Small Study: Olanzapine Effective against Trichotillomania

Article excerpt

PARIS -- Trichotillomania was highly responsive to olanzapine in a small, randomized, placebo-controlled trial that suggests repetitive hair pulling may be closer to tics and Tourette's syndrome than to other obsessive-compulsive disorders.

Eleven of 13 patients (85%) on olanzapine (Zyprexa) improved during the 12-week trial reported by Dr. Michael Van Ameringen at the annual congress of the European College of Neuropsychopharmacology. Only 2 of 12 patients (17%) on placebo were able to stop pulling out their hair.

Dr. Van Ameringen, codirector of the anxiety disorders clinic at McMaster University in Hamilton, Ont., said he and his colleagues began testing antipsychotics because treatments for obsessive-compulsive disorder have been largely ineffective in patients with trichotillomania.

The investigators wondered, he said, whether the condition might be closer to tics and Tourette's syndrome, disorders characterized by compulsive urges and ritualistic behavior that also do not respond to the selective serotonin reuptake inhibitors (SSRIs) used for obsessive-compulsive disorder.

"We found a very robust effect in our study (85% vs. 17%).... It would be one of the biggest drug-placebo differences in psychiatry if it holds up in larger trials," Dr. Van Ameringen said in an interview at the meeting.

The investigators had previously studied haloperidol (Haldol) with good results in this population though not in a placebo-controlled trial, he said. They also have had positive clinical experiences with risperidone (Risperdal) and quetiapine (Seroquel), he added. Dr. Van Ameringen said he would like to see a large, randomized, controlled trial with one of the new atypical antipsychotics if he could find funding. Eli Lilly Canada provided medication for the olanzapine trial.

The 25 participants ranged in age from 18 to 35 years, with a mean age of 33. …