An Alzheimer's Drug Might Ease Hair-Pulling Disorder
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- 01 Mar 2023
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A long-established Alzheimer’s drug can help people with a disorder that causes them to compulsively pull at their hair or pick at their skin, a new clinical trial has concluded.
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Memantine considerably improved symptoms in 3 out of 5 patients with either trichotillomania (hair-pulling disorder) or excoriation (skin-picking) disorder, researchers reported in the American Journal of Psychiatry.
“I think it was encouraging that it helped reduce the behavior of picking and pulling, compared to a placebo,” said lead researcher Dr. Jon Grant, a professor of psychiatry and behavioral neuroscience at the University of Chicago. “It gives me the idea that perhaps we're onto the right underlying mechanism that might be happening here.”
Hair-pulling and skin-picking disorders affect an estimated 3% to 4% of Americans, Grant said. Patients obsessively pull out strands of hair or pick at their skin, often doing themselves real physical harm.
Memantine inhibits the activity of glutamate, one of the most abundant neurotransmitters in the brain.
Overly high levels of glutamate in the brain can cause nerve cells to become overexcited, and this has been associated with conditions like Alzheimer’s disease, Parkinson’s disease, Lou Gehrig’s disease and multiple sclerosis, according to the Cleveland Clinic.
Glutamate also has been linked to mental health problems like mood disorders and obsessive-compulsive disorder, the Cleveland Clinic says.
The U.S. Food and Drug Administration approved memantine to treat moderate-to-severe Alzheimer’s in 2003, and it is now available as a generic medication.
But some psychiatrists have been prescribing memantine off-label to help treat obsessive-compulsive disorder, “which is sort of a cousin of hair pulling and skin picking,” Grant said.
That gave Grant an idea.
“Could a medication that affects glutamate -- such as this fairly innocuous Alzheimer's medication, which is generic, cheap and has a fairly innocuous side effect profile -- could this be beneficial” in treating trichotillomania and excoriation disorder? he said.
To test this notion, Grant and his colleagues recruited 100 adults with skin-picking or hair-pulling disorder, and randomly assigned them to take either memantine or a placebo for eight weeks.
Memantine treatment wound up “much or very much” improving symptoms in 60% of patients taking the drug, while only 8% of patients on placebo reported similar improvement.
However, only about six patients in the memantine group (11%) completely stopped picking or pulling by the end of the trial, compared with one in the placebo group (2%). Read More…
