A randomized, double-blind, placebo-controlled trial of olanzapine in the treatment of trichotillomania.
BACKGROUND
Trichotillomania has been considered as part of the obsessive-compulsive disorder spectrum; however, trichotillomania treatment with obsessive-compulsive disorder medications has largely been unsuccessful.


OBJECTIVE
To determine whether a dopaminergic treatment as used in tics and Tourette's syndrome would be effective in trichotillomania.


METHODS
Twenty-five participants with DSM-IV trichotillomania participated in a 12-week, randomized, double-blind, placebo-controlled trial of flexible-dose olanzapine for trichotillomania. Recruitment occurred between August 2001 and December 2005, and follow-up was completed in February 2006. The primary outcome measure was the Clinical Global Impressions-Improvement (CGI-I) scale, and secondary measures of efficacy included the Yale-Brown Obsessive Compulsive Scale for Trichotillomania (TTM-YBOCS) and the Clinical Global Impressions-Severity of Illness (CGI-S) scale.


RESULTS
Eleven of 13 participants (85%) in the olanzapine group and 2 of 12 (17%) in the placebo group were considered responders according to the CGI-I (P = .001). There was a significant change from baseline to end point in the TTM-YBOCS (P < .01) and the CGI-S (P < .001). The mean ± SD dose of olanzapine at end point was 10.8 ± 5.7 mg/d. Twenty-one of 25 patients (84%) reported at least 1 adverse event, but no adverse events resulted in early withdrawal from the study.


CONCLUSIONS
Olanzapine seems to be a safe and effective treatment for primary DSM-IV trichotillomania.


BACKGROUND
clinicaltrials.gov Identifier: NCT00182507.
Van Ameringen
Michael
M
Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada. vanamer@mcmaster.ca
Mancini
Catherine
C
Patterson
Beth
B
Bennett
Mark
M
Oakman
Jonathan
J
D000293:Adolescent; D000328:Adult; D014150:Antipsychotic Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D001569:Benzodiazepines / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D000077152:Olanzapine; D010919:Placebos; D011569:Psychiatric Status Rating Scales; D012720:Severity of Illness Index; D014256:Trichotillomania / Q000188:drug therapy*
D014150:Antipsychotic Agents; D010919:Placebos; D001569:Benzodiazepines; D000077152:Olanzapine