title: An open-label, flexible-dose study of olanzapine in the treatment of trichotillomania.
abstract: BACKGROUND
  Thus far, only selective serotonin reuptake inhibitors have been systematically studied in the treatment of trichotillomania, and the results are conflicting. This open-label study is the first to systematically evaluate an atypical neuroleptic, olanzapine, as a monotherapy in the treatment of trichotillomania.
  
  
  METHODS
  Twenty-one patients were screened and 18 patients were enrolled in a 3-month open-label study of olanzapine for trichotillomania (diagnosis based on modified DSM-IV criteria). Patients with comorbid psychiatric disorders or on treatment with psychoactive medication were excluded. Olanzapine was titrated gradually in 2.5-mg/week increments up to a maximum dose of 10 mg/day.
  
  
  RESULTS
  Seventeen patients who completed at least 1 week of olanzapine treatment were evaluated. Hair pulling, as measured by the Massachusetts General Hospital Hairpulling Scale, decreased by 66% from baseline (p < or =.001), and mean scores on the Hamilton Rating Scale for Anxiety decreased by 63% (p < or =.05). Clinical Global Impressions scale scores also revealed significant improvement as a whole (p < or =.001), with 4 patients having complete symptom remission at the end of the study period.
  
  
  CONCLUSIONS
  Findings suggest that olanzapine may be an effective monotherapy for trichotillomania.
authors.affiliation: Department of Psychiatry, The University of Texas Southwestern Medical Center at Dallas, 75390-9101, USARege.Stewart@UTSouthwestern.edu
authors.forename: Rege S
authors.initials: RS
authors.lastname: Stewart
authors.forename: Vicki A
authors.initials: VA
authors.lastname: Nejtek
mesh_terms: D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D014150:Antipsychotic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D001008:Anxiety Disorders / Q000175:diagnosis / Q000523:psychology; D001569:Benzodiazepines; D003866:Depressive Disorder / Q000175:diagnosis / Q000523:psychology; D004334:Drug Administration Schedule; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D000077152:Olanzapine; D010890:Pirenzepine / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000627:therapeutic use*; D011569:Psychiatric Status Rating Scales; D016896:Treatment Outcome; D014256:Trichotillomania / Q000188:drug therapy* / Q000523:psychology
chemical_list: D014150:Antipsychotic Agents; D001569:Benzodiazepines; D010890:Pirenzepine; D000077152:Olanzapine