Hostname: page-component-78c5997874-8bhkd Total loading time: 0 Render date: 2024-10-31T23:09:56.577Z Has data issue: false hasContentIssue false

Fluvoxamine in the Treatment of Trichotillomania: An 8-Week, Open-Label Study

Published online by Cambridge University Press:  07 November 2014

Abstract

This short-term, open-label study investigates short- and long-term effects of the selective serotonin reuptake inhibitor (SSRI) fluvoxamine for the treatment of trichotillomania (TTM). Additionally, this study aimed to test the hypothesis that the presence of hair pulling compulsiveness is predictive of SSRI response. Nineteen subjects meeting the Diagnostic and Statistical Manual of Mental Disorders, Third Edition Revised, (DSM-III-R) criteria for TTM were treated with fluvoxamine at doses up to 300 mg/day. Random regression analysis of change across time for patients who completed the study (n=14) and those who dropped out (n=5) revealed statistically significant improvements in Physician Rating Scale, hair-pulling episodes, Trichotillomania Impairment Scale, and Trichotillomania Symptom Severity Scale, but not in estimated amount of hair pulled. In addition, the percentage of patients' focused or compulsive hair-pulling symptoms was predictive of treatment response. Unfortunately, all three subjects who entered long-term treatment displayed substantial movement back toward baseline by the end of 6 months. We concluded that fluvoxamine produces moderate reductions in symptoms during the short-term treatment of TTM and that the presence of focused or compulsive hair pulling may be predictive of treatment response. However, responses may be short lived when treatment is extended.

