Cochrane · systematic review · CD007662
Pharmacotherapy for trichotillomania
Hoffman, J, Williams, T, Rothbart, R, et al. · Cochrane Database of Systematic Reviews · 2021 · Cochrane Library
Common Mental DisordersAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
30
current version
GRADE rated
28
No studies
2
Included studies
NR
No studies 2 · 6.7%Ungraded 0 · 0%Very low 5 · 16.7%Low 21 · 70%Moderate 2 · 6.7%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Antioxidants versus placebo for trichotillomania in adults
Population: adults with trichotillomania
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Treatment responseaClinical Global Impressions ‐ Improvement Scale (CGI‐I) or similar (no. of responders) Antioxidants vs placebo | RR 2.25 [0.84, 5.99] | 1 study · 36 participants | Low Downgraded: imprecision |
Reduction of TTM symptom severityMassachusetts General Hospital Hair‐Pulling Scale (MGH‐HPS) Antioxidants vs placebo | no estimate extracted | 1 study · 27 participants | Low Downgraded: imprecision |
Tolerability of treatment ‐ dropouts due to adverse eventsDropout rate Antioxidants vs placebo | no estimate extracted | 1 study · 18 participants | Low Downgraded: imprecision |
Antioxidants versus placebo for trichotillomania in adolescents
Population: children with trichotillomania
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Treatment responseaClinical Global Impressions ‐ Improvement Scale (CGI‐I) or similar (no. of responders) Antioxidants vs placebo | RR 2 [0.28, 14.2] | 1 study · 8 participants | Low Downgraded: imprecision |
Reduction of TTM symptom severityMassachusetts General Hospital Hair‐Pulling Scale (MGH‐HPS) Antioxidants vs placebo | no estimate extracted | 1 study · 6 participants | Low Downgraded: imprecision |
Tolerability of treatment ‐ dropouts due to adverse eventsDropout rate Antioxidants vs placebo | no estimate extracted | 1 study · 6 participants | Low Downgraded: imprecision |
Antipsychotics versus placebo for trichotillomania in adults
Population: adults with trichotillomania
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Treatment responseaClinical Global Impressions ‐ Improvement Scale (CGI‐I) (no. of responders) Antipsychotics vs placebo | RR 5.08 [1.4, 18.37] | 1 study · 25 participants | Low Downgraded: imprecision |
Reduction of TTM symptom severityMassachusetts General Hospital Hair‐Pulling Scale (MGH‐HPS) Antipsychotics vs placebo | no estimate extracted | 1 study · 25 participants | Low Downgraded: imprecision |
Tolerability of treatment ‐ dropouts due to adverse eventsDropout rate Antipsychotics vs placebo | no estimate extracted | 1 study · 25 participants | Low Downgraded: imprecision |
Cell signal transducers versus placebo for trichotillomania in adults
Population: adults with trichotillomania
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Treatment responseaClinical Global Impressions ‐ Improvement Scale (CGI‐I) (no. of responders) Cell signal transducers vs placebo | RR 1.33 [0.57, 3.11] | 1 study · 38 participants | Low Downgraded: imprecision |
Reduction of TTM symptom severityMassachusetts General Hospital Hair‐Pulling Scale (MGH‐HPS) Cell signal transducers vs placebo | no estimate extracted | 1 study · 38 participants | Low Downgraded: imprecision |
Tolerability of treatment ‐ dropouts due to adverse eventsDropout rate Cell signal transducers vs placebo | no estimate extracted | 1 study · 38 participants | Low Downgraded: imprecision |
Glutamate modulators versus placebo for trichotillomania in adults
Population: adults with trichotillomania
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Treatment responseaClinical Global Impressions ‐ Improvement Scale (CGI‐I) (no. of responders) Glutamate modulators vs placebo | RR 3.5 [1.34, 9.17] | 1 study · 50 participants | Moderate Downgraded: imprecision |
Reduction of TTM symptom severityMassachusetts General Hospital Hair‐Pulling Scale (MGH‐HPS) Glutamate modulators vs placebo | no estimate extracted | 1 study · 50 participants | Moderate Downgraded: imprecision |
