Behavioral therapy and selective serotonin reuptake inhibitors have both been reported effective in the treatment of trichotillomania. Dutch researchers examined the efficacy of behavioral therapy and fluoxetine (Prozac) 60 mg/day compared with a waiting-list control group. Forty-three patients with trichotillomania participated in this 12-week, randomized, controlled study. Forty patients (behavioral therapy, 14; fluoxetine, 11; wait list, 15) completed the trial.
Treatment effects were evaluated using the Massachusetts General Hospital Hairpulling Scale. Severity of hair loss was rated by independent assessors. General symptoms of psychopathologic abnormalities and depression were also measured.
Behavioral therapy was found to be superior for reducing the symptoms of trichotillomania. Patients in the behavioral therapy group had significantly reduced trichotillomania symptoms, higher effect sizes (behavioral therapy, 3.80; fluoxetine, 0.42; wait list, 1.09), and more clinically significant changes than patients in the fluoxetine and wait-list groups (behavioral therapy, 64%; fluoxetine, 9%; wait list, 20%). A similar trend was also found for severity of hair loss. No significant differences between groups were established for general psychopathologic and depressive symptoms.
The researchers concluded, "Behavioral therapy is highly effective for reducing symptoms of trichotillomania in the short term, whereas fluoxetine is not."
Reference: van Minnen A, Hoogduin KA, Keijsers GP et al. (2003), Treatment of trichotillomania with behavioral therapy or fluoxetine: a randomized, waiting-list controlled study. Arch Gen Psychiatry 60(5):517-522.
Low Nevirapine Plasma Concentrations Predict Virological Failure in an Unselected HIV-1-Infected Population
De Vries and colleagues (2003) reported on the results of a study assessing plasma nevirapine (Viramune) concentrations and plasma HIV-1 RNA response in patients infected with HIV-1.