An Open-Label, Flexible-Dose Study of Olanzapine in the Treatment of Trichotillomania
J Clin Psychiatry 2003;64(1):49-52
© Copyright 2014 Physicians Postgraduate Press, Inc.
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Background: Thus far, only selective serotonin
reuptake inhibitors have been systematically studied in the
treatment of trichotillomania, and the results are conflicting.
This open-label study is the first to systematically evaluate an
atypical neuroleptic, olanzapine, as a monotherapy in the
treatment of trichotillomania.
Method: Twenty-one patients were screened and 18
patients were enrolled in a 3-month open-label study of
olanzapine for trichotillomania (diagnosis based on modified
DSM-IV criteria). Patients with comorbid psychiatric disorders or
on treatment with psychoactive medication were excluded.
Olanzapine was titrated gradually in 2.5-mg/week increments up to
a maximum dose of 10 mg/day.
Results: Seventeen patients who completed at
least 1 week of olanzapine treatment were evaluated. Hair
pulling, as measured by the Massachusetts General Hospital
Hairpulling Scale, decreased by 66% from baseline (p<=.001),
and mean scores on the Hamilton Rating Scale for Anxiety
decreased by 63% (p<=.05). Clinical Global Impressions scale
scores also revealed significant improvement as a whole
(p<=.001), with 4 patients having complete symptom remission
at the end of the study period.
Conclusion: Findings suggest that olanzapine may
be an effective monotherapy for trichotillomania.