Repetitive Transcranial Magnetic Stimulation for Treatment of Trichotillomania: Case Series
Efruz Pirdoğan Aydın *, Jülide Güler Kenar , Aslı Tutan , Ömer Akil Özer , Kayıhan Oğuz Karamustafalıoğlu
University of Health Sciences, Sisli Etfal Teaching and Research Hospital, Psychiatry Clinic
Received: March 31, 2019; Revised: June 14, 2019; Accepted: June 27, 2019; Published online: June 27, 2019.
© The Korean College of Neuropsychopharmacology. All rights reserved.

Abstract
Trichotillomania is a psychiatric disorder characterised by compulsive pulling out of one’s hair resulting in hair loss, which is included in DSM-5 category ‘Obsessive-compulsive disorder (OCD) and related disorders’. Behavioural therapy and some medications are suggested for the treatment of trichotillomania, though these are not effective for all patients. Therefore, new treatment options are needed. Five female patients diagnosed with trichotillomania applied low-frequency rTMS over bilateral supplementary motor area (SMA) for 3 weeks. Baseline and after rTMS, patients were given Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI) and Massachusetts General Hospital Hair Pulling Scale (MGH-HP) to evaluate the severity of disorder at baseline and post-rTMS. In this case series, three of five patients with trichotillomania obtained a substantial benefit from treatment, while one patient obtained a partial symptom reduction. The last patient experienced a mild increase in severity of disease after rTMS treatment. rTMS treatment can be effective in some patients with trichotillomania and can be a promising option in treatment of trichotillomania.
Keywords: Trichotillomania, treatment, repetitive transcranial magnetic stimulation, SMA


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