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NAC Shows Promise for Hair Pulling (Video)

Below, is a nice summary regarding this exciting avenue of treatment by principal investigator and Trichotillomania Learning Center (TLC)  Scientific Advisory Board member, Dr. Jon Grant:

N-Acetyl Cysteine (NAC), a dietary supplement and amino acid that affects glutamate levels in the brain, has been studied in the treatment of a number of conditions across medicine and psychiatry. In recent years, NAC has been thought to have the potential to improve symptoms of Trichotillomania (hair pulling).  As no medication or other substance to date has shown effectiveness in the treatment of  TTM, this finding is one of promise and one that warrants consideration and further investigation.

A preliminary (controlled, randomized) study of 50 individuals with Trichotillomania concluded that 56% of individuals reported a significant reduction of symptoms after 9-12 weeks of treatment (Grant, JE, et al, 2009).  This is encouraging.  Of course, it must be kept in mind that this was a small study (50 individuals makes it difficult to generalize results). It is also important to note that 44% of individuals did not report significant improvement of symptoms; thus, if it is effective, it is not likely to be effective for everyone who struggles with hair pulling behavior.

This being said, NAC has shown promise in becoming an evidence-based treatment for TTM.   Current evidence-based treatment for TTM is a specific cognitive behavioral therapy approach [namely, habit reversal training (HRT) or Comprehensive Behavioral treatment (ComB)].

I see many individuals with TTM in my practice.  I often discuss NAC as an option to supplement treatment, particularly for those who struggle with behavior therapy or for those who have a co-occurring autism spectrum disorder or other diagnosis that may challenge the successful treatment of hair pulling.

Glutamate may play an important role in, not only TTM, but also other body-focused repetitive behaviors (BFRBs) such as skin picking, nail biting, cheek biting, and others.  It will be an important area of investigation in future treatment trials and an option to consider in treatment planning.


Dr. Deibler

*Grant JE, Oldaug BL, Kim SW. 2009. A double-blind, placebo-controlled trial of a glutamate modulating agent, N-acetyl cysteine, in the treatment of trichotillomania. Arch Gen Psychiatry 66(7): 756-763

NAC Shows Promise for Hair Pulling (Video)

Marla W. Deibler, PsyD

Marla W. Deibler, Psy.D., is a clinical psychologist and nationally-recognized expert in anxiety disorders and the obsessive-compulsive spectrum, including trichotillomania and other body-focused repetitive behaviors, obsessive-compulsive disorder, hoarding, and tic disorders. She is the Founder and Executive Director of The Center for Emotional Health of Greater Philadelphia in New Jersey, an outpatient facility specialized in providing evaluation and evidence-based, cognitive-behavioral therapies for these and other difficulties. She currently serves on the Board of Directors of OCD-NJ, the New Jersey affiliate of the International OCD Foundation (IOCDF). Dr. Deibler gained her formative clinical experiences at the National Institute of Mental Health (NIMH) at the National Institutes of Health (NIH), Children’s National Medical Center, and the Kennedy Krieger Institute at Johns Hopkins University Medical Center. She gained specialized behavior therapy experience in the treatment of obsessive-compulsive spectrum disorders at the nationally-recognized Behavior Therapy Center of Greater Washington. Dr. Deibler served as a clinician at the National Center for Phobias, Anxiety, and Depression. She also served as Director of Behavioral Sciences at the Temple University School of Dentistry and served on the clinical faculty at Temple University Schools of Medicine and Allied Health as well as Temple University Children’s Medical Center. Dr. Deibler has published scientific research in peer-reviewed journals and has presented clinical training seminars and research findings at national and international meetings. She has appeared on the Dr. Oz Show, A&E’s “Hoarders”, TLC’s “Hoarding: Buried Alive”, CBS News, ABC News, FOX News, It’s Your Call with Lynn Doyle (CN8, Retirement TV), and CBS’s “Swift Justice with Nancy Grace”. She has been quoted by media outlets, including the Wall Street Journal, CNN, Philadelphia Inquirer, Philadelphia Daily News, and the Connecticut Post, among others. Dr. Deibler holds licenses to practice psychology in New Jersey (Lic. No. 35S100438000) and Pennsylvania (Lic. No. PS0157790). She is an active member of the American Psychological Association, Trichotillomania Learning Center, International OCD Foundation, OCD-New Jersey, Association for Behavioral and Cognitive Therapies, and Anxiety Disorders Association of America. Dr. Deibler resides in suburban Philadelphia with her husband (who is also a psychologist) and three children.

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APA Reference
Deibler, M. (2012). NAC Shows Promise for Hair Pulling (Video). Psych Central. Retrieved on September 21, 2020, from


Last updated: 27 Dec 2012
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