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Hair pulling 2
Pregunta
Our 30-year-old daughter with CdLS has always pulled at her hair, but she is in the midst of a terrible bout with this problem. She has pulled a whole bald spot on her head. How do we and her residential school help her? She had gone for a long time without the issue being too bad, but we are very concerned about her now.
Respuesta de nuestros expertos
Was Prozac originally prescribed for hair pulling, or is it something new? It is sometimes a useful treatment for trichotillomania, but sometimes it can do the opposite. I am sometimes inclined to use a mild anxiety drug, like Tranxene, instead of Prozac, or if that doesn't work, Gabatril
TK 7-13-10
As TG indicates, Prozac is often cited as a treatment for obsessive-compulsive symptoms such as trichotillomania. However, since the hair pulling is a pleasurable response to underlying anxiety, the tendency of Prozac to cause some anxiety can be a problem (it can cause the behavior to increase at first). Also, the hair pulling takes on a "habitual" quality which can persist after the "anxiety" is dealt with. I have tried about everything at one time of another for this disorder and cannot recommend a single "best" treatment. That said, I'd agree with TG that a mild anti-anxiety drug, such as Tranxene or Ativan, can help. The Prozac needs to be evaluated clinically to see if it is helping or hurting the situation. Alternatives with potentially fewer "anxiety" side-effects include Celexa, Luvox, or Paxil
DS/TK 7-13-10
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