Pharmacotherapy for trichotillomania
Open accessAbstract
Background Trichotillomania (TTM) (hair-pulling disorder) is a prevalent and disabling disorder characterised by recurrent hair-pulling. The effect of medication on trichotillomania has not been systematically evaluated. Objectives To assess the effects of medication for trichotillomania in adults compared with placebo or other active agents. Search methods We searched the Cochrane Central Register of Controlled Trials and the Cochrane Depression, Anxiety and Neurosis Group Register (to 31 July 2013), which includes relevant randomised controlled trials from the following bibliographic databases: The Cochrane Library (all years); EMBASE (1974 to date); MEDLINE (1950 to date) and PsycINFO (1967 to date). Two review authors identified relevant trials by assessing the abstracts of all possible studies. Selection criteria We selected randomised controlled trials (RCTs) of a medication versus placebo or active agent for TTM in adults. Data collection and analysis Two review authors independently performed the data extraction and 'Risk of bias' assessments, and disagreements were resolved through discussion with a third review author. Primary outcomes included the mean difference (MD) in reduction of trichotillomania symptoms on a continuous measure of trichotillomania symptom severity, and the risk ratio (RR) of the clinical response based on a dichotomous measure, with 95% confidence intervals (CIs). Main results We identified eight studies with a total of 204 participants and a…
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Pharmacotherapies including n-acetylcysteine, clomipramine, olanzapine, and dronabinol have indicated efficacious outcomes in trichotillomania, although each has been shown to be efficacious in relatively small samples of clinical trial patients.
“Pharmacotherapies which have indicated efficacious outcomes in trichotillomania include n-acetylcysteine (NAC), clomipramine, olanzapine, and dronabinol; although, each of these treatments has been shown to be efficacious in relatively small samples of clinical trial patients.”
From Trichotillomania (hair pulling disorder) (2019) · cites this paper as [34]
Cites
Meta-analyses involving cross-over trials: methodological issues
Elbourne, D. R., Altman, D. G., Higgins, J. P., Curtin, F., Worthington, H. V., & Vail, A. (2002) · International Journal of Epidemiology · doi:10.1093/ije/31.1.140 · Cited by 2,305 · see citing works
Deeks, J. J., Altman, D. G., & Bradburn, M. J. (2001) · Systematic Reviews in Health Care · doi:10.1002/9780470693926.ch15 · Cited by 2,163 · see citing works
Statistics Notes: Detecting skewness from summary information: Table 1
Altman, D. G., & Bland, J. M. (1996) · BMJ · doi:10.1136/bmj.313.7066.1200 · Cited by 1,278 · see citing works
Marshall, M., Lockwood, A., Bradley, C., Adams, C., Joy, C., & Fenton, M. (2000) · British Journal of Psychiatry · doi:10.1192/bjp.176.3.249 · Cited by 870 · see citing works
Linear mixed models for longitudinal data
(2000) · Springer Series in Statistics · doi:10.1007/b98969 · Cited by 818 · see citing works
Als-Nielsen, B., Chen, W., Gluud, C., & Kjaergard, L. L. (2003) · JAMA · doi:10.1001/jama.290.7.921 · Cited by 746 · see citing works
Swedo, S. E., Leonard, H. L., Rapoport, J. L., Lenane, M. C., Goldberger, E. L., & Cheslow, D. L. (1989) · New England Journal of Medicine · doi:10.1056/nejm198908243210803 · Cited by 601 · see citing works
Characteristics of 60 adult chronic hair pullers
(1991) · American Journal of Psychiatry · doi:10.1176/ajp.148.3.365 · Cited by 570 · see citing works
The 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 · see citing works
Grant, J. E., Odlaug, B. L., & Won Kim, S. (2009) · Archives of General Psychiatry · doi:10.1001/archgenpsychiatry.2009.60 · Cited by 424 · see citing works
Woods, D. W., Wetterneck, C. T., & Flessner, C. A. (2006) · Behaviour Research and Therapy · doi:10.1016/j.brat.2005.05.006 · Cited by 381 · see citing works
Woods, 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 · see citing works
Self-citationA placebo-controlled trial of cognitive-behavioral therapy and clomipramine in trichotillomania
Ninan, P. T., Rothbaum, B. O., Marsteller, F. A., Knight, B. T., & Eccard, M. B. (2000) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.v61n0111 · Cited by 303 · see citing works
Systematic Review: Pharmacological and Behavioral Treatment for Trichotillomania
Bloch, M. H., Landeros-Weisenberger, A., Dombrowski, P., Kelmendi, B., Wegner, R., Nudel, J., Pittenger, C., Leckman, J. F., & Coric, V. (2007) · Biological Psychiatry · doi:10.1016/j.biopsych.2007.05.019 · Cited by 280 · see citing works
van Minnen, A., Hoogduin, K. A. L., Keijsers, G. P. J., Hellenbrand, I., & Hendriks, G.-J. (2003) · Archives of General Psychiatry · doi:10.1001/archpsyc.60.5.517 · Cited by 234 · see citing works
Treatment strategies for tics in Tourette syndrome
Eddy, C. M., Rickards, H. E., & Cavanna, A. E. (2011) · Therapeutic Advances in Neurological Disorders · doi:10.1177/1756285610390261 · Cited by 158 · see citing works
McGuire, J. F., Ung, D., Selles, R. R., Rahman, O., Lewin, A. B., Murphy, T. K., & Storch, E. A. (2014) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2014.07.015 · Cited by 142 · see citing works
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 · see citing works
Self-citation
Flagged first, then by citations
Cited by
Sorted by citations
Grant, J. E., & Chamberlain, S. R. (2016) · American Journal of Psychiatry · doi:10.1176/appi.ajp.2016.15111432 · Cited by 252 · see citing works
Self-citationTrichotillomania: 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 · see citing works
Self-citationPharmacotherapy of trichotillomania.
