Fluoxetine in pathologic skin-picking - Open-label and double-blind results

Various studies suggest that selective serotonin reuptake inhibitors (SSRIs ) may be useful in treating pathologic skin-picking. The authors investigat ed the effectiveness of fluoxetine in treating this behavior. Fifteen subje cts with clinically significant skin-picking were recruited by newspaper ad vertisement. They, received 6 weeks of open-label treatment with fluoxetine . Responders were then randomized to 6 weeks of double-blind fluoxetine or placebo. Treatment effect was assessed with standardized rating scales. All 15 subjects completed open-label treatment, and 8 were responders. Of thes e eight, the four randomized to double-blind fluoxetine maintained clinical ly significant improvement. The four randomized to placebo returned to thei r baseline symptom level. Larger studies are needed to determine which indi viduals are likely to respond to fluoxetine and the relative effectiveness of fluoxetine, other SSRIs, and other forms of treatment.