Tolerability of treatment ‐ dropouts due to adverse eventsDropout rate Glutamate modulators vs placebo | no estimate extracted | 1 study · 50 participants | Low Downgraded: imprecision |
Glutamate modulators versus placebo for trichotillomania in children and adolescents
Population: children and adolescents with trichotillomania
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Treatment responseaClinical Global Impressions ‐ Improvement Scale (CGI‐I) (no. of responders) Glutamate modulators vs placebo | RR 1.19 [0.37, 3.77] | 1 study · 39 participants | Low Downgraded: imprecision |
Reduction of TTM symptom severityMassachusetts General Hospital Hair‐Pulling Scale (MGH‐HPS) Glutamate modulators vs placebo | no estimate extracted | 1 study · 39 participants | Low Downgraded: imprecision |
Tolerability of treatment ‐ dropouts due to adverse eventscDropout rate Glutamate modulators vs placebo | RR 2.86 [0.12, 66.11] | 1 study · 39 participants | Low Downgraded: imprecision |
Opioid antagonists versus placebo for trichotillomania in adults
Population: adults with trichotillomania
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Treatment responseaClinical Global Impressions ‐ Improvement Scale (CGI‐I) (no. of responders) & NIMH Trichotillomania Severity Scale (NIMH‐TSS) (no. of responders as > 50% reduction) Opioid antagonists vs placebo | RR 2.14 [0.25, 18.17] | 2 studies · 68 participants | Very low Downgraded: imprecision, inconsistency |
Reduction of TTM symptom severityMassachusetts General Hospital Hair‐Pulling Scale (MGH‐HPS) Opioid antagonists vs placebo | no estimate extracted | 1 study · 51 participants | Low Downgraded: imprecision |
Tolerability of treatment ‐ dropouts due to adverse events Opioid antagonists vs placebo | no estimate extracted | NR | No studies |
SSRIs versus placebo for trichotillomania in adults
Population: adults with trichotillomania
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Treatment response SSRIs vs placebo | no estimate extracted | NR | No studies |
Reduction of TTM symptom severityaMassachusetts General Hospital Hair‐Pulling Scale (MGH‐HPS) mean change score SSRIs vs placebo | no estimate extracted | 1 study · 31 participants | Very low Downgraded: risk of bias, imprecision |
Tolerability of treatment ‐ dropouts due to adverse eventseDropout rate SSRIs vs placebo | RR 3 [0.33, 27.62] | 2 studies · 78 participants | Low Downgraded: imprecision |
TCAs with predominantly SRI actions versus placebo for trichotillomania in adults
Population: adults with trichotillomania
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Treatment responseaClinical Global Impressions ‐ Improvement Scale (CG‐I) (no. of responders) TCAs with predominantly SRI actions vs placebo | RR 5.73 [0.36, 90.83] | 1 study · 16 participants | Very low Downgraded: risk of bias, imprecision |
Reduction of TTM symptom severityNIMH Trichotillomania Severity Scale (NIMH‐TSS) TCAs with predominantly SRI actions vs placebo | no estimate extracted | 1 study · 16 participants | Very low Downgraded: risk of bias, imprecision |
Tolerability of treatment ‐ dropouts due to adverse eventsdDropout rate TCAs with predominantly SRI actions vs placebo | RR 4.45 [0.27, 73.81] | 1 study · 16 participants | Very low Downgraded: risk of bias, imprecision |
TCAs with predominantly SRI actions versus other TCAs for trichotillomania in adults
Population: adults with trichotillomania
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Treatment responseaPhysician‐rated Clinical Progress Scale TCAs with predominantly SRI actions vs other TCAs | no estimate extracted | 1 study · 26 participants | Low Downgraded: imprecision |
Reduction of TTM symptom severityNIMH Trichotillomania Severity Scale (NIMH‐TSS) TCAs with predominantly SRI actions vs other TCAs | no estimate extracted | 1 study · 26 participants | Low Downgraded: imprecision |
Tolerability of treatment ‐ dropouts due to adverse eventsDropout rate TCAs with predominantly SRI actions vs other TCAs | no estimate extracted | 1 study · 26 participants | Low Downgraded: imprecision |