Medication for Trichotillomania

Some doctors prescribe medication to treat trichotillomania. Many different types have been tried and discussed by our website users; although none have yet been found a resounding success at treating trichotillomania. Medication can be helpful for treating anxiety problems that often accompany trich. We recommend that you consult your doctor if you want to try medication.

See our survey results of 1,342 people's experiences with certain medications they tried: what worked for them and what didn't. Read our forum to hear other people’s views on medications they have tried.

There have been many research projects into medication for trichotillomania, with limited results. Trichsters are often given medication for OCD. OCD compulsions are often the result of compulsive thoughts, such as "I must do this to prevent that"; by contrast, hair pulling is not usually preceded by such thoughts or cognitive problems. Trichotillomania symptoms most often begin in early adolescence (9 - 13), while OCD usually begins in late teens (Himle et al., 1995). Selective serotonin reuptake inhibitors (SSRIs) and exposure treatments are effective for OCD, but have not been shown to prevent pulling.

Certain reported similarities have been found between motor tic urges and hair pulling urges (Prado et al., 2008). Van Ameringen et al., 2006 tested the antipsychotic Olanzapine (10.8 mg/daily), on people with trichotillomania. This medication has been effective for treating motor tics. Of the trichsters, 85% of those given olanzapine pulled less than before, as compared to 17% of those taking the placebo. There may therefore be a positive outcome with the well supervised use of Olanzapine in treating trichotillomania, especially if used alongside behavioral modification therapy.

Most of the major medical and psychiatric journals contain misinformation about trichotillomania and some advocate the use of medications which can be unhelpful to trichsters. Many medications prescribed for trichotillomania cause tiredness, and tiredness increases urges to pull. This might explain why urges are often reported to increase with medication.

We have seen no evidence to recommend medication for trichotillomania. Our studies of over five thousand people who have been medicated for trichotillomania reveal that no one has stopped pulling through medication alone, and that for many, pulling was made worse. Anti-depressants and SSRIs do not work for trichotillomania but should still be taken if prescribed for co-existing health conditions.