Sharma, V. (2017) · Journal of Psychiatry & Neuroscience · doi:10.1503/jpn.160223 · Cited by 83 · see citing works
Obsessive-Compulsive and Related Disorders
Leigh, H. (2014) · Springer eBooks · doi:10.1007/978-3-319-11005-9_24 · Cited by 32 · see citing works
Movsisyan, A., Melendez-Torres, G. J., & Montgomery, P. (2016) · Journal of Clinical Epidemiology · doi:10.1016/j.jclinepi.2016.03.014 · Cited by 50 · see citing works
“In comparison with GRADEendorsed reviews, a higher proportion of those not endorsing GRADE in both complex and simple intervention review groups reported either the narrative synthesis of the data [42,50,51,61,62] or the quantitative synthesis applied to only part of the included outcomes [8,35,43,44,47e49,68].”
ResultStriatal abnormalities in trichotillomania: a multi-site MRI analysis
Isobe, M., Redden, S. A., Keuthen, N. J., Stein, D. J., Lochner, C., Grant, J. E., & Chamberlain, S. R. (2018) · NeuroImage: Clinical · doi:10.1016/j.nicl.2017.12.031 · Cited by 37 · see citing works
“There is no widely accepted pharmacological ‘standard of care’ for this disorder (Rothbart et al., 2013), which means that evaluation of medication effects would likely be a moot point in the absence of large data using evidence-based pharmacological treatments.”
BackgroundSelf-citationTrichotillomania (hair pulling disorder)
Grant, J. (2019) · Indian Journal of Psychiatry · doi:10.4103/psychiatry.indianjpsychiatry_529_18 · Cited by 35 · see citing works
Cullen, K. R., Schreiner, M. W., Klimes-Dougan, B., Eberly, L. E., LaRiviere, L. L., Lim, K. O., Camchong, J., & Mueller, B. A. (2020) · Progress in Neuro-Psychopharmacology and Biological Psychiatry · doi:10.1016/j.pnpbp.2019.109778 · Cited by 34 · see citing works
Movsisyan, A., Meléndez‐Torres, G. J., & Montgomery, P. (2015) · Journal of Clinical Epidemiology · doi:10.1016/j.jclinepi.2015.09.010 · Cited by 46 · see citing works
Identifying 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 · see citing works
Kim, D., Ryba, N., Kalabalik, J., & Westrich, L. (2018) · Drugs in R&D · doi:10.1007/s40268-018-0246-8 · Cited by 37 · see citing works
“TTM and ExD share common features.”
InfluentialUse of antipsychotic drugs in dermatology.
Gupta, M., Vujcic, B., Pur, D., & Gupta, A. (2018) · Clinical Dermatology · doi:10.1016/j.clindermatol.2018.08.006 · Cited by 26 · see citing works
Slikboer, R., Nedeljkovic, M., Bowe, S., & Moulding, R. (2017) · Clinical Psychologist · doi:10.1111/cp.12074 · Cited by 26 · see citing works
“This is in agreement with both Bloch et al. (2007) and Rothbart et al. (2013).”
ResultBellia, 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 32 · see citing works
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 · see citing works
“…for trichotillomania found that although clomipramine (a tetracyclic antidepressant) has shown moderate efficacy compared with placebo, selective serotonin reuptake inhibitors (SSRIs) do not produce significant improvements in symptom severity (Bloch et al., 2007; Rothbart et al., 2013).”
BackgroundPharmacotherapy 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 · see citing works
“In addition, many of the scales used have not been well validated, which diminishes the quality of the evidence [9].”
BackgroundMethodResultInfluentialSelf-citationFrom anxiety to compulsivity – a review of changes to OCD classification in DSM-5 and ICD-11
Krzanowska, E., & Kuleta, M. (2017) · Archives of Psychiatry and Psychotherapy · doi:10.12740/app/76150 · Cited by 12 · see citing works
“However, although hypochondriasis has been shown to respond to SSRIs and CBT/ERP, it is unclear whether these are preferential or if they are just one of several effective modes of treatment for the disorder [38,39].”
