi:10.1177/12034754231155888 · Cited by 13
Brierley, M.-E. E., Thompson, E. M., Albertella, L., & Fontenelle, L. F. (2021) · Psychosomatic Medicine · doi:10.1097/psy.0000000000000988 · Cited by 14
“These studies showed negligible changes in participants’ symptom severity of OCD (48,50) and TTM (49,52).”
BackgroundResultInfluentialRecent advances in the treatment of trichotillomania (hair‐pulling disorder)
Everett, G. J., Jafferany, M., & Skurya, J. (2020) · Dermatologic Therapy · doi:10.1111/dth.13818 · Cited by 36
“In a 2009 double-blind placebo-controlled trial studying NAC use in 50 adults with TTM, NAC 1200 mg twice daily was found to show significant benefit over placebo.(45) A 2013 study failed to reproduce this benefit in 39 pediatric patients aged 8 to 17 years with TTM using the same dose of NAC 1200 mg twice daily.”
MethodSnorrason, Í., Ricketts, E. J., Ólafsson, R. P., Rozenman, M. S., Colwell, C. S., & Piacentini, J. C. (2018) · Journal of Psychopathology and Behavioral Assessment · doi:10.1007/s10862-018-9712-4 · Cited by 19
“2010) and glutamatergic (N-acetylcysteine; Grant et al. 2009) medications”
BackgroundUse of N-Acetylcysteine in Psychiatric Conditions among Children and Adolescents: A Scoping Review
Naveed, S., Amray, A., Waqas, A., Chaudhary, A. M., & Azeem, M. (2017) · Cureus · doi:10.7759/cureus.1888 · Cited by 14
Inducible nitric oxide synthase (NOS2) knockout mice as a model of trichotillomania
Casarotto, P., Biojone, C., Montezuma, K., Cunha, F. Q., Joca, S., Castrén, E., & Guimarães, F. S. (2016) · bioRxiv · doi:10.1101/086173 · Cited by 14
“Recent studies also indicate that the glutamatergic neurotransmission modulator n-acetylcysteine, is effective in alleviating the symptoms of TTM (Grant et al., 2009).”
BackgroundMethodPsychometric Properties of Trichotillomania Severity Measures
Barber, K. E., Woods, D. W., Bauer, C. C., Twohig, M. P., Saunders, S. M., Compton, S. N., & Franklin, M. E. (2023) · Cognitive Therapy and Research · doi:10.1007/s10608-023-10406-4 · Cited by 14
“The CGI-S has good psychometric properties (Berk et al., 2008; Leon et al., 1993) and is often used as an outcome measure in TTM treatment studies (Diefenbach et al., 2006; Grant et al., 2009; Woods et al., 2022).”
Moreno-Amador, B., Piqueras, J. A., Rodríguez‐Jiménez, T., Martínez‐González, A. E., & Cervin, M. (2023) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2023.958015 · Cited by 15
Park, J. M., Rahman, O., Murphy, T., & Storch, E. (2012) · Infant Mental Health Journal · doi:10.1002/imhj.21317 · Cited by 13
“Most recently, Grant, Odlaug, and Kim (2009), in a 12-week, double-blinded, placebo controlled trial with 50 adults, found that N-acetylcysteine, an amino acid based supplement available over the counter, was effective in reducing TTM symptoms.”
Gawłowska-Sawosz, M., Wolski, M., Kamiński, A., Albrecht, P., & Wolańczyk, T. (2016) · Psychiatria Polska · doi:10.12740/pp/59513 · Cited by 13
“Obiecujących wyników dostarczają wstępne wyniki badań z zastosowaniem modulatora układu glutaminergicznego – N-acetylocysteiny.”
