A DOUBLE-BLIND TRIAL OF FLUOXETINE IN PATHOLOGICAL SKIN PICKING

Background: Our objective was to determine the efficacy of fluoxetine in the treatment of pathologic skin picking in a double-blind, placebo -controlled, parallel trial. Method: Twenty-one adults with chronic pa thologic skin picking agreed to participate and received 10 weeks of p lacebo or fluoxetine with a flexible dosing schedule up to 80 mg/day. Three skin-picking measures were employed: the Clinical Global Impress ion-Improvement (CGI-I) scale, the Skin Picking Treatment Scale (SPTS) , and a visual analog scale of self-rated change (VAS). In addition, d epression, anxiety, and obsessions-compulsions were rated using the Ha milton Rating Scale for Depression (HAM-D), the Hamilton Rating Scale for Anxiety (HAM-A), the Spielberger State-Trait Anxiety Inventory (ST AI), and the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) for the du ration of the study. Results: Seventeen subjects (6 treated with fluox etine and 11 treated with placebo) completed the trial, at a mean fluo xetine dose of 55 mg/day. Fluoxetine was significantly superior to pla cebo in the treatment of skin picking according to two of the three me asures for the completer analysis and to one of the three measures for the intent-to-treat analysis. Neither baseline level nor change in de pression, anxiety, or obsessive-compulsive symptoms was significantly related to change in skin picking. Conclusion: This first controlled t rial of the treatment of pathologic skin picking suggests that fluoxet ine may be of therapeutic benefit. Larger controlled studies are warra nted.