Type
Feature Article
Copyright
Copyright © Cambridge University Press 1998

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

1.American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 4th ed. Washington, DC: American Psychiatric Association; 1994.Google Scholar
2.Christenson, G, Mackenzie, TB, Mitchell, JE. Characteristics of 60 adult chronic hair pullers. Am J Psychiatry. 1991;148:365370.Google ScholarPubMed
3.Christenson, GA, Pyle, RL, Mitchell, JE. Estimated life-time prevalence of trichotillomania in college students. J Clin Psychiatry. 1991;52:415417.Google Scholar
4.Swedo, SE, Leonard, HL. Trichotillomania: an obsessive compulsive spectrum disorder? Psychiatr Clin North Am. 1992;15:777790.CrossRefGoogle ScholarPubMed
5.Swedo, SE, Leonard, HL, Rapoport, JL, Lenane, MC, Goldberger, EL, Cheslow, DL. A double-blind comparison of clomipramine and desipramine in the treatment of trichotillomania (hair pulling). N Eng J Med. 1989;321:497501.CrossRefGoogle ScholarPubMed
6.Swedo, SE, Rapoport, JL, Leonard, HL, Schapiro, MB, Rapoporl, SI, Grady, CL. Regional cerebral glucose metabolism of women with trichotillomania. Arch Gen Psychiatry. 1991;48:828833.CrossRefGoogle ScholarPubMed
7.Rettew, DC, Cheslow, DL, Rapoport, JL, et al.Neuropsychological test performance in trichotillomania: a further link with obsessive-compulsive disorder. J Anxiety Disord. 1991;5:225235.CrossRefGoogle Scholar
8.Schlosser, S, Black, DW, Blum, N, Goldstein, RB. The demography, phenomenology, and family history of 22 persons with compulsive hair pulling. Ann Clin Psychiatry. 1994;6:147152.CrossRefGoogle ScholarPubMed
9.Lenane, MC, Swedo, SE, Rapoport, JL, Leonard, H, Sceery, W, Guroff, JJ. Rates of Obsessive Compulsive Disorder in first degree relatives of patients with trichotillomania: a research note. J Child Psychol Psychiatry. 1992;33:925933.CrossRefGoogle ScholarPubMed
10.Christenson, GA, Mackenzie, TB. Trichotillomania. In: Hersen, M, Ammerman, RT, eds. Handbook of Prescriptive Treatments for Adults. New York, NY: Plenum Press; 1994:217235.CrossRefGoogle Scholar
11.Christenson, GA, Mackenzie, TB. Clinical presentation and treatment of trichotillomania. Directions in Psychiatry. 1994;14:18.Google Scholar
12.Ristvedt, SL, Mackenzie, TB, Christenson, GA. Identification of trichotillomania cue profiles. Behav Res Ther. 1993;31:721729.CrossRefGoogle Scholar
13.Christenson, GA, Crow, SJ. The characterization and treatment of trichotillomania. J Clin Psychiatry. 1996;57(suppl 8):4249.Google ScholarPubMed
14.Pigott, TA, L'Heueux, F, Grady, TA, et al.Controlled comparison of clomipramine and fluoxetine in trichotillomania. In: Abstracts of Panels and Posters of the 31st Annual Meeting of the American College of Neuropsychopharmacology; Dec 18, 1992; San Juan, Puerto Rico; 157.Google Scholar
15.Christenson, GA, Mackenzie, TB, Mitchell, JE, Callies, AL. A placebo-controlled, double-blind crossover study of fluoxetine in trichotillomania. Am J Psychiatry. 1991;148:15661571.Google ScholarPubMed
16.Streichenwein, SM, Thornby, JI. A long-term, placebo-controlled crossover trial of the efficacy of fluoxetine for trichotillomania. Am J Psychiatry. 1995;152:11921196.Google ScholarPubMed
17.Benarroche, CL. Trichotillomania symptoms and fluoxetine response. In: New Research Program and Abstracts of the 143rd Annual Meeting of the American Psychiatric Association; May 15, 1990; New York, NY. Abstract NR327:173.Google Scholar
18.Winchel, RM, Jones, JS, Stanley, B, Molcho, A, Stanley, M. Clinical characteristics of trichotillomania and its response to fluoxetine. J Clin Psychiatry. 1992;53:304308.Google ScholarPubMed
19.Koran, LM, Ringold, A, Hewlett, W. Fluoxetine for trichotillomania: an open clinical trial. Psychopharmacol Bull. 1992;28:145149.Google ScholarPubMed
20.Minichiello, WE, O'Sullivan, RL, Osgood-Hynes, D, et al.Trichotillomania: clinical aspects and treatment strategies. Harvard Rev Psychiatry. 1994;1:336344.CrossRefGoogle ScholarPubMed
21.Bradford, JM, Gratzer, TG. A treatment for impulse control disorders and paraphilia: a case report. Can J Psychiatry. 1995;40:45.CrossRefGoogle ScholarPubMed
22.Rahman, MA, Gregory, R. Trichotillomania associated with HIV infection and response to sertraline (letter). Psychosomatics. 1995;36:417418.CrossRefGoogle Scholar
23.Stanley, MA, Breckernridge, JK, Swann, AC, Freeman, EB, Reich, L. Fluvoxamine treatment of trichotillomania. J Clin Psychopharmacol. 1997;17:278283.CrossRefGoogle ScholarPubMed
24.Swedo, SE, Lenane, MC, Leonard, HL. Long-term treatment of trichotillomania (hair pulling) (letter). N Engl J Med. 1993;329:141142.CrossRefGoogle ScholarPubMed
25.Benarroche, CL. Discontinuation of fluoxetine in trichotillomania. In: New Research Program and Abstracts of the 144th Annual Meeting of the American Psychiatric Association; May 14, 1991; New Orleans, La. Abstract NR380:138.Google Scholar
26.Pollard, CA, Ibe, IO, Krojanker, DN, Kitchen, AD, Branson, SS, Flynn, TM. Clomipramine treatment of trichotillomania: a follow-up report on four cases. J Clin Psychiatry. 1991;52:128130.Google ScholarPubMed
27.Hamilton, M. A rating scale for depression. J Nuerol Neurosurg Psychiatry. 1960;28:5662.CrossRefGoogle Scholar
28.Spitzer, RL, Williams, JBW, Gibbon, M, et al.Instruction Manual for the Structured Clinical Interview for DSM-1II-R (SCID). New York, NY: Biometric Research; 1988.Google Scholar
29.Cooper, J. The Leyton Obsessional Inventory. Psychol Med. 1970;1:4864.CrossRefGoogle ScholarPubMed
30.Sanavio, E. Obsessions and compulsions: the Padua Inventory. Behav Res Ther. 1988;26:169177.CrossRefGoogle ScholarPubMed
31.Hamilton, M. The assessment of anxiety states by rating. Br J Med Psychol. 1959;32:5055.CrossRefGoogle ScholarPubMed
32.Gibbon, RD, Hedeker, D, Elkin, I, et al.Some conceptual and statistical issues in analysis of longitudinal psychiatric data. Arch Gen Psychiatry. 1993;50:739750.CrossRefGoogle Scholar
33.Azrin, NH, Nunn, RO, Frantz, SE. Treatment of hairpulling (trichotillomania): a comparative study of habit reversal and negative practice training. J Behav Ther Exp Psychiatry. 1980;11:1320.CrossRefGoogle Scholar