InfluentialPersico, A. M., Asta, L., Chehbani, F., Mirabelli, S., Parlatini, V., Cortese, S., Arango, C., & Vitiello, B. (2024) · Progress in Neuro-Psychopharmacology and Biological Psychiatry · doi:10.1016/j.pnpbp.2024.111176 · Cited by 11
The Role of Compulsivity in Body-Focused Repetitive Behaviors
Grant, J., & Chamberlain, S. (2022) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2022.05.001 · Cited by 12
Self-citationTrichotillomania and Traction Alopecia
Uzunçakmak, T., Kayıran, M., Tekin, B., & Cebeci, F. (2017) · InTech eBooks · doi:10.5772/66746 · Cited by 12
“The glutamatergic system dysregulation is involved in obsessive‐ compulsive disorders etiology and it has been reported that N‐acetyl‐cysteine (NAC) might have a therapeutic effect on these entities by acting on the glutamatergic system and reducing oxidative stress [23].”
BackgroundN-Acetylcysteine as a Treatment for Addiction
Ma, J. E., Lacoste, J., & Belin, D. (2012) · InTech eBooks · doi:10.5772/50210 · Cited by 5
“In a double-blind placebo-controlled study (Grant et al., 2009), 50 patients with trichotillomania (compulsive hair-pulling), with a mean age of 34.”
BackgroundMethodInfluentialState of the Evidence for Use of Psychotropic Medications in School-Age Youth
Shahidullah, J. D., Roberts, H. J., Parkhurst, J. T., Ballard, R., Mautone, J. A., & Carlson, J. S. (2023) · Children · doi:10.3390/children10091454 · Cited by 11
“A randomized controlled trial of NAC in 50 adults resulted in decreased hair pulling compared with placebo; a similar study in 39 adolescents showed no difference between NAC and placebo [99,100].”
ResultKishi, T., Sakuma, K., & Iwata, N. (2022) · Translational Psychiatry · doi:10.1038/s41398-022-02026-5 · Cited by 11
“Twelve studies included individuals with OCD [39–41, 43–47, 50, 51, 53, 55], four others included individuals with trichotillomania [42, 48, 52, 54], and the remaining study included individuals with excoriation disorder [49].”
BackgroundThe Influence of Hair Pulling Styles in the Treatment of Trichotillomania.
McGuire, J., Myers, N., Lewin, A., Storch, E., & Rahman, O. (2020) · The Behavior Therapist · doi:10.1016/j.beth.2019.12.003 · Cited by 11
Neurochemical correlates of behavioral treatment of pediatric trichotillomania
Peris, T. S., Piacentini, J. C., Vreeland, A., Salgari, G. C., Levitt, J. G., Alger, J., Posse, S., McCracken, J. T., & O’Neill, J. (2020) · Journal of Affective Disorders · doi:10.1016/j.jad.2020.04.061 · Cited by 13
A Pilot Examination of Oxidative Stress in Trichotillomania
Grant, J. E., & Chamberlain, S. R. (2018) · Psychiatry Investigation · doi:10.30773/pi.2018.09.07.1 · Cited by 11
Self-citationResch, J., Albano, R., Liu, X., Hjelmhaug, J., Lobner, D., Baker, D. A., & Choi, S. (2014) · Synapse · doi:10.1002/syn.21772 · Cited by 11
“homeostasis, system xc is positioned to heavily influence a variety of pathologies ranging from compulsive disorders to neurodegenerative disease (Berman et al., 2011; de Groot and Sontheimer, 2011; Grant et al., 2007; Grant et al., 2009; Knackstedt et al., 2009; Park et al., 2004; Sontheimer, 2011; Zhou and Kalivas,…”
BackgroundGadallah, A.-H., Ebada, M. A., Gadallah, A., Ahmed, H., Rashad, W., Eid, K. A., Bahbah, E. I., & Alkanj, S. (2020) · Journal of Obsessive-Compulsive and Related Disorders · doi:10.1016/j.jocrd.2020.100529 · Cited by 15
Grant, J., Redden, S., & Chamberlain, S. (2019) · Journal of Clinical Psychopharmacology · doi:10.1097/jcp.0000000000001005 · Cited by 10
Self-citationPlacebo Response in Trichotillomania
Grant, J., Chamberlain, S., Redden, S., Odlaug, B., van Ameringen, M. V., Dougherty, D., Keuthen, N., & Kim, S.-W. (2017) · International Clinical Psychopharmacology · doi:10.1097/yic.0000000000000185 · Cited by 10
“Detailed methodologies of the various clinical trials have been published previously (Dougherty et al., 2006; Grant et al., 2009, 2014; Van Ameringen et al., 2010; Leppink et al., 2017).”
