A Randomized, Double-Blind, Placebo-Controlled Trial of Olanzapine in the Treatment of Trichotillomania

Ameringen, Michael Van; Mancini, Catherine; Patterson, Beth; Bennett, Mark; Oakman, Jonathan M.

doi:10.4088/jcp.09m05114gre

Cited by 110 publications

(69 citation statements)

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“…Although initially considered effective in TTM (Stein et al, 1997), more recent studies report that SSRIs are ineffective in TTM (Streichenwein and Thornby, 1995; van Minnen et al, 2003) or only effective in a specific subgroup of TTM patients (Stanley et al, 1997a; Gadde et al, 2007). More recent clinical trials showed that treatment with atypical antipsychotics, such as olanzapine and aripiprazole, which exert their effects on among others, the serotonergic and dopaminergic system, are more promising (Van Ameringen et al, 2010; White and Koran, 2011). …”

Section: Inhibition In Other Frontal–striatal Disordersmentioning

confidence: 99%

Response Inhibition and Interference Control in Obsessiveâ€“Compulsive Spectrum Disorders

Velzen

Vriend

Wit

et al. 2014

Front. Hum. Neurosci.

139

128

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Over the past 20 years, motor response inhibition and interference control have received considerable scientific effort and attention, due to their important role in behavior and the development of neuropsychiatric disorders. Results of neuroimaging studies indicate that motor response inhibition and interference control are dependent on cortical–striatal–thalamic–cortical (CSTC) circuits. Structural and functional abnormalities within the CSTC circuits have been reported for many neuropsychiatric disorders, including obsessive–compulsive disorder (OCD) and related disorders, such as attention-deficit hyperactivity disorder, Tourette’s syndrome, and trichotillomania. These disorders also share impairments in motor response inhibition and interference control, which may underlie some of their behavioral and cognitive symptoms. Results of task-related neuroimaging studies on inhibitory functions in these disorders show that impaired task performance is related to altered recruitment of the CSTC circuits. Previous research has shown that inhibitory performance is dependent upon dopamine, noradrenaline, and serotonin signaling, neurotransmitters that have been implicated in the pathophysiology of these disorders. In this narrative review, we discuss the common and disorder-specific pathophysiological mechanisms of inhibition-related dysfunction in OCD and related disorders.

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Section: Inhibition In Other Frontal–striatal Disordersmentioning

confidence: 99%

Response Inhibition and Interference Control in Obsessiveâ€“Compulsive Spectrum Disorders

Velzen

Vriend

Wit

et al. 2014

Front. Hum. Neurosci.

139

128

View full text Add to dashboard Cite

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“…Controlled clinical trials evaluating potential pharmacological interventions for trichotillomania have demonstrated that N-acetyl cysteine (Grant et al 2009), olanzapine (Van Ameringen et al 2010), and clomipramine (Swedo et al 1993) all show some promise in reducing hair-pulling behavior. Similarly, psychosocial interventions, particularly cognitive behavioral therapy, have become established treatments for trichotillomania (Keuthen et al 2011;Woods et al 2006a, b;Diefenbach et al 2006), but few individuals seek these treatments or can find trained therapists.…”

Section: Introductionmentioning

confidence: 99%

Dronabinol, a cannabinoid agonist, reduces hair pulling in trichotillomania: a pilot study

et al. 2011

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This study, the first to examine a cannabinoid agonist in the treatment of trichotillomania, found that dronabinol demonstrated statistically significant reductions in trichotillomania symptoms, in the absence of negative cognitive effects. Pharmacological modulation of the cannabinoid system may prove useful in controlling a range of compulsive behaviors. Given the small sample and open-label design, however larger placebo-controlled studies incorporating cognitive measures are warranted.

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“…While antipsychotic medications (e.g., olanzapine, aripiprazole) have demonstrated efficacy in open-label trials (Stewart and Nejtek, 2003; White and Koran, 2011), only one RCT has evaluated the efficacy of olanzapine and identified its therapeutic benefit relative to placebo (Van Ameringen et al, 2010). Comparatively, antidepressant medications (e.g., clomipramine, fluoxetine, sertraline) remain the most frequently used treatment for individuals with TTM (Franklin et al, 2008; Woods et al, 2006a), but have mixed evidence across RCTs (Christenson et al, 1991a; Dougherty et al, 2006; Ninan et al, 2000; Streichenwein and Thornby, 1995; Swedo et al, 1989; van Minnen et al, 2003), with some evidence of long-term therapeutic benefit (Swedo et al, 1993).…”

Section: Introductionmentioning

confidence: 99%

Treating trichotillomania: A meta-analysis of treatment effects and moderators for behavior therapy and serotonin reuptake inhibitors

McGuire

Ung

Selles

et al. 2014

Journal of Psychiatric Research

121

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Few randomized controlled trials (RCTs) exist examining the efficacy of behavior therapy (BT) or serotonin reuptake inhibitors (SRIs) for the treatment of trichotillomania (TTM), with no examination of treatment moderators. The present meta-analysis synthesized the treatment effect sizes (ES) of BT and SRI relative to comparison conditions, and examined moderators of treatment. A comprehensive literature search identified 11 RCTs that met inclusion criteria. Clinical characteristics (e.g., age, comorbidity, therapeutic contact hours), outcome measures, treatment subtypes (e.g., SRI subtype, BT subtype), and ES data were extracted. The standardized mean difference of change in hair pulling severity was the outcome measure. A random effects meta-analysis found a large pooled ES for BT (ES= 1.41, p< 0.001). BT trials with greater therapeutic contact hours exhibited larger ES (p= 0.009). Additionally, BT trials that used mood enhanced therapeutic techniques exhibited greater ES relative to trials including only traditional BT components (p= 0.004). For SRI trials, a random effects meta-analysis identified a moderate pooled ES (ES= 0.41, p= 0.02). Although clomipramine exhibited larger ES relative to selective serotonin reuptake inhibitors, the difference was not statistically significant. Publication bias was not identified for either treatment. BT yields large treatment effects for TTM, with further examination needed to disentangle confounded treatment moderators. SRI trials exhibited a moderate pooled ES, with no treatment moderators identified. Sensitivity analyses highlighted the need for further RCTs of SRIs, especially among youth with TTM.

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A Randomized, Double-Blind, Placebo-Controlled Trial of Olanzapine in the Treatment of Trichotillomania

Abstract: clinicaltrials.gov Identifier: NCT00182507.

Cited by 110 publications

References 0 publications

Response Inhibition and Interference Control in Obsessiveâ€“Compulsive Spectrum Disorders

Response Inhibition and Interference Control in Obsessiveâ€“Compulsive Spectrum Disorders

Dronabinol, a cannabinoid agonist, reduces hair pulling in trichotillomania: a pilot study

Treating trichotillomania: A meta-analysis of treatment effects and moderators for behavior therapy and serotonin reuptake inhibitors

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