Skip to main content Accessibility help
×
Home

Venlafaxine Treatment of Trichotillomania: An Open Series of Ten Cases

Published online by Cambridge University Press:  07 November 2014

Abstract

In this article, we discuss the use of venlafaxine, an antidepressant with predominant effects at both noradrenergic and serotonergic reuptake sites, in the treatment of trichotillomania (TTM), a complex psychiatric condition manifested by chronic, severe hair pulling. We review case examples of 10 consecutive patients exhibiting moderately severe TTM symptoms, as judged by self-report, extent of hair loss, and duration of remission, and discuss our observations regarding the effects of venlafaxine therapy (mean dose, 274 mg/day) on these patients over the course of several months (mean, 15.1 weeks). The Massachusetts General Hospital Hair Pulling Scale, Massachusetts General Hospital Trichotillomania Impact Scale (MGH TIS), Psychiatric Institute Trichotillomania Scale (PITS), Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), and Clinical Global Improvement (CGI) scale were used to appraise the patients' condition during routine clinical visits. A retrospective chart review of clinical data demonstrated significant improvement in TTM symptoms from baseline to last clinical visit in both behavioral (MGH HPS, P=.02; PITS, P=.02) and psychosocial (MGH TIS, P=.009) terms. Mean improvement on the CGI scale was 2.38±1.51, between “much improved” (2) and “slightly improved” (3). There were no significant differences from baseline to endpoint scores on the BDI or BAI. This retrospective treatment review indicates that short-term treatment with venlafaxine improved TTM symptoms; however, longer controlled trials with extended baseline periods are needed for optimal assessment of pharmacologic treatment of TTM. We look to future studies to confirm and supplement our initial positive findings.

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.

