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
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“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×
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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
Systematic Review: Pharmacological and Behavioral Treatment for Trichotillomania
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The Massachusetts General Hospital (MGH) hairpulling scale: 2. Reliability and validity
O’Sullivan, R. L., Keuthen, N. J., Hayday, C. F., Ricciardi, J. N., Buttolph, L., Jenike, M. A., & Baer, L. (2010) · Psychotherapy and Psychosomatics · doi:10.1159/000289004 · Cited by 191 · cited 1×
“The MGH-HPS has demonstrated excellent test-retest reliability, convergent and divergentvalidity,andsensitivitytochange.(39) AnalysisoftheMGHHPShasdemonstrated2separate factors,withacceptable reliabilityforboth:“severity”and“resistanceandcontrol.”
BackgroundAn open-label trial of N-acetylcysteine for the treatment of cocaine dependence: A pilot study
Mardikian, P. N., LaRowe, S. D., Hedden, S., Kalivas, P. W., & Malcolm, R. J. (2007) · Progress in Neuro-Psychopharmacology and Biological Psychiatry · doi:10.1016/j.pnpbp.2006.10.001 · Cited by 179
Trichotillomania: neurobiology and treatment
Chamberlain, S. R., Odlaug, B. L., Boulougouris, V., Fineberg, N. A., & Grant, J. E. (2009) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2009.02.002 · Cited by 126 · cited 2×
“Although trichotillomania has been described for almost 2 centuries,(8) it remains a poorly understood disorder with limited data regarding pathogenesis and treatment.(9) Currently, there is no Food and Drug Administration–approved treatment for trichotillomania, despite almost 2 decades of research.”
BackgroundSelf-citationBehavioural treatment of trichotillomania: two-year follow-up results
Keijsers, G. P. J., van Minnen, A., Hoogduin, C. A. L., Klaassen, B. N. W., Hendriks, M. J., & Tanis-Jacobs, J. (2006) · Behaviour Research and Therapy · doi:10.1016/j.brat.2005.03.004 · Cited by 76
Group treatment for trichotillomania: behavior therapy versus supportive therapy
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“4% reduction in the MGHHPS score).(49,50,57) These findings suggest that Nacetylcysteine compares favorably with existing treatment options available to physicians.”
Background
Cited by
Sorted by citations
The chemistry and biological activities of N-acetylcysteine
Samuni, Y., Goldstein, S., Dean, O. M., & Berk, M. (2013) · Biochimica et Biophysica Acta (BBA) - General Subjects · doi:10.1016/j.bbagen.2013.04.016 · Cited by 876
Gawryluk, J. W., Wang, J.-F., Andreazza, A. C., Shao, L., & Young, L. T. (2011) · The International Journal of Neuropsychopharmacology · doi:10.1017/s1461145710000805 · Cited by 594
“In fact, both GSH (Agarwal & Shukla, 1999) and glutamate levels (Grant et al. 2009) can be elevated with pharmacological treatment by N-acetylcysteine (NAC).”
N-acetylcysteine in psychiatry: current therapeutic evidence and potential mechanisms of action
Dean, O., Giorlando, F., & Berk, M. (2011) · Journal of Psychiatry and Neuroscience · doi:10.1503/jpn.100057 · Cited by 494
“Grant et al.(40) TTM 50 1200–2400 12-wk double-blind, placebo-controlled trial MGH-HPS, CGI, PITS, Sheehan”
MethodInfluentialFineberg, N. A., Chamberlain, S. R., Goudriaan, A. E., Stein, D. J., Vanderschuren, L. J. M. J., Gillan, C. M., Shekar, S., Gorwood, P. A. P. M., Voon, V., Morein-Zamir, S., et al. (2014) · CNS Spectrums · doi:10.1017/s1092852913000801 · Cited by 488
“However, unlike OCD, trichotillomania appears SSRI-unresponsive, and data from single randomized controlled trials suggest that monotherapy with olanzapine (an antipsychotic agent)(15) and n-acetyl cysteine (an amino acid compound) can be effective.(16) Antipsychotics represent first-line treatment for Tourette syndro…”
BackgroundClinical trials of N-acetylcysteine in psychiatry and neurology: A systematic review
Deepmala, Slattery, J., Kumar, N., Delhey, L., Berk, M., Dean, O., Spielholz, C., & Frye, R. (2015) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2015.04.015 · Cited by 463
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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