The potential role of haloperidol in the treatment of trichotillomania.
BACKGROUND
Trichotillomania is categorized as an impulse control disorder in DSM-IV and is considered by some to be closely related to Obsessive Compulsive Disorder (OCD). We review the clinical phenomenology and pharmacological response of trichotillomania, and suggest that it may be more related to Tourette Syndrome than to OCD. Serotonin reuptake inhibitors (SRIs) are typically employed in the treatment of OCD, while neuroleptic medications such as haloperidol are typically used in the treatment of Tourette Syndrome. Evidence for the efficacy of treatment of trichotillomania with drugs typically used for OCD is equivocal.


METHODS
Nine patients with trichotillomania were treated with haloperidol. Six patients unresponsive to SSRI medication had haloperidol added to their treatment. Three patients received only haloperidol. Response to treatment was assessed using descriptions of hair pulling, quantity of hair pulled, and severity of depilation at hair pulling sites.


RESULTS
Eight of nine patients responded to haloperidol treatment, with seven experiencing complete or near complete cessation of hair pulling.


CONCLUSIONS
Inferences from the results of this study are limited by the lack of a control group, the small sample size, and the use of unstandardized ratings as measures of symptom severity.


CONCLUSIONS
Results suggest that the addition of haloperidol to SSRIs or haloperidol alone may be effective in the treatment of trichotillomania. Results also encourage speculation about the relation between OCD, Tourette Syndrome, and trichotillomania.
Van Ameringen
M
M
Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada. vanamer@fhs.mcmaster.ca
Mancini
C
C
Oakman
J M
JM
Farvolden
P
P
D000328:Adult; D018726:Anti-Dyskinesia Agents / Q000494:pharmacology / Q000627:therapeutic use*; D005260:Female; D006220:Haloperidol / Q000494:pharmacology / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009771:Obsessive-Compulsive Disorder / Q000150:complications / Q000523:psychology; D005879:Tourette Syndrome / Q000150:complications / Q000523:psychology; D016896:Treatment Outcome; D014256:Trichotillomania / Q000188:drug therapy* / Q000523:psychology
D018726:Anti-Dyskinesia Agents; D006220:Haloperidol