Onychotillomania treated with pimozide (Orap)

Area of Science:

• Psychiatry
• Dermatology

Background:

• Onychotillomania is a body-focused repetitive behavior characterized by the compulsive picking or tearing of nails.
• This condition can lead to significant nail damage and distress, often co-occurring with delusional beliefs.

Observation:

• A 70-year-old woman presented with a 5.5-year history of onychotillomania, resulting in the complete loss of all fingernails.
• The patient exhibited a fixed hypochondrial delusion concerning a nail disease.

Findings:

• Treatment with pimozide (Orap), an antipsychotic medication, was initiated.
• After 7 months of continuous pimozide therapy, the patient's fingernails returned to a normal state.

Implications:

• This case highlights the potential efficacy of pimozide in managing onychotillomania, particularly when associated with delusional ideation.
• Further research into psychopharmacological interventions for body-focused repetitive behaviors like onychotillomania is warranted.