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Pharmacotherapy for trichotillomania.
Jacob Hoffman1, Taryn Williams1, Rachel Rothbart2
1Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa.
The Cochrane Database of Systematic Reviews
|September 28, 2021
Summary
Medications for trichotillomania (hair-pulling disorder) show limited evidence of efficacy. Preliminary findings suggest potential benefits for N-acetylcysteine, clomipramine, and olanzapine in adults, but more research is needed.
Area of Science:
- Psychiatry
- Pharmacology
- Clinical Trials
Background:
- Trichotillomania (TTM), or hair-pulling disorder, is a prevalent and disabling condition.
- Recurrent hair-pulling characterizes TTM, necessitating effective treatment strategies.
Purpose of the Study:
- To evaluate the efficacy of various medications for treating trichotillomania in adults, children, and adolescents.
- To compare medication effects against placebo or other pharmacological interventions.
Main Methods:
- Systematic review and meta-analysis of randomized controlled trials (RCTs).
- Searched multiple databases and trial registries up to November 2020.
- Included 12 RCTs involving 334 participants comparing medications to placebo or other drugs.
Main Results:
- Insufficient evidence from meta-analysis to confirm efficacy of most agents for TTM.
- Preliminary evidence suggests potential benefits of N-acetylcysteine, clomipramine, and olanzapine in adults.
- Low to moderate certainty evidence for various drug classes, with some showing little to no difference compared to placebo.
Conclusions:
- Current evidence is insufficient to definitively confirm or refute the efficacy of medications for TTM.
- N-acetylcysteine, clomipramine, and olanzapine show preliminary promise in adult TTM treatment.
- Further high-quality RCTs are needed to establish effective pharmacological treatments for TTM across age groups.
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