Hopkins PodBlog: Trichotillomania Treatment (!)

An Effective Treatment for Chronic Hair Pulling

Lots of people engage in repetitive behaviors; most of us eat on a regular basis for example. But some people engage in behaviors they repeat over and over again, sometimes resulting in personal harm, and over which they cannot seem to exert control. Such behaviors are then termed 'compulsive.' One such is trichotillomania, or chronic hair pulling. (The word itself isn't as bizarre as it sounds. Tricho always refers to hair, tillo to pull out, and mania, insanity.) Those who manifest trichotillomania will pull out their own hair, creating bald patches. But now a good news study in this week's Archives of General Psychiatry suggests an effective treatment.

Even better, the treatment used in this study is available over the counter in many health food stores, doesn't seem to have any deleterious side effects and points the way toward an understanding of why people pull their hair out to begin with.

N-acetylcysteine, 1200-2400 milligrams per day, was used by study participants for 12 weeks. 56% of those taking the supplements reported themselves "much or very much improved" compared to 16% of the folks who weren't taking N-acetylcysteine (the control group). The effectiveness of this treatment seems to indicate that glutamate, a chemical used by cells in the brain and elsewhere to communicate, may be too low, and giving this supplement helps.

Previous studies on this condition had focused on serotonin, the darling of the depression world, with conflicting study results. Shifting the focus to glutamate may also help in the management of other compulsive behaviors.

Other topics this week included Adiponectin Levels and Risk of Type 2 Diabetes in JAMA, Travel and Risk for Venous Thromboembolism and Working Conditions in Primary Care: Physician Reactions and Care Quality in Annals of Internal Medicine. Until next week, y'all live well.