A placebo-controlled trial of cognitive-behavioral therapy and clomipramine in trichotillomania.

Abstract

BACKGROUND:

The major treatments reported to be effective in the treatment of trichotillomania are cognitive-behavioral therapy (CBT) with habit reversal and serotonin-norepinephrine reuptake inhibitors such as clomipramine. However, the 2 treatments have not been previously compared with each other. This study examines the efficacy of CBT and clomipramine compared with placebo in the treatment of trichotillomania.

METHOD:

Twenty-three patients with trichotillomania as determined by the Structured Clinical Interview for DSM-III-R entered and 16 completed a 9-week, placebo-controlled, randomized, parallel-treatment study of CBT and clomipramine. Efficacy was evaluated by the Trichotillomania Severity Scale, the Trichotillomania Impairment Scale, and the Clinical Global Impressions-Improvement scale, which were conducted by an independent assessor blinded to the treatment condition.

RESULTS:

CBT had a dramatic effect in reducing symptoms of trichotillomania and was significantly more effective than clomipramine (p = .016) or placebo (p = .026). Clomipramine resulted in symptom reduction greater than that with placebo, but the difference fell short of statistical significance. Placebo response was minimal.

CONCLUSION:

Clinicians should be aware of the potential treatments available for trichotillomania. A larger and more definitive study comparing CBT and a serotonin-norepinephrine reuptake inhibitor is indicated.

• Authors: P T Ninan, B O Rothbaum, F A Marsteller, B T Knight, M B Eccard
• Journal: The Journal of clinical psychiatry (J Clin Psychiatry) Vol. 61 Issue 1 Pg. 47-50 (Jan 2000) ISSN: 0160-6689 [Print] United States
• PMID: 10695646 (Publication Type: Clinical Trial, Comparative Study, Journal Article, Randomized Controlled Trial)

Chemical References

• Placebos
• Serotonin Uptake Inhibitors
• Clomipramine

Topics

• Adult
• Clomipramine (therapeutic use)
• Cognitive Behavioral Therapy
• Double-Blind Method
• Female
• Humans
• Male
• Middle Aged
• Placebos
• Psychiatric Status Rating Scales
• Selective Serotonin Reuptake Inhibitors (therapeutic use)
• Severity of Illness Index
• Treatment Outcome
• Trichotillomania (diagnosis, drug therapy, therapy)