Should I use Medications for Trichotillomania?

Harris Harrington explains why medication is not the best option for curing trichotillomania.

CapsulesI am not a licensed psychologist, or psychiatrist.  This article is simply a list of ideas regarding the use of medications in treating trichotillomania. Before taking any medications for trichotillomania you must consult with a psychiatrist who has experience in this area. This article does not recommend the use of medications. Medications have many potential side effects, some of them irreversible, and many medications may increase hair pulling.

Before considering or trying medications, undergo behavior therapy

There is no known cure for TTM using medication.

There are very few studies on medications for Trichotillomania. No known medication cure exists for the disorder.

Some studies have shown that cognitive and behavioral therapy (the type of therapy I teach in my program) is superior to medications.

I personally overcame trich without the use of medications.

Before trying medications, I urge you to give behavioral therapy a chance. Medications are not risk free. There are many medications that may cause serious irreversible side effects, and even death. Many medications increase hair pulling. Likewise, you should give yourself a chance to overcome trichotillomania of your own accord without taking a pill.

I also want to caution you against medications because if your pulling has gone on for many years or decades, you may feel a lack of confidence in yourself to overcome the disorder without medications. You may see medications as a light at the end of a tunnel. This view is not accurate. It’s very likely that every “technique” you tried was actually counterproductive, and you likely haven’t undergone a proper course of treatment as outlined in my program.

The principles, mindset shifts, and techniques in my program have been used by many people to completely overcome the disorder. With that said, if you have undergone significant cognitive and behavioral therapy for the disorder, have gone through stress management and relaxation techniques, and have even managed any other problems but STILL have the full blown disorder, you may want to talk to a very experienced psychiatrist about medications. Preferably the psychiatrist would have years of experience with trichotillomania sufferers.

When talking to a therapist, keep in mind that some therapists are extremely pro-medication, and others tend to be hesitant to use medication. The pro-medication therapist’s bias may not be the most informed, and it may still not be in your best interest to use medications for trich if they recommend it. Remember that you must empower yourself with knowledge before trying any medication. Many people have become a “statistic” with medications, and you want to make sure that you take responsibility for being aware of any and all possible side effects, no matter how rare.

Even if you do take medications, the psychiatrist (if he is any good) will also urge you to do behavior therapy, stress reduction, and other techniques. It goes without saying that if medications do help you at all, then using my program in conjunction with medications will help you achieve an even better result.

It bears repeating that medications should really only be used if therapy has not helped you, and you have truly addressed the problem. Keep in mind that many people currently on medications still pull just as much as they did previously.

A rule of thumb about medications for TTM:

If a medication increases arousal, or results in hyperactivity, this will likely increase your hair pulling. People tend to pull to either escape overarousal (anxiety) or underarousal (boredom).

Anafranil (Clomipramine)

Anfranil is a tricyclic anti-depressant that has been around for decades. Tricyclics are an older medication than SSRIs (another common class of medications used for TTM). Tricyclics tend to have more side effects than SSRIs, but often times are more effective. Side effects of Anafranil are usually worst in the first few weeks, and the benefits may not be felt until 2-4 weeks. Anafranil is also commonly used to treat OCD, depression, panic disorder,

If used under the guidance of a trained psychiatrist, Anafranil may be one of your better bets for reducing trich symptoms and minimizing side effects.

Likewise, if you suffer from obsessive-compulsive disorder, Anafranil may help you.

Make sure before trying this medication that you not only talk with an experienced psychiatrist, but that you also make yourself aware of ALL potential side effects, some of them irreversible. These side effects include weight gain, sexual dysfunction, seizures, tardive dyskinesia, death, etc. The list of potential side effects for most medications is so long they can’t be listed here. It should be noted that most serious, irreversible or life threatening side effects with Anafranil are rare when used safely.

In addition, it is smart to use the minimum effective dose as possible when using this drug or any other medication.

SSRIs (Selective Serotonin Reuptake inhibitors)

SSRIs are more commonly used than tricyclic anti-depressants these days because they have fewer side effects, but they are most likely less effective at treating Trichotillomania than Anafranil. The most well known example is Prozac. Though they have fewer side effects, there are still withdrawal symptoms that occur when reducing the dosage of these drugs.

In conclusion, the most common medication used to treat trich is Anafranil (Clomipramine) followed by one of many SSRIs.

In my program I show you how to overcome trich without medications.