Hair Pulling Halted by Amino Acid

The amino acid N-acetylcysteine (NAC) can reduce symptoms of compulsive hair-pulling, a condition known as trichotillomania.


This is according to a study published in the Archives of General Psychiatry, one of the JAMA/Archives journals.


Trichotillomania has been described for almost 200 years and researched for more than two decades. “Psychosocial problems are common in individuals with trichotillomania and include significantly reduced quality of life, reduced work productivity and impaired social functioning.” the study explains.


The amino acid N-acetylcysteine (NAC) has previously shown promise in the treatment of repetitive or compulsive disorders. N-acetylcysteine (NAC) acts on the glutamate system, the largest neurotransmitter system in the human brain.


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Jon E. Grant, J.D., M.D., M.P.H., from the University of Minnesota School of Medicine conducted a 12-week, double-blind controlled trial among 50 individuals with trichotillomania (45 women and five men). Twenty-five were randomly assigned to receive 1,200 milligrams to 2,400 milligrams of N-acetylcysteine (NAC) per day for 12 weeks; the other 25 received placebo.


After 12 weeks, patients taking the N-acetylcysteine (NAC) had significantly greater reductions in hair-pulling symptoms than those taking placebo. “Fifty-six percent of patients ‘much or very much improved’ with N-acetylcysteine use compared with 16 percent taking placebo,” the authors write. “Significant improvement was initially noted after nine weeks of treatment.” None of the participants reported adverse effects.


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The magnitude of improvement observed in patients taking N-acetylcysteine (NAC) was higher than that seen with other medications and similar to that reported for cognitive behavior therapy alone or combined with medication, suggesting that N-acetylcysteine (NAC) compares favorably with existing treatment options, the authors note. Its efficacy lends further support to the hypothesis that therapies manipulating the glutamate system (called glutamatergic agents) may target core symptoms of compulsive behaviors.


“N-acetylcysteine is an amino acid, is available in health-food stores, is cheaper than most insurance co-payments and seems to be well-tolerated. N-acetylcysteine could be an effective treatment option for people with trichotillomania,” the authors write.


Future studies should evaluate long-term effects of the treatment as well as its efficacy when combined with behavioral therapy, they conclude.


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Archives of General Psychiatry, 2009;66(7):756-763. “N-Acetylcysteine, a Glutamate Modulator, in the Treatment of Trichotillomania: A Double-blind, Placebo-Controlled Study” Jon E. Grant, JD, MD, MPH; Brian L. Odlaug, BA; Suck Won Kim, MD, Department of Psychiatry, University of Minnesota School of Medicine, Minneapolis.


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