BackgroundMethodSelf-citationSarris, J., Oliver, G., Camfield, D., & Dean, O. (2016) · Clinical Psychological Science · doi:10.1177/2167702616639864 · Cited by 10
Bupropion XL for the sustained treatment of trichotillomania.
Klipstein, K., & Berman, L. (2012) · Journal of Clinical Psychopharmacology · doi:10.1097/jcp.0b013e31824858f7 · Cited by 10
Advances in Topical Therapies for Clinically Relevant and Prevalent Forms of Alopecia
Parikh, A. K., Tan, I. J., Wolfe, S. M., & Cohen, B. A. (2024) · Life · doi:10.3390/life14121577 · Cited by 9
“…with a double-blind placebo-controlled trial using 1200–2400 mg/day NAC showing significant reductions in hair pulling based on the Massachusetts General Hospital Hair Pulling Scale ( p 0.001) and the Psychiatric Institute Trichotillomania Scale ( p = 0.001) compared to placebo at 12 weeks [5].”
InfluentialNovel inflammatory targets for immunotherapies in pediatric patients with trichotillomania
Kütük, M. Ö., Tufan, A. E., Kılıçaslan, F., Mutluer, T., Gökçen, C., Karadağ, M., Yektaş, Ç., Kandemır, H., Büber, A., Aksu, G. G., et al. (2020) · Immunobiology · doi:10.1016/j.imbio.2020.151913 · Cited by 11
Insights into recurrent body-focused repetitive behaviors: evidenced by New York Times commenters
Stewart, C. R., & Lipner, S. (2020) · Archives of Dermatological Research · doi:10.1007/s00403-020-02045-6 · Cited by 9
“found no significant benefit in a pediatric population [26, 27].”
BackgroundRicketts, E. J., Rozenman, M. S., Snorrason, Í., Perez, J. B., Peng, M. G., Kim, J., & Piacentini, J. C. (2019) · Psychiatry Research · doi:10.1016/j.psychres.2019.01.022 · Cited by 8
“Trichotillomania (Grant et al., 2009) and Excoriation Disorder (Grant et al.”
Background
Metadata
- Authors
- Grant, J. E., Odlaug, B. L., & Won Kim, S.
- Affiliations
- University of Minnesota (US)
- Venue
- Archives of General Psychiatry
- Publisher
- American Medical Association (AMA)
- Published
- 2009-07-01
- Volume
- 66
- Issue
- 7
- Pages
- 756
- ISSN
- 0003-990X (ISSN-L)
- OpenAlex
- W2038083244
- Cited by
- 424
- References
- 0
- Citations by year
- 2026: 13 · 2025: 12 · 2024: 17 · 2023: 35 · 2022: 15 · 2021: 22 · 2020: 23 · 2019: 22 · 2018: 31 · 2017: 23 · 2016: 31 · 2015: 41 · 2014: 28 · 2013: 27 · 2012: 29
- FWCI
- 29.66
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Archives of General Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Obsessive-Compulsive Spectrum Disorders
- Health Sciences › Medicine › Dermatology › Hair Growth and Disorders
- Social Sciences › Psychology › Clinical Psychology › Body Image and Dysmorphia Studies
- Keywords
- trichotillomania, N-acetylcysteine, glutamate modulation, glutamatergic agents, compulsive behavior, hair pulling, nucleus accumbens, pharmacotherapy, treatment efficacy, tolerability, depression, anxiety, psychosocial functioning
- MeSH terms
- Acetylcysteine, Adolescent, Adult, Double-Blind Method, Female, Follow-Up Studies, Humans, Male, Middle Aged, Personality Inventory, Psychometrics, Trichotillomania, Excitatory Amino Acid Agents, Young Adult
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