“Trichotillomania is an impulse control disorder or form of self-injury characterized by the repeated urge to pull out scalp hair, eyelashes, facial hair, nose hair, pubic hair, eyebrows or other body hair, sometimes resulting in noticeable bald patches. Trichotillomania is classified in the DSM-IV (Diagnostic and Statistical Manual of Mental Disorders) as an impulse control disorder. It may seem, at times, to resemble a habit, an addiction, a tic disorder or an obsessive-compulsive disorder. Trichotillomania often begins during the individual’s teenage years. Depression or stress can trigger the condition. Due to social implications the disorder is often unreported and it is difficult to predict accurately prevalence (1)” but it is estimated to affect 2-4% of the population and seems to be more common in women than men.
Usually trichotillomania is treated with SSRI (Selective Serotonin Reuptake Inhibitor) anti-depressant drugs which many people prefer not to take due to the potential side-effects. Researchers at the University of Minnesota Medical School have just published a study (2) which suggests that NAC (N-Acetylcysteine) a commonly available health food supplement may help to stop the urges of those suffering with trichotillomania. NAC is an amino acid that acts as an antioxidant in the body.
The study(2) was small but well designed involving 50 trichotillomania sufferers, with an average age of around 34, for 12 weeks. Half were given 1,200mg of NAC each day for 6 weeks. For the following 6 weeks they were given 2,400mg NAC per day. The other half were given placebo (inactive) supplements. After 9 weeks, those taking NAC had a significant reduction in the incidence of hair-pulling. After 12 weeks 56% of those on the NAC supplement reported feeling much, or very much improved (compared to only 16% of those on the placebo). No side-effects were found when taking the NAC supplement.
The study offers significant hope to sufferers of this distressing self-harming condition and is also an important study as it is one of the first studies of compulsive behaviours to look at lowering levels of glutamate, a chemical that triggers excitement, in the brain to curb harmful behaviours. NAC seems to affect levels of glutamate in a very specific area of the brain which may be why it seems to help patients curb their self-harmful behaviour.
Dysfunction of glutamate-mediated brain nerve functions has also been implicated in obsessive-compulsive disorder (OCD). The study authors believe that NAC and other glutamate modulators may be applicable to other disorders, addictions and compulsive behaviours. Prior to this study a case was documented (3) where NAC was shown to be clinically helpful for a sufferer of OCD (obsessive compulsive disorder). Further studies are certainly warranted in this area, especially since many individuals are looking for natural alternatives to psychiatric drugs. It may be that NAC will be useful in conjunction with other known nutritional mood influencing aids, I certainly look forward to further studies being published in this area.
If you are suffering with trichotillomania (or other compulsive behaviours) you may wish to contact the following online support networks and may wish to speak to your doctor or health professional about trying NAC to see if it is useful for you:
UK and Ireland Trichotillomania Support Group and the Trichotillomania Support Online
(1)http://wapedia.mobi/en/Trichotillomania
(2) Grant JE et al. 2009. N-Acetylcysteine, a Glutamate Modulator, in the Treatment of Trichotillomania: A Double-blind, Placebo-Controlled Study. Arch Gen Psychiatry. 66(7):756-763
(3) Lafleur DL et al. 2006. N-acetylcysteine augmentation in serotonin reuptake inhibitor refractory obsessive-compulsive disorder. Psychopharmacology. 184(2):254-256.
(Written by Ani Kowal)
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