Monoamine oxidase inhibitors (MAOIs) for trichotillomania: a case series

Grant, Jon E. and Chamberlain, Samuel (2023) Monoamine oxidase inhibitors (MAOIs) for trichotillomania: a case series. Journal of Clinical Psychopharmacology, 43 (2), 149-151. (doi:10.1097/jcp.0000000000001654).

Record type: Article

Abstract

Purpose/Background Despite several decades of research, there are no US Food and Drug Administration-approved medications for trichotillomania or medications generally approved in other geographical jurisdictions. Monoamine oxidase inhibitors show efficacy in the treatment of depression and some possible promise for obsessive compulsive disorder. Methods/Procedures We present new data from a case series collected in a specialty clinical practice over a 4-year period. Findings/Results In 5 treatment-resistant patients whose trichotillomania had not improved with at least 1 course of cognitive behavior therapy and trials of n-acetyl cysteine, an antipsychotic, and a serotonin selective reuptake inhibitor, 2 had marked clinical improvement (>40% improvement) on phenelzine, 1 improved on tranylcypromine, and 2 showed no improvement (<10%) on phenelzine. In 2 of the 3 patients who experienced improvement, there was co-occurring depression. Implications/Conclusions Monoamine oxidase inhibitors in trichotillomania may deserve large-scale randomized controlled trials, particularly in specialist settings where first-line interventions have proven inadequate to manage severe symptoms.

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e-pub ahead of print date: 26 January 2023

Published date: 1 April 2023

Additional Information: Funding Information: J.E.G. has received research grants from Janssen and Biohaven Pharmaceuticals. He receives yearly compensation from Springer Publishing for acting as editor-in-chief of the Journal of Gambling Studies and has received royalties from Oxford University Press, American Psychiatric Publishing, Inc., Norton Press, and McGraw Hill. S.R.C.'s involvement in this research was funded by a Wellcome Trust Clinical Fellowship (110049/Z/15/Z). He receives a stipend from Elsevier for editorial work. For the purpose of open access, the author has applied a CC BY public copyright license to any author accepted manuscript version arising from this submission. Publisher Copyright: © 2023 Wolters Kluwer Health, Inc.

Keywords: MAOI, pharmacotherapy, trichotillomania

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