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Low-dose pimozide augmentation of serotonin reuptake blockers in the treatment of trichotillomania.

Author(s): Stein DJ, Hollander E

Affiliation(s): Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, NY.

Publication date & source: 1992-04, J Clin Psychiatry., 53(4):123-6.

Publication type: Case Reports; Clinical Trial

BACKGROUND: There is some overlap in the phenomenology and treatment response of trichotillomania, Gilles de la Tourette's syndrome (TS), and obsessive compulsive disorder (OCD). Neuroleptics may play a role in the treatment of TS as well as refractory OCD, and the question arises whether this also holds for trichotillomania. METHOD: Patients with trichotillomania were treated in open clinical practice with serotonin reuptake blockers. When symptom resolution was incomplete or symptom relapse occurred, low-dose pimozide was added. RESULTS: In six out of seven patients, the addition of pimozide to a serotonin reuptake blocker led to an improvement in hair pulling. In patients who were able to tolerate their medication, this response was sustained. CONCLUSION: Augmentation of serotonergic agents with dopamine blockers may play a role in the treatment of trichotillomania. Further controlled trials of pimozide augmentation in trichotillomania are needed.

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