Trichotillomania: A heads-up on severe cases
Since childhood, Ms. D has been compulsively pulling out and eating her hair. Multiple surgeries, financial hardships, and social isolation have not stemmed her behavior. How would you help this patient?
I have had excellent results with other trichotillomania patients—especially children and adolescents. Simply naming their condition and demystifying the problem can be therapeutic. Many patients have responded to SSRIs combined with CBT.
Not long ago, trichotillomania patients were met with ignorance and disbelief within the medical community as the disorder was poorly understood. We need to break this cycle of shame and continue investigating treatment strategies.
- StopPulling.com, an interactive behavioral program for persons with trichotillomania. www.stoppulling.com.
- Penzel F. The hair pulling problem: a complete guide to trichotillomania. New York: Oxford University Press, 2003.
- Keuthen NJ, Stein DJ, Christenson GA. Help for hair pullers: understanding and coping with trichotillomania. Oakland, CA: New Harbinger Publications, 2001.
Drug brand names
- Amitriptyline • Elavil
- Buspirone • BuSpar
- Clomipramine • Anafranil
- Fluoxetine • Prozac
- Fluvoxamine • Luvox
- Haloperidol • Haldol
- Lithium • Eskalith, others
- Methylphenidate • Concerta, Ritalin
- Naltrexone • ReVia
- Olanzapine • Zyprexa
- Paroxetine • Paxil
- Pimozide • Orap
- Quetiapine • Seroquel
- Risperidone • Risperdal
- Sertraline • Zoloft
- Tramadol • Ultram
- Ziprasidone • Geodon
Disclosure
Dr. Lundt receives research grants from and/or is a speaker for Eli Lilly and Co., Pfizer Inc., GlaxoSmithKline, and Bristol-Myers Squibb Co.
