N‐Acetylcysteine in the treatment of trichotillomania: remarkable results in two patients

Background The management of trichotillomania is challenging. The limited efficacy and side‐effects of pharmacological medications and difficulty in long‐term maintenance of behavioural therapies necessitates alternative treatment options. A dysregulated glutamatergic system has been implicated in the pathophysiology of trichotillomania. A limited number of reports indicate that N‐acetylcysteine ( NAC ), a glutamate modulator, may be a promising treatment for this disorder. Objectives We report two patients with trichotillomania for whom treatment with NAC was successful. Methods The first patient was a 30‐year‐old female, and the second patient was a 14‐year‐old girl, both who were diagnosed with trichotillomania and prescribed NAC (1200 mg/d, p.o.). Results Hair pulling behaviour subsided within 2 months and 2 weeks of initiating NAC in the first and second patient, respectively. Complete hair regrowth was observed after 4 and 6 months of NAC treatment in the first and second patient, respectively. No side‐effects related to NAC were noted. Conclusion NAC could be a well‐tolerated and effective treatment option for trichotillomania.