title: Use of Topiramate in Skin-Picking Disorder: A Pilot Study.
abstract: OBJECTIVE
  Repetitive skin picking that culminates in skin lesions and excoriations has a fairly common prevalence and causes clinically significant distress. Myriads of agents have been used to treat the condition with no convincing results.
  
  
  METHODS
  Ten patients (8 women and 2 men) with skin-picking disorder (per DSM-5 criteria) were enrolled in the study. The study was conducted from December 1, 2013, to December 29, 2014. The patients were treated with 12-week open-label topiramate in a titrating-upward dose (25-200 mg/d). Different measures to evaluate the efficacy of topiramate included subjective and objective assessment, photographs, the Skin Picking Scale modified after the Yale-Brown Obsessive-Compulsive Scale (SPS-Y-BOCS), the Skin Picking Impact Scale, the Clinical Global Impressions-Improvement (CGI-I) and CGI-Severity scales, and the Beck Anxiety Inventory and Beck Depression Inventory.
  
  
  RESULTS
  Topiramate improved time spent skin picking from 85 minutes to 30 minutes per day. Seven patients (70%) were very much improved (n = 4) and much improved (n = 30) on the CGI-I. The scores on the Skin Picking Impact Scale and SPS-Y-BOCS also improved. The mean time to respond to topiramate was about 8 to 10 weeks. Anxiety and depression symptoms improved after reduction in skin-picking symptoms (the Beck Anxiety Inventory score improved from a mean of 38.8 to 13.8 and the Beck Depression Inventory score from 28.9 to 10.1).
  
  
  CONCLUSIONS
  Topiramate appears to be a promising agent in the treatment of skin-picking symptoms. Double-blind controlled trials are needed to further evaluate the safety and efficacy of topiramate in larger population samples.
  
  
  BACKGROUND
  ISRCTN registry identifier: ISRCTN15791118.
authors.affiliation: Department of Psychiatry, Central Michigan University College of Medicine, 1000 Houghton Ave, Saginaw, MI 48602. Jaffe1m@cmich.edu.|Department of Psychiatry, Central Michigan University College of Medicine, Saginaw.
authors.forename: Mohammad
authors.initials: M
authors.lastname: Jafferany
authors.affiliation: Department of Psychiatry, Central Michigan University College of Medicine, Saginaw.
authors.forename: Ferdnand C
authors.initials: FC
authors.lastname: Osuagwu
mesh_terms: D000293:Adolescent; D000328:Adult; D001007:Anxiety / Q000453:epidemiology; D003863:Depression / Q000453:epidemiology; D007174:Disruptive, Impulse Control, and Conduct Disorders / Q000188:drug therapy* / Q000453:epidemiology / Q000473:pathology; D005260:Female; D005632:Fructose / Q000031:analogs & derivatives* / Q000627:therapeutic use; D006801:Humans; D008297:Male; D010865:Pilot Projects; D011569:Psychiatric Status Rating Scales; D011619:Psychotropic Drugs / Q000627:therapeutic use*; D012720:Severity of Illness Index; D012867:Skin / Q000473:pathology; D012959:Socioeconomic Factors; D013997:Time Factors; D000077236:Topiramate; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D011619:Psychotropic Drugs; D000077236:Topiramate; D005632:Fructose