Posted by elleff on June 23, 2003, at 4:35:36
In reply to Re: Cuticle destructionEddie, posted by 2em on June 22, 2003, at 22:24:42
It's interesting to read the posts of so many who are afflicted in the same graphically awful ways. I have also had this problem since at least my early teenage years - and pretty continuously for 30 or so years thereafter. For me it's also associated, more episodically, with severe chewing of the inside of my lips and cheeks.
I made a serendipitous discovery last year that might be useful to some: Selegiline almost completely stops my cuticle, nail and lip destruction, whereas nothing else has ever made any difference. Selegiline (at 15mg per day) also, for me, works better for my ADD and atypical depressive symptoms than anything else I've tried for either. I've had, over the past 15 years or so, pretty adequate trials of TCAs, nonselective MAOIs, and SSRIs for depression. Parnate was definitely the best of these for me as I'm sure it helped my ADD symptoms very well long before I recognised that I had them. After these were recognised in syndromal form a few years ago I was given a trial of Ritalin (which I found mind-bendingly mentally slowing) and Dexamphetamine (which was considerably better). I don't however like the "speedy" feeling of DA particularly and, in retrospect Parnate felt pretty similar. There is a strong history of ADD in my family - I'm certainly not the most outstanding case. As well, though no-one has Tourette's Syndrome in full form, many of us have motor tics and what I would think of as an array of unusual "habit spasms", mostly involving our hands. I'm the only severe nail and cuticle biter.
I tried Selegiline after tracking down a few papers which suggested it worked very well for patients with combined ADHD and Tourette's Syndrome, eg. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=8442708&dopt=Abstract
In this paper Jankovic mentions that 21 of 26 patients with this combined disorder reported that selegiline (5-15mg per day) was better than either Ritalin or Dexamphetamine. That's certainly my experience too. The really surprising thing was that my nail and cuticle chewing went down 95% too!
It may be irrelevant, but it's certainly interesting to note that there is a congenital mental retardation syndrome with is characterised by awful chewing mutilation of lips and hands (ie. not just nails and cuticles, but also fingertips and even whole fingers): Lesch-Nyhan Syndrome which results from homozygous deficiency of the enzyme hypoxanthine guanine phosphoribosyltransferase, an enzyme in the purine salvage pathway. Don't ask me how, but the resulting metabolic abnormality causes severe deficiencies in development of dopaminergic pathways in the developing brain, eg see http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11882343&dopt=Abstract
Maybe it's the case that in some people cuticle chewing is a manifestation of dopaminergic or phenyethylaminergic dysfunction. Certainly Selegiline has worked well for me and I've be interested in hearing of any other similar or contrary experiences.
elleff
poster:elleff
thread:235679
URL: http://www.dr-bob.org/babble/20030619/msgs/236240.html