The Clinician’s Guide to the Treatment of Trichotillomania available through the Trichotillomania Learning Center website (www.trich.org) lists several potential medications that have been found useful for some people with trich.
These include clomipramine (trade name Anafranil) which has the capacity to block the reuptake of serotonin and norepinephrine, which are two key neurotransmitters in the brain and venlafaxine (Effexor), which shares similar chemical properties as clomipramine and also has documented benefits in trichotillomania. In addition, several studies using antidepressant medications that block the reuptake of serotonin alone, called selective serotonin reuptake inhibitors (SSRI’s), including fluoxetine (Prozac), fluvoxamine (Luvox), and sertraline (Zoloft), have shown mixed results.
The problem is, as the TLC site points out, that even though individuals often have a reduction in hair pulling in response to the above medications,” improvement is often modest and rarely complete. Some individuals experience initial improvement but find that the effect wears off with time.” In addition, these drugs also often create many unwanted side effects that cause people to discontinue using them.
The reason for the lackluster success of these medications is that although they are targeting one of the key reasons people experience trich – namely, neurotransmitter imbalance – they do nothing to actually restore proper neurotransmitter function in the body. They are simply shuffling the neurotransmitters around in an attempt to trick the body into thinking there is more of a given neurotransmitter than there actually is. They do nothing to actually increase the amount of the neurotransmitters present in the brain and do not help improve neurotransmitter imbalance(s) or function. However, they do cause further depletion of neurotransmitters over time, which is why the effects may ‘wear off with time’ and why many people find that their symptoms are worse when they stop taking a drug than before they started.
It is also interesting to note that even though people suffering from trich may not see a decrease in hair pulling, they may experience improvements in other areas of their lives using the drugs above. The TLC Guide states that “many individuals who do not experience much improvement in their hair pulling report improvement in other areas such as reduction of anxiety and improvement of mood.” This is because areas such as depression and anxiety are also under direct influence of neurotransmitters. However, because the drugs are not actually helping address the underlying imbalance(s), these effects will also wear off with time.
So what’s the answer? Give the body the nutrients it needs to restore proper neurotransmitter balance and function. Doing so addresses the underlying cause that creates the urge to pull for most people. It will also improve any other disorders associated with improper neurotransmitter balance, including improvements in depression, anxiety, mood, sleep, migraines and a host of other ailments. The best part is, there are no side effects, as all you are doing is restoring proper neurotransmitter balance. No tricking the body, no artificial chemicals and no urge to pull – that is a great combination for success!