References

1.American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 4th ed. Washington, DC: American Psychiatric Association; 1994.Google Scholar
2.Christenson, GA, Mackenzie, TB, Mitchell, JE. Characteristics of 60 adult chronic hair pullers. Am J Psychiatry. 1991;148:365370.Google ScholarPubMed
3.Soriano, J, O'Sullivan, RL, Baer, L, Phillips, K, McNally, RJ, Jenike, MA. Trichotillomania and self-esteem: a survey of sixty-two female hairpullers. J Clin Psychiatry. 1996;57:7782.Google Scholar
4.O'Sullivan, RL, Keuthen, N, Gumley, G, Jenike, MA. Carpal tunnel syndrome and trichotillomania. J Clin Psychiatry. 1996;57:17.Google ScholarPubMed
5.Minichiello, WE, O'Sullivan, RL, Osgood-Hynes, D, Baer, L. Trichotillomania: clinical aspects and treatment strategies. Harvard Rev Psychiatry. 1994;1:336–44.CrossRefGoogle ScholarPubMed
6.Christenson, GA, Pyle, RL, Mitchell, JE. Estimated lifetime prevalence of trichotillomania in college students. J Clin Psychiatry. 1991;52:415417.Google ScholarPubMed
7.King, RA, Zohar, AH, Ratzoni, G, et al.An epidemiological study of trichotillomania in Israeli adolescents. J Am Acad Child Adolesc Psychiatry. 1995;34:12121225.CrossRefGoogle ScholarPubMed
8.Christenson, GA, O'Sullivan, RL. Trichotillomania: rational treatment options. CNS Drugs. 1996;6:2334.CrossRefGoogle Scholar
9.Christenson, GA, Crow, SJ. The characterization and treatment of trichotillomania. J Clin Psychiatry. In press.Google Scholar
10.Keuthen, NJ, O'Sullivan, RL, Jefferys, D. Trichotillomania: clinical concepts and treatment approaches. In: Jenike, MA, Baer, L, Minichiello, WE, eds. Obsessive-Compulsive Disorders: Theory and Management. 3rd ed. Philadelphia, Pa: Mosby Year Book; 1998.Google Scholar
11.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. N Engl J Med. 1989;321:497501.CrossRefGoogle ScholarPubMed
12.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. 1992; San Juan, Puerto Rico.Google Scholar
13.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
14.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
15.Koran, LM, Ringold, A, Hewlett, W. Fluoxetine for trichotillomania: an open clinical trial. Psychopharmacol Bull. 1992;28:145149.Google Scholar
16.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
17.Stanley, MA, Bowers, TC, Swann, AC, Taylor, DJ. Treatment of trichotillomania with fluoxetine. J Clin Psychiatry. 1991;52:282.Google ScholarPubMed
18.Stein, DJ, Bouwer, C, Maud, CM. Use of the selective serotonin reuptake inhibitor eitalopram in treatment of trichotillomania. Eur Arch Psychiatry Clin Neurosci. 1997;234236.Google Scholar
19.Christenson, GA, Popkin, MK, Mackenzie, TB, Realmuto, CM. Lithium treatment of chronic hair pulling. J Clin Psychiatry. 1991;52:116120.Google ScholarPubMed
20.Snyder, S. Trichotillomania treated with amitriptyline. J Nerv Ment Dis. 1980;168:505507.CrossRefGoogle Scholar
21.Sachdeva, JS, Sidhu, BS. Trichotillomania associated with depression. J Indian Med Assoc. 1987;85:151152.Google ScholarPubMed
22.Stein, DJ, Hollander, E. Low-dose pimozide augmentation of serotonin reuptake blockers in the treatment of trichotillomania. J Clin Psychiatry. 1992;53:123126.Google ScholarPubMed
23.VanAmerigen, M, Mancini, C. Treatment of trichotillomania with haloperidol. Presented at Anxiety Disorders Association of America Annual Meeting; 1996. Orlando Fla.Google Scholar
24.Christenson, GA, Crow, SJ, Mackenzie, TB, Crosby, RD, Mitchell, JE. A placebo controlled double-blind study of naltrexone for trichotillomania. In: New Research Program and Abstracts of the 150th Annual Meeting of the American Psychiatric Association; May 26, 1994; Philadelphia, Pa. Abstract NR 597:212.Google Scholar
25.Swedo, SE, Lenane, MC, Leonard, HL. Long-term treatment of trichotillomania (hair pulling). N Engl J Med. 1993;329:141142.CrossRefGoogle Scholar
26.Winchel, RM, Jones, JS, Molcho, A, Parsons, B, Stanley, B, Stanley, M. The Psychiatric Institute Trichotillomania Scale (PITS). Psychopharmacol Bull. 1992;28:463476.Google Scholar
27.Keuthen, N, O'Sullivan, RL, Ricciardi, J, et al.The MGH Hairpulling Scale. I. Scale development and factor analyses. Psychother Psychosom. 1995;64:141145.CrossRefGoogle ScholarPubMed
28.O'Sullivan, RL, Keuthen, N, Hayday, CF, et al.The MGH Hairpulling Scale: II. reliability and validity. Psychother Psychosom. 1995;64:146148.CrossRefGoogle Scholar
29.Montgomery, SA. Venlafaxine: a new dimension in antidepressant pharmacotherapy. J Clin Psychiatry. 1993;54:119126.Google Scholar
30.Geracioli, TD. Venlafaxine treatment of panic disorders: a case series. J Clin Psychiatry. 1995;56:408410.Google Scholar
31.Emmanuel, NP, et al. Venlafaxine in social phobia: a case series. Presented at the American Psychiatric Association Annual Meeting; May 21–25, 1995; Miami Beach, Fla.Google Scholar
32.Zajecka, JM, Fawcett, J, Guy, C. Coexisting major depression and obsessive-compulsive disorder treated with venlafaxine. J Clin Psychopharmacol. 1990;10:151152.CrossRefGoogle ScholarPubMed
33.Yaryura-Tobias, JA, Neziroglu, FA, McKay, DR. The action of venlafaxine on obsessive-compulsive disorder, (abstract). Biol Psychiatry. 1994;35:737.CrossRefGoogle Scholar
34.Ananth, J, Burgoyne, K, Smith, M, Swartz, R. Venlafaxine treatment of obsessive-compulsive disorder. Am J Psychiatry; 1995,152:1832.Google ScholarPubMed
35.Grossman, R, Hollander, E. Treatment of obsessive-compulsive disorder with venlafaxine. Am J Psychiatry. 1996;153:576577.Google ScholarPubMed
36.Rauch, SL, O'Sullivan, RL, Jenike, MA. Open treatment of OCD with venlafaxine: a series of ten cases. J Clin Psychopharmacol. 1996;16:8183.CrossRefGoogle Scholar
37.Beck, AT, Ward, CH, Mendelsohn, M, Mock, J, Erbaugh, J. An inventory for measuring depression. Arch Gen Psychiatry. 1961;4:561571.CrossRefGoogle ScholarPubMed
38.Beck, AT, Epstein, N, Brown, G, Steer, R. An inventory for measuring anxiety: psychometric properties. J Clin Psychol. 1988;893897.Google Scholar
39.Guy, W. ECDEU Assessment Manual for Psychopharmacology. Washington, DC: Department of Health, Education, and Welfare. Publication No. (ADM); 1976.Google Scholar
40.Ninan, PT, Knight, B, Johns, B, Kirk, L, Logan, C, Rothbaum, B. Trichotillomania: a controlled trial of venlafaxine. Poster No. 55. Presented at New Clinical Drug Evaluation Unit Program; 1997.Google Scholar
41.Keuthen, NJ, O'Sullivan, RL, Goodchild, G, Rodriguez, D, Jenike, MA, Baer, L. A retrospective review of treatment outcome in 63 hairpullers. Am J Psychiatry. In press.Google Scholar
42.Cohen, LJ, Stein, DJ, Simeon, D, et al.Clinical profile, comorbidity, and treatment history in 123 hair pullers: a survey study. J Clin Psychiatry. 7:319326.Google Scholar

Full text views

Full text views reflects PDF downloads, PDFs sent to Google Drive, Dropbox and Kindle and HTML full text views.

Total number of HTML views: 0
Total number of PDF views: 16 *
View data table for this chart

* Views captured on Cambridge Core between September 2016 - 18th January 2021. This data will be updated every 24 hours.

Hostname: page-component-77fc7d77f9-94bw7 Total loading time: 0.217 Render date: 2021-01-18T01:37:52.490Z Query parameters: { "hasAccess": "0", "openAccess": "0", "isLogged": "0", "lang": "en" } Feature Flags last update: Mon Jan 18 2021 00:53:57 GMT+0000 (Coordinated Universal Time) Feature Flags: { "metrics": true, "metricsAbstractViews": false, "peerReview": true, "crossMark": true, "comments": true, "relatedCommentaries": true, "subject": true, "clr": true, "languageSwitch": true, "figures": false, "newCiteModal": false, "shouldUseShareProductTool": true, "shouldUseHypothesis": true, "isUnsiloEnabled": true }

Send article to Kindle

To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Venlafaxine Treatment of Trichotillomania: An Open Series of Ten Cases
Available formats
×

Send article to Dropbox

To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

Venlafaxine Treatment of Trichotillomania: An Open Series of Ten Cases
Available formats
×

Send article to Google Drive

To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

Venlafaxine Treatment of Trichotillomania: An Open Series of Ten Cases
Available formats
×
×

Reply to: Submit a response


Your details


Conflicting interests

Do you have any conflicting interests? *