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Trichotillomania is a difficult-to-treat impulse control disorder thought to be part of the “obsessive-compulsive spectrum of disorders,” although it differs from obsessive-compulsive disorder (OCD) in age of onset, sex distribution, patterns of comorbidity, and response to selective serotonin reuptake inhibitors (these are typically ineffective for trichotillomania). In a small, manufacturer-funded, 12-week trial, researchers examined the efficacy of the atypical antipsychotic olanzapine, which is effective for Tourette syndrome (which has similarities with trichotillomania).
Twenty-five patients without current major depression, OCD, psychosis, substance use disorders, or bipolar disorder were randomized to olanzapine (mean dose, 10.8 mg) …