Inositol for Trichotillomania and Skin Picking

By Arline Kaplan c 2004 (All Rights Reserved)

 Inositol, one of the B-vitamins, may help in the treatment of compulsive hair pulling (trichotillomania) and compulsive skin picking, according to recent case reports published in the Journal of Clinical Psychiatry (Seedat et al., 2001).

Researchers Soraya Seedat, M.B., and Dan J. Stein, M.B., of the University of Stellenbosch, and Brian H. Harvey, Ph.D., of the University of Potchefstroom, in South Africa, described two women with trichotillomania and one with compulsive skin picking who were treated with 6 grams of powdered inositol dissolved in water or juice three times per day. Their progress was followed for between eight and 16 weeks.

“The three cases described here suggest that inositol might be a treatment option in some patients with hair pulling and skin picking and could be considered in patients who tolerate SRIs [selective reuptake inhibitors] poorly or who are unwilling to take them,” the researchers concluded in their article.

The first case was a 43-year-old woman who had compulsively picked at her face for 26 years. She picked at her skin daily, resulting in scarring and scab formation. At the beginning of treatment, the woman also suffered from depression.  She was given inositol in addition to citalopram (Celexa), an SRI antidepressant. After four weeks of the combination drug therapy, she was able to reduce her skin picking from several hours every day to picking her skin only once or twice a week for short intervals (10 minutes). Her depressive symptoms also lessened.

The second case was a 21-year-old woman who had compulsively pulled hair from her scalp, legs and pubic regions since age 12. She was diagnosed as having both trichotillomania and depression. After four weeks on inositol treatment, she reported that her hair pulling was much reduced (she went from daily hair pulling to pulling about once a week). Her low mood also improved.

The third case was a 26-year-old woman who compulsively pulled her hair for 10 years and compulsively bite her nails since childhood. She experienced a considerable reduction in both hair pulling and nail biting when treated with inositol.

Side effects of the treatment included gas, diarrhea, headaches and abdominal cramps.

Inositol is converted by the body to a substance that regulates the action of serotonin within brain cells. Serotonin is a brain transmitter chemical implicated in depression, trichotillomania, obsessive-compulsive disorder and other mental illnesses. Inositol’s efficacy for treating depression, panic disorder and obsessive-compulsive disorder has been evaluated in clinical trials (Benjamin et al., 1995; Fux et al., 1996; Levine, 1997; Levine et al., 1995)

The Medical Research Council Research Unit on Anxiety and Stress Disorders supported the Seedat et al., study (2001). The unit, located in the department of psychiatry at the University of Stellenbosch in South Africa, studies the psychobiology and treatment of such anxiety disorders as posttraumatic stress disorder, social phobia, obsessive-compulsive disorder and panic disorder.  Stein, director of the research unit and a co-author on the Seedat study, has co-edited a book for health professionals, Trichotillomania (Stein et al., 1999) and co-authored a paperback book for sufferers and their families, Help for Hair Pullers: Understanding and Coping with Trichotillomania (Keuthen et al., 2001) [Editor’s Note:  see information on the book at www. trichhelp.com].

[Warning: this article is for your information only and is not medical advice. Consult with your physician if you want to take inositol. There are side effects and drug interactions related to its use.]

References

Benjamin J, Levine J, Fux M et al. (1995), Double-blind, placebo-controlled, crossover trial of inositol treatment for panic disorder. Am J Psychiatry 152(7):1084-1086.

Fux M, Levine J, Aviv A, Belmaker RH (1996), Inositol treatment of obsessive-compulsive disorder. Am J Psychiatry 153(9):1219-1221.

Keuthen NJ, Stein DJ, Christensen GA (2001), Help for Hair Pullers: Understanding and Coping with Trichotillomania. Oakland, Calif.: New Harbinger Publications.

Levine J (1997), Controlled trials of inositol in psychiatry. Eur Neuropsychopharmacol 7(2):147-155.

Levine J, Barak Y, Gonzalves M et al. (1995), Double-blind, controlled trial of inositol treatment of depression. Am J Psychiatry 152(5):792-794.

Seedat S, Stein D, Harvey B (2001), Inositol in the treatment of trichotillomania and compulsive skin picking (letter). J Clin Psychiatry 62(1):60-61.

Stein DJ, Christenson GA, Hollander E (1999), Trichotillomania. Washington, DC: American Psychiatric Press.

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