Posted by yxibow on April 16, 2006, at 3:55:19
In reply to Meds for trichotillomania?, posted by Caedmon on April 12, 2006, at 22:55:53
> Any ideas?
>
> My Sx are mainly pulling my eyebrow hairs and skin picking and rubbing of my face and neck. It's really bothering me in conjunction w/ acne. My acne meds cause some degree of skin peeling and increased epithelial turnover. So, I end up rubbing off dead skin cells or "finding" tags of dead skin. (Acne meds are 100mg bid minocycline, also benzaclin qam and tazorac qpm.)
This is good that you have not been given Accutane in the mix as that has definite psychological side effect possibilities.
This in turn causes more acne, since I've got my stupid hands all over my face half the day. The hair pulling is less bothersome, in fact it probably keeps me somewhat groomed, lol.
>
> I know there's like, nothing. Prognosis is poor. But I'd be willing to give almost anything a shot. For the record I'm not sure if my TTM fits within an OCD spectrum problem, or is more of a motor tic (this is my inclination... not preceded by obessions or anxiety) or exists by itself (as it does in most people w/ TTM).
>
> I've heard serotonergics could help. They don't from what I've been on. I've heard antipsychotics could help. I love my Risperdal (which I take prn for manic episodes), but it's never done anything in that area and I'm too scared to try anything more hardcore such as haloperidol.
Antipsychotics generally are better on a continual basis, at least for a 30 day episode or more (as in BP). As far as old line antipsychotics, Orap (pimozide) has been used for tics, which as you mentioned TTM does fall into the OC Spectrum range. It of course carries the usual greater risk of TD. Though very high dose Risperdal is nearly the same as its chemical cousin Haloperidol which is just a molecule switch. Orap has also been used in TTM in combination with SRI/SSRIs. Clonidine (Catapres) as well.Something more lower down in the spectrum might help, since you mentioned BP as well, such as Seroquel or Zyprexa which both have been approved for BP, though one has to consider the lipid profile of course, especially with the complication of binge eating.
>
> Naltrexone you think?There has been a case report of Naltrexone in combination with Prozac although the explanation isn't entirely clear.
> I'm a 23-yr-old male. BP-II, social phobia, binge eating, and the trich. And assorted oddities. I take Parnate 10 now titrating up to 30 mg, Topamax 100mg, diazepam 10mg. Supplements: fish oil 3 g epa/dha, multivitamin, 1/3 B-complex, Vitamin E 400IU, Vitamin C 500mg, Ginkgo biloba 60mg bid.
>
> If you read my entire post and bother to reply, I would like to take you out for drinks. Thanks,
>
> - CCBT though in combination with any of the above probably holds a higher chance of efficacy than drug treatment alone. This of course holds true for most all OC Spectrum disorders.
poster:yxibow
thread:632431
URL: http://www.dr-bob.org/babble/20060412/msgs/633746.html