Anti-seizure drug reduces compulsive skin picking

NEW YORK (Reuters Health) - For patients with chronic skin picking, a type of obsessive-compulsive disorder, that is severe enough to cause physical damage, results of a small study suggest that the anti-seizure drug lamotrigine may reduce the behavior and improve social functioning.

Writing in the Journal of Clinical Psychiatry, investigator Dr. Jon E. Grant and associates point out that some degree of skin picking is common and normal. However, "pathology exists in the duration and extent of the behavior, as well as in the reasons for picking, associated emotions, and resulting problems."

The research in this area is limited, note the investigators from the University of Minnesota, Minneapolis. They looked at the use of lamotrigine because earlier studies have provided evidence that the same class of drug is active in other obsessive compulsive disorders. Also, lamotrigine may be effective in treating repetitive addictive behaviors.

In the new study, the researchers treated 24 patients with lamotrigine for 12 weeks. The drug dose ranged from 25 to 300 milligrams per day as tolerated.

Among the 20 subjects who completed the study, average time per day spent picking fell from 118.1 to 59.9 minutes. Sixteen subjects were classified as improved or very much improved, based on standard test scores documented at each visit. Seven reported no picking at all by the end of the study.

Measures of urge and behavior also improved, as did perceived stress and levels of functioning assessed by another standard test.

Grant's team observed that subjects whose skin picking was "automatic" tended to have milder symptoms, suggesting that behavioral therapy may be sufficient treatment for their symptoms. Those with strong urges to pick may benefit from lamotrigine treatment.

SOURCE: Journal of Clinical Psychiatry, September 2007.