N-Acetylcysteine in the treatment of trichotillomania: remarkable results in two patients.

ABSTRACT

BACKGROUND: The management of trichotillomania is challenging. The limited efficacy and side-effects of pharmacological medications and difficulty in long-term maintenance of behavioural therapies necessitates alternative treatment options. A dysregulated glutamatergic system has been implicated in the pathophysiology of trichotillomania. A limited number of reports indicate that N-acetylcysteine (NAC), a glutamate modulator, may be a promising treatment for this disorder. OBJECTIVES: We report two patients with trichotillomania for whom treatment with NAC was successful. METHODS: The first patient was a 30-year-old female, and the second patient was a 14-year-old girl, both who were diagnosed with trichotillomania and prescribed NAC (1200 mg/d, p.o.). RESULTS: Hair pulling behaviour subsided within 2 months and 2 weeks of initiating NAC in the first and second patient, respectively. Complete hair regrowth was observed after 4 and 6 months of NAC treatment in the first and second patient, respectively. No side-effects related to NAC were noted. CONCLUSION: NAC could be a well-tolerated and effective treatment option for trichotillomania.