Double-blind, placebo-controlled study of memantine in trichotillomania and skin scratching disorder
Abstract
Objective:
Trichotillomania and skin pinching disorder are poorly recognized conditions and often Disabling in which people repeatedly pull their hair or pinch their skin, leading to noticeable hair loss or tissue damage.To date, there is a severe shortage of evidence-based treatments for these conditions. In this study, the authors sought to determine whether memantine, a glutamate modulator, is more effective than placebo at reducing hair-pulling and skin-pinching behavior.
Methods:
One hundred adults with trichotillomania or skin pinching disorder (86 women; mean age, 31.4 years [SD=10.2]) were enrolled in a double-blind trial of memantine (dosage range, 10–20 mg/day) or placebo for 8 weeks. Participants were assessed with measures of severity of pulls and pinches.
We examined the results using a linear mixed-effects model. The prespecified primary outcome measure was treatment-related change on the NIMH Trichotillomania Symptom Severity Scale, modified to include skin scratching.
Results:
Compared with placebo, memantine treatment was associated with significant improvements in NIMH scores, Sheehan’s disability scale, and global clinical impression severity scale in terms of treatment interactions by time.
At the end of the study, 60.5% of participants in the memantine group improved greatly or very much, compared with 8.3% in the placebo group (number needed to treat = 1.9).Adverse events did not differ significantly between treatment arms.
Conclusions:
This study found that treatment with memantine resulted in statistically significant reductions in symptoms of hair pulling and skin scratching compared to placebo, with relatively high efficacy (based on the number needed to treat) and was well tolerated. The glutamate system may be a beneficial target in the treatment of compulsive behaviors.
Comments
New research at the Medical University of Chicago has found that a drug commonly used to treat symptoms of Alzheimer’s disease effectively reduces symptoms for adults who experience compulsive hair pulling and skin pinching.
skin slagging disorder is related to obsessive-compulsive disorder, in which the person cannot avoid carrying out a particular action.It can be triggered by: boredom, stress or anxiety or negative emotions, such as guilt or shame.
Treatment with the drug memantine was associated with significant improvements compared to placebo for patients with trichotillomania (a disorder in which people cannot resist the temptation to pull out their hair) and skin scratching disorder (also known as
Currently, the U.S. Food and Drug Administration (FDA) has not approved any medications for the disorders, which can cause obvious hair loss and skin damage, emotional distress and reduced ability to function socially, at school or at work, said lead author Dr. Jon Grant. Professor of Psychiatry and Behavioral Neuroscience at the Medical University of Chicago.
“A person’s self-esteem is greatly affected by these behaviors, so they may not attend interviews for a better job, for example.They may not have the social life they want,” Grant said.
Trichotillomania and skin pinching disorder are considered two separate diagnoses, but they have many similarities. Cognitive behavioral therapy is a first-line treatment, but finding therapists well-versed in the disorders can be difficult, she said. “People often feel they have to educate the doctor,” Grant said.
Source – https://www.intramed.net/103806