Memantine therapy lessens hair pulling, skin picking in adults

Treatment with memantine significantly reduces hair pulling and skin-picking symptoms when compared with placebo, demonstrating relatively high efficacy and tolerability, reports a study.

“Trichotillomania and skin-picking disorder are underrecognized and often disabling conditions in which individuals repeatedly pull at their hair or pick at their skin, leading to noticeable hair loss or tissue damage,” the authors said.

To determine whether memantine, a glutamate modulator, is more effective than placebo in reducing hair-pulling and skin-picking behaviour, a double-blind trial was conducted in 100 adults with trichotillomania or skin-picking disorder (mean age 31.4 years, 86 women). Participants were assigned to receive either memantine 10‒20 mg/day or placebo for 8 weeks.

The authors then assessed participants with measures of pulling and picking severity. They examined outcomes using a linear mixed-effects model. The primary outcome measure was treatment-related change on the National Institute of Mental Health (NIMH) Trichotillomania Symptom Severity Scale, modified to include skin picking.

Memantine treatment resulted in significant improvements in scores on the NIMH scale, Sheehan Disability Scale, and Clinical Global Impressions severity scale in terms of treatment-by-time interactions as compared with placebo.

Overall, 60.5 percent of participants in the memantine group reported “much or very much improved” symptoms compared with just 8.3 percent of participants in the placebo group (number needed to treat, 1.9). Additionally, no significant between-group difference was observed in adverse events.

“The glutamate system may prove to be a beneficial target in the treatment of compulsive behaviors,” the authors said.