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Dronabinol, a cannabinoid agonist, reduces hair pulling in trichotillomania: a pilot study.
Psychopharmacology (Berl) 2011; 218(3):493-502P

Abstract

RATIONALE

Trichotillomania is characterized by repetitive pulling causing noticeable hair loss. Pharmacological treatment data for trichotillomania are limited.

OBJECTIVE

Dronabinol appears to reduce the exocitotoxic damage caused by glutamate release in the striatum and offers promise in reducing compulsive behavior.

METHODS

Fourteen female subjects (mean age = 33.3 ± 8.9) with DSM-IV trichotillomania were enrolled in a 12-week open-label treatment study of dronabinol (dose ranging from 2.5-15 mg/day). The primary outcome measure was change from baseline to study endpoint on the Massachusetts General Hospital Hair Pulling Scale (MGH-HPS). In order to evaluate effects on cognition, subjects underwent pre- and post-treatment assessments using objective computerized neurocognitive tests. Data were collected from November 2009 to December 2010.

RESULTS

Twelve of the 14 subjects (85.7%) completed the 12-week study. MGH-HPS scores decreased from a mean of 16.5 ± 4.4 at baseline to 8.7 ± 5.5 at study endpoint (p = 0.001). Nine (64.3%) subjects were "responders" (i.e., ≥ 35% reduction on the MGH-HPS and "much or very much improved" Clinical Global Impression scale). The mean effective dose was 11.6 ± 4.1 mg/day. The medication was well-tolerated, with no significant deleterious effects on cognition.

CONCLUSIONS

This study, the first to examine a cannabinoid agonist in the treatment of trichotillomania, found that dronabinol demonstrated statistically significant reductions in trichotillomania symptoms, in the absence of negative cognitive effects. Pharmacological modulation of the cannabinoid system may prove useful in controlling a range of compulsive behaviors. Given the small sample and open-label design, however larger placebo-controlled studies incorporating cognitive measures are warranted.

Authors+Show Affiliations

Department of Psychiatry, University of Minnesota School of Medicine, 2450 Riverside Avenue, Minneapolis, MN 55454, USA. grant045@umn.eduNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

21590520

Citation

Grant, Jon E., et al. "Dronabinol, a Cannabinoid Agonist, Reduces Hair Pulling in Trichotillomania: a Pilot Study." Psychopharmacology, vol. 218, no. 3, 2011, pp. 493-502.
Grant JE, Odlaug BL, Chamberlain SR, et al. Dronabinol, a cannabinoid agonist, reduces hair pulling in trichotillomania: a pilot study. Psychopharmacology (Berl). 2011;218(3):493-502.
Grant, J. E., Odlaug, B. L., Chamberlain, S. R., & Kim, S. W. (2011). Dronabinol, a cannabinoid agonist, reduces hair pulling in trichotillomania: a pilot study. Psychopharmacology, 218(3), pp. 493-502. doi:10.1007/s00213-011-2347-8.
Grant JE, et al. Dronabinol, a Cannabinoid Agonist, Reduces Hair Pulling in Trichotillomania: a Pilot Study. Psychopharmacology (Berl). 2011;218(3):493-502. PubMed PMID: 21590520.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Dronabinol, a cannabinoid agonist, reduces hair pulling in trichotillomania: a pilot study. AU - Grant,Jon E, AU - Odlaug,Brian L, AU - Chamberlain,Samuel R, AU - Kim,Suck Won, Y1 - 2011/05/19/ PY - 2011/03/11/received PY - 2011/05/02/accepted PY - 2011/5/19/entrez PY - 2011/5/19/pubmed PY - 2012/3/20/medline SP - 493 EP - 502 JF - Psychopharmacology JO - Psychopharmacology (Berl.) VL - 218 IS - 3 N2 - RATIONALE: Trichotillomania is characterized by repetitive pulling causing noticeable hair loss. Pharmacological treatment data for trichotillomania are limited. OBJECTIVE: Dronabinol appears to reduce the exocitotoxic damage caused by glutamate release in the striatum and offers promise in reducing compulsive behavior. METHODS: Fourteen female subjects (mean age = 33.3 ± 8.9) with DSM-IV trichotillomania were enrolled in a 12-week open-label treatment study of dronabinol (dose ranging from 2.5-15 mg/day). The primary outcome measure was change from baseline to study endpoint on the Massachusetts General Hospital Hair Pulling Scale (MGH-HPS). In order to evaluate effects on cognition, subjects underwent pre- and post-treatment assessments using objective computerized neurocognitive tests. Data were collected from November 2009 to December 2010. RESULTS: Twelve of the 14 subjects (85.7%) completed the 12-week study. MGH-HPS scores decreased from a mean of 16.5 ± 4.4 at baseline to 8.7 ± 5.5 at study endpoint (p = 0.001). Nine (64.3%) subjects were "responders" (i.e., ≥ 35% reduction on the MGH-HPS and "much or very much improved" Clinical Global Impression scale). The mean effective dose was 11.6 ± 4.1 mg/day. The medication was well-tolerated, with no significant deleterious effects on cognition. CONCLUSIONS: This study, the first to examine a cannabinoid agonist in the treatment of trichotillomania, found that dronabinol demonstrated statistically significant reductions in trichotillomania symptoms, in the absence of negative cognitive effects. Pharmacological modulation of the cannabinoid system may prove useful in controlling a range of compulsive behaviors. Given the small sample and open-label design, however larger placebo-controlled studies incorporating cognitive measures are warranted. SN - 1432-2072 UR - https://www.unboundmedicine.com/medline/citation/21590520/abstract/Dronabinol_a_cannabinoid_agonist_reduces_hair_pulling_in_trichotillomania:_a_pilot_study_ L2 - https://dx.doi.org/10.1007/s00213-011-2347-8 DB - PRIME DP - Unbound Medicine ER -