Stein D J, Hollander E
Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, NY.
J Clin Psychiatry. 1992 Apr;53(4):123-6.
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.
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.
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.
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.
拔毛癖、抽动秽语综合征（TS）和强迫症（OCD）在现象学和治疗反应方面存在一些重叠。抗精神病药可能在TS以及难治性OCD的治疗中发挥作用，于是出现了这是否也适用于拔毛癖的问题。
在开放临床实践中，使用5-羟色胺再摄取阻滞剂治疗拔毛癖患者。当症状缓解不完全或症状复发时，添加低剂量匹莫齐特。
在7名患者中的6名中，在5-羟色胺再摄取阻滞剂基础上加用匹莫齐特使拔毛行为得到改善。在能够耐受药物治疗的患者中，这种反应得以持续。
用多巴胺阻滞剂增强5-羟色胺能药物可能在拔毛癖的治疗中发挥作用。需要进一步进行关于匹莫齐特增强治疗拔毛癖的对照试验。