BackgroundInfluentialNovel 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 10 · see citing works
Trichotillomania associated with a 25-hydroxy vitamin D deficiency: A case report
Titus-Lay, E. N., Eid, T., Kreys, T.-J., Chu, B. X. J., & Malhotra, A. (2020) · Mental Health Clinician · doi:10.9740/mhc.2020.01.038 · Cited by 7 · see citing works
“While no first-line treatment exists for TTM and a recent meta-analysis concluded that no particular medication class demonstrates efficacy in the treatment of TTM, anecdotal evidence suggests treatment effects of clomipramine, N-acetylcysteine, and olanzapine based on 3 individual trials with small sample sizes.(4)”
Review of Psychopharmacological Approaches for Trichotillomania and Other Body-Focused Behaviors
Grant, J. (2015) · Current Treatment Options in Psychiatry · doi:10.1007/s40501-015-0058-1 · Cited by 3 · see citing works
Perfiles psicológicos de los pacientes con psicodermatosis
Armenteros, J. M. F., Ponce, I., Campanera, E. C., & Seuma, J. (2016) · Piel · doi:10.1016/j.piel.2015.05.009 · Cited by 2 · see citing works
Gastric perforation in a 16 year old girl
Nunn, A., Jahn, N., Hewes, J., & Wong, C. (2017) · British medical journal · doi:10.1136/bmj.j1859 · Cited by 1
Psychopharmacotherapy of Obsessive-Compulsive and Related Disorders
Hoffman, J. A., & Stein, D. (2021) · NeuroPsychopharmacotherapy · doi:10.1007/978-3-319-56015-1_433-1 · Cited by 1 · see citing works
Self-citationHoward, J., & Serrano, W. C. (2017) · Springer eBooks · doi:10.1007/978-3-319-46352-0_3 · Cited by 1 · see citing works
Pharmacotherapy for trichotillomania
Hoppe, L. J., Ipser, J., Fineberg, N. A., Chamberlain, S. R., & Stein, D. J. (2009) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd007662
Self-citationTricotilomanía: un trastorno psicodermatológico incapacitante
García-Cárdenas, C., Carrasco-Cancino, C., & Arceu-Ojeda, M. (2020) · Piel · doi:10.1016/j.piel.2020.05.004
Obsessive-Compulsive and Related Disorders in Transitional-Age Youth
Okereke, N. (2021) · Transition-Age Youth Mental Health Care · doi:10.1007/978-3-030-62113-1_9
Trichotillomania (Hair Pulling Disorder)
Romanov, D., Michenko, A., Romanova, I. I., & Lvov, A. (2021) · Psychodermatology in Clinical Practice · doi:10.1007/978-3-030-54307-5_16
The endocannabinoid system and trichotillomania
Grant, J. E., Odlaug, B. L., & Chamberlain, S. R. (2015) · Elsevier eBooks · doi:10.1016/b978-0-12-417041-4.00017-5
Self-citation
- Authors
- Rothbart, R., Amos, T., Siegfried, N., Ipser, J. C., Fineberg, N., Chamberlain, S. R., & Stein, D. J.
- Affiliations
- University of British Columbia (CA)
- University of Cape Town (ZA)
- Queen Elizabeth II Hospital (GB)
- University of Cambridge (GB)
- Venue
- Cochrane Database of Systematic Reviews
- Publisher
- Wiley
- Published
- 2013-11-08
- Volume
- 9
- Issue
- 11
- Pages
- CD007662-CD007662
- ISSN
- 1361-6137 (ISSN-L)
- 1465-1858
- PMC
- PMC8478440
- OpenAlex
- W2085240634
- Cited by
- 106
- References
- 0
- Citations by year
- 2025: 3 · 2024: 3 · 2023: 8 · 2022: 4 · 2021: 14 · 2020: 9 · 2019: 9 · 2018: 9 · 2017: 9 · 2016: 11 · 2015: 11 · 2014: 3 · 2013: 1 · 2012: 1
- FWCI
- 1.27
- Type
- journal article
- Language
- en
- Update notices
- new_version (2021-09-28)
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Cochrane Database of Systematic Reviews (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Obsessive-Compulsive Spectrum Disorders
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Health Sciences › Medicine › Urology › Hair Growth and Disorders
- Keywords
- trichotillomania, pharmacotherapy, olanzapine, N-acetylcysteine, clomipramine, naltrexone, selective serotonin reuptake inhibitors, symptom severity, treatment response, adults, adverse events, attrition bias, risk of bias, obsessive-compulsive spectrum
- MeSH terms
- Olanzapine, Acetylcysteine, Adult, Benzodiazepines, Clomipramine, Humans, Naltrexone, Trichotillomania, Randomized Controlled Trials as Topic, Selective Serotonin Reuptake Inhibitors
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
