Alzheimer’s Disease Drug May Improve Trichotillomania

A drug used to treat Alzheimer’s disease is associated with significant improvements in symptoms of adults who suffer from trichotillomania or excoriation disorder (skin-picking disorder).¹

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Study authors at the University of Chicago Medicine enrolled 79 adults with either disorder in a double-blind trial of memantine (Namenda)or a placebo for 8 weeks. The patients were assessed every 2 weeks using the National Institute of Mental Health Trichotillomania Symptom Severity Scale (modified for skin-picking). Researchers recorded the changes using 4 other self-reported and clinician-observed reports of symptoms and behaviors.

The study found that after 8 weeks, 26 of the 43 patients on memantine showed significant improvement. 6 of them reported complete relief of symptoms. The analysis found that memantine is more effective than other treatments studied thus far, including behavioral therapy, the drug olanzapine (used to treat schizophrenia and bipolar disorder), the drug clomipramine (used to treat obsessive-compulsive disorder), and N-acetylcysteine (an over-the-counter supplement).

There is no current medication approved by the US Food and Drug Administration for either disorder. Trichotillomania and excoriation disorder can cause skin and hair loss along with emotional distress.

Memantine is approved to aid in memory loss but has also been used off-label for psychiatric disorders. The study’s lead author, Jon Grant, MD, said the medication is well-tolerated by patients and has few adverse effects, and might be considered a first-line treatment equal to behavioral therapy in the treatment process for these conditions. Trichotillomania and skin picking frequently co-occur, and both disorders commonly present with co-occurring depression or anxiety.² Grant noted that longer-term use of memantine and different doses are potential avenues for future studies.

References

1. Grant JE, Chesivoir E, Valle S, Ehsan D, Chamberlain SR. Double-Blind placebo-controlled study of memantine in trichotillomania and skin-picking disorder. AJP. 2023:appi.ajp.20220737. doi: 10.1176/appi.ajp.20220737

2. Grant J, Chamberlain S. Trichotillomania and Skin-Picking Disorder: Different Kinds of OCD. Psychiatry Online. https://focus.psychiatryonline.org/doi/10.1176/appi.focus.130212. Published April 15, 2015. Accessed March 9, 2023.