Dj. Stein et al., USE OF THE SELECTIVE SEROTONIN REUPTAKE INHIBITOR CITALOPRAM IN TREATMENT OF TRICHOTILLOMANIA, European archives of psychiatry and clinical neuroscience, 247(4), 1997, pp. 234-236
Previous trials of selective serotonin reuptake inhibitors (SSRIs) in
the treatment of trichotillomania have provided conflicting data. Furt
hermore, the efficacy of citalopram, the most selective of the SSRIs,
in trichotillomania has not previously been documented. Citalopram was
used on an open-label naturalistic basis in 14 (1 male and 13 females
) patients who presented with chronic hair-pulling and met DSM-IV crit
eria for trichotillomania. Ratings were completed every 2 weeks for 12
weeks, during which time dosage was increased to a maximum of 60 mg d
aily (mean dose 36.2 +/- 13.9 mg), One patient was unable to tolerate
citalopram. in completers, ratings on each of the scales employed were
significantly improved after treatment. Of completers 38.5% were resp
onders (Clinical Global impressions score of 2 or less) at week 12. Ci
talopram appears to be safe in trichotillomania, and it may be effecti
ve in a subset of patients. Given the relatively low response rate, ho
wever, a controlled trial is needed before this agent can be said to b
e more effective than placebo. The pharmacotherapy of trichotillomania
deserves further study.