In a post on her Alternative Medicine Blog, Cathy Wong noted that the supplement N-Acetylcysteine (NAC) could help tame trichotillomania.
She cited a study in which 50 people with trichotillomania took either a NAC supplement or a placebo pill daily. According to the study’s author, NAC appeared to moderate levels of glutamate, which is a brain chemical known to trigger excitement.
The study’s authors believe this may lead to a decreased desire to pull.
Secondary therapy to help stop pulling hair
We believe NAC can be beneficial for trichotillomania, but we use it mainly as a secondary therapy, and only if needed.
There are two reasons for this approach.
1. Glutamate is a secondary excitatory transmitter
As Cathy Wong noted in her post, NAC is thought to exhibit its largest effects of glutamate, a secondary excitatory transmitter. (Read this previous stop pulling hair out post for more on excitatory transmitters.)
In our clinic, we have confirmed the work of Marty Hinz, MD, that the primary neurotransmitters in the brain are serotonin, dopamine, norepinephrine and epinephrine.
What we’ve found is that once we’ve corrected the primary neurotransmitter imbalances, the secondary neurotransmitters – i.e., the glutamate – will often self-regulate and correct themselves.
2. Balancing the excitatory neurotransmitters with the inhibitory neurotransmitters
We also believe that it’s essential to balance the excitatory neurotransmitters with the inhibitory neurotransmitters. This is a crucial step in long term success.
With trichotillomania, the primary inhibitory neurotransmitter is serotonin. GABA is the secondary (gamma aminobutyric acid) inhibitory neurotransmitter (and works in connection with glutamate).
If you don’t achieve this balance, and raise only the excitatory neurotransmitters (by administering NAC, for example), you will create further imbalance with time. The reason for this has to do with how the neurotransmitters are broken down. The result will be even more symptoms to add to the trichotillomania. These could include depression, anxiety, sleep disturbances, food cravings, and more.
The study mentioned by Cathy Wong is one of many short-term solutions that won’t stand the test of time for most people with trich. Here’s a link to another study which indicates the need to use NAC and SSRI medications (which will work on the inhibitory neurotransmitters.)
Again, these approaches are headed in the direction, but don’t yield the long-term solutions we’ve produced by managing the primary excitatory and inhibitory neurotransmitters in a balanced long-term fashion.
