Gabapentin in the treatment of trichotillomania: A case report

Abstract

Trichotillomania (TTM) is an underdiagnosed and distressing condition that necessitates an effective medication; however, there is currently no established first-line pharmacological treatment. TTM is characterized by compulsive hair pulling, leading to noticeable hair loss and significant distress. We present the first documented case of using gabapentin as a treatment for trichotillomania. Our patient, who has chronic depression and anxiety, developed TTM following a traumatic brain injury to the right temporal region. Multiple pharmacotherapies over five years, including various selective serotonin reuptake inhibitors (SSRIs), buspirone, N-acetylcysteine, and valproate, produced minimal benefit. When gabapentin was added to the ongoing treatment with citalopram and valproate, the patient reported cessation of hair-pulling behavior and hair growth by the next visit, eight weeks later. This improvement was sustained for an additional fourteen weeks. However, the therapeutic effects deteriorated within two weeks after the patient individually gabapentin. Gabapentin’s potential as an effective agent for TTM deserves further investigation.