Gadde Kishore M, Ryan Wagner Harry, Connor Kathryn M, Foust Mariko S
Duke University Medical Centre, Durham, NC 27710, USA.
Int Clin Psychopharmacol. 2007 Jan;22(1):39-42. doi: 10.1097/YIC.0b013e3280113d2b.
With the understanding that serotonergic drugs might curb compulsive hair pulling, we conducted a preliminary investigation examining the effectiveness of escitalopram, a potent and selective serotonin uptake inhibitor, in the treatment of trichotillomania. Twenty women meeting the Diagnostic and Statistical Manual-IV-Text revision criteria for trichotillomania participated in a 12-week open-label trial of treatment with escitalopram 10-30 mg/day. Response was prospectively defined as meeting the following criteria: (i) clinician version of clinical global impressions-improvement scale score of 1 or 2 (very much improved or much improved), and (ii) > or =50% reduction from baseline in the National Institute of Mental Health trichotillomania severity scale total score. Sixteen individuals, who had at least one postbaseline assessment, were included in the intention-to-treat analysis. Eight individuals (50%) were judged to be responders. Trichotillomania severity scale mean (SE) total score decreased significantly over time in the intention-to-treat analysis [15.4 (0.9)-9.4 (1.4); F=7.3; P<0.0001] and for completers [15.8 (1.0)-7.5 (1.2); F=10.1; P<0.0001]. Side effects were mild. Escitalopram treatment for 12 weeks led to significant improvement of trichotillomania in some patients in this small open-label trial.
鉴于血清素能药物可能抑制强迫性拔毛行为，我们进行了一项初步调查，研究强效选择性血清素再摄取抑制剂艾司西酞普兰治疗拔毛癖的有效性。20名符合《精神疾病诊断与统计手册》第四版修订版拔毛癖诊断标准的女性参与了一项为期12周的开放标签试验，接受每天10 - 30毫克艾司西酞普兰治疗。反应被前瞻性地定义为符合以下标准：（i）临床医生版临床总体印象改善量表评分为1或2（显著改善或明显改善），以及（ii）国立精神卫生研究所拔毛癖严重程度量表总分较基线降低≥50%。16名至少有一次基线后评估的个体被纳入意向性分析。8名个体（50%）被判定为有反应者。在意向性分析中，拔毛癖严重程度量表平均（SE）总分随时间显著下降[15.4（0.9）- 9.4（1.4）；F = 7.3；P < 0.0001]，完成治疗者也是如此[15.8（1.0）- 7.5（1.2）；F = 10.1；P < 0.0001]。副作用轻微。在这项小型开放标签试验中，12周的艾司西酞普兰治疗使部分患者的拔毛癖有显著改善。
