Add-on treatment of aripiprazole in an adult onychophagia patient

Abstract

Nail biting (onychophagia) is a common disorder which has not been investigated yet. There are different opinions about to classify onychophagia, but according to DSM-IV-TR it is classified as impulse control disorder not otherwise specified. The knowledge about treatment of onychophagia is limited. There are a few studies about treatment of onychophagia with psychotherapy and a study with pharmacotherapy. Some studies suggest that an atypical antipsychotic aripiprazole may have beneficial effects in the treatment of impulse control disorders. In this study we report a case of onychophagia which has successfully treated with aripiprazole add-on to escitalopram treatment that has never reported before.

Keywords

• Onychophagia, aripiprazole, add-on