A randomized, double-blind, placebo-controlled trial of olanzapine in the
treatment of trichotillomania.
Author(s): Van Ameringen M, Mancini C, Patterson B, Bennett M, Oakman J.
Affiliation(s): Department of Psychiatry and Behavioural Neurosciences, McMaster University,
Hamilton, Ontario, Canada. vanamer@mcmaster.ca
Publication date & source: 2010, J Clin Psychiatry. , 71(10):1336-43
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.
METHOD: 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.
CONCLUSION: Olanzapine seems to be a safe and effective treatment for primary
DSM-IV trichotillomania.
TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT00182507.
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