N-acetylcysteine in the treatment of skin-picking disorder

Silva-Netto, Regina; Jesus, Gustavo Nobre de; Nogueira, Marcelo Saito; Tavares, Hermano

doi:10.1590/1516-4446-2013-1154

Cited by 27 publications

(24 citation statements)

References 3 publications

(3 reference statements)

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“…There are case reports describing the therapeutic benefit of using NAC in TTM (Odlaug & Grant, 2007;Rodrigues-Barata, Tosti, Rodriguez-Pichardo, & Camacho-Martinez, 2012;Silva-Netto, Jesus, Nogueira, & Tavares, 2014;Taylor & Bhagwandas, 2014). One large double-blind placebo-controlled study enrolled 50 adults who received either 1,200 mg/day of NAC over a 6-weeks period and 2,400 mg/day for another 6 weeks.…”

Section: N-acetyl Cysteinementioning

confidence: 99%

Trichotillomania (hair pulling disorder): Clinical characteristics, psychosocial aspects, treatment approaches, and ethical considerations

França

Kumar

Castillo

et al. 2018

Dermatologic Therapy

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Trichotillomania (hair pulling disorder) is a fairly common but underreported disorder characterized by recurrent episodes of pulling hair from different parts of the body. Currently classified in Diagnostic and Statistical Manual of Psychiatric Disorders (DSM-5) under the heading of the "Obsessive-compulsive spectrum and related disorders." The estimated prevalence data suggest that 0.5-2% of the general population suffers from this disorder. Stress and anxiety are directly correlated to the production of trichotillomania symptoms. The psychosocial aspects of trichotillomania are greatly underestimated, but recent literature suggests an increased interest in this neglected area. Although no FDA approved medications are available for the treatment of trichotillomania, a variety of medications including N-acetylcysteine have shown benefit in case reports. Combined liaison clinics, with an interdisciplinary approach, are highly advisable in the treatment of these cases.

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Section: N-acetyl Cysteinementioning

confidence: 99%

Trichotillomania (hair pulling disorder): Clinical characteristics, psychosocial aspects, treatment approaches, and ethical considerations

França

Kumar

Castillo

et al. 2018

Dermatologic Therapy

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“…However, one patient did not have regrowth of the hair on her eyebrows and eyelashes. One patient in a case report by Silva‐Netto et al . had both SPD and TTM.…”

Section: Resultsmentioning

confidence: 99%

“…Of these, 15 were excluded, leaving 14 included papers. An additional case report in the references of an included article was found to meet inclusion criteria, leading to a total of 15 papers included in this review (Table ) …”

Section: Resultsmentioning

confidence: 99%

A review of N‐acetylcysteine in the treatment of grooming disorders

et al. 2019

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Background Pathologic grooming disorders can lead to clinically significant distress and functional impairment. Studies on treatment of these disorders with selective serotonin reuptake inhibitors (SSRIs) and anticonvulsants have led to inconsistent findings. Nacetylcysteine (NAC) has shown promise in treatment of obsessive-compulsive and related disorders. The objective of this article is to perform an updated review of NAC in the treatment of grooming disorders. Methods PubMed was searched from inception to October 2017 to identify literature on the use of NAC in the management of trichotillomania, onychophagia, and pathological skin picking. Case reports, case series, and randomized controlled trials were included. Data on study design, dosing regimens, comorbidities, concurrent treatment, and side effects were extracted from the included articles.Results Fifteen articles were included in this review, which consisted of 10 case reports, one case series, and four randomized controlled trials. Dosing of oral NAC ranged from 450 to 2,400 mg per day, and treatment periods lasted from 1 to 8 months. Side effects were uncommon, mild, and usually gastrointestinal in nature, with severe aggression reported in one child.Conclusions While there are multiple reports of the safety and efficacy of NAC in the treatment of grooming disorders, there are currently few randomized controlled trials on this topic, and more research is needed to develop a formal treatment algorithm. While current data should be considered very preliminary, case reports have demonstrated mostly positive results and a lack of significant side effects. A trial of NAC may be a viable option for pathologic grooming disorders, especially in patients who have failed prior psychologic or pharmacologic treatment.

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“…Indeed, the GSH-precursor, NAC, has demonstrated preliminary efficacy in the treatment of OCD (65–67) and other OCRD such as trichotillomania (68–70), excoriation disorder (69, 71) and nail biting (69, 72). While others have theorized that the beneficial effects of NAC in OCRD result from its ability to modulate glutamatergic neurotransmission (68), we propose that NAC’s capacity to increase GSH synthesis may also play a significant role.…”

Section: Discussionmentioning

confidence: 99%

Lower Posterior Cingulate Cortex Glutathione Levels in Obsessive-Compulsive Disorder

Brennan

Jensen

Perriello

et al. 2016

Biological Psychiatry: Cognitive Neuroscience and Neuroimaging

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Background Several lines of evidence support the hypothesis that lower cerebral levels of glutathione (GSH), associated with increased oxidative stress, may contribute to obsessive-compulsive disorder (OCD). However, no studies to date have investigated brain GSH levels in individuals with OCD. Methods Twenty-nine individuals with OCD and 25 age-, sex-, and race-matched comparison individuals without OCD underwent single voxel 2D J-resolved proton magnetic resonance spectroscopy (MRS) to examine GSH levels in the posterior cingulate cortex (PCC). MRS data were analyzed using LCModel and a simulated basis set. Group metabolite differences referenced to total creatine (Cr), as well as relationships between metabolite ratios and symptom severity as measured by the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS), were analyzed using linear regression with adjustment for age, sex, and race. Results One OCD participant failed to produce usable PCC MRS data. We found significantly lower PCC GSH/Cr in OCD participants compared with non-OCD participants (β = −0.027 [95% CI: −0.049 to −5.9 × 10−3]; P = 0.014). PCC GSH/Cr was not significantly associated with total Y-BOCS score in the OCD group (β = 5.7 × 10−4 [95% CI: −4.8 × 10−3 to 5.9 × 10−3]; P = 0.83). Conclusions Lower PCC GSH/Cr may be indicative of increased oxidative stress secondary to hypermetabolism in this brain region in OCD. Future MRS studies are warranted to investigate GSH levels in other brain regions that comprise the cortico-striato-thalamo-cortical circuit thought to be abnormal in OCD.

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N-acetylcysteine in the treatment of skin-picking disorder

Cited by 27 publications

References 3 publications

Trichotillomania (hair pulling disorder): Clinical characteristics, psychosocial aspects, treatment approaches, and ethical considerations

Trichotillomania (hair pulling disorder): Clinical characteristics, psychosocial aspects, treatment approaches, and ethical considerations

A review of N‐acetylcysteine in the treatment of grooming disorders

Lower Posterior Cingulate Cortex Glutathione Levels in Obsessive-Compulsive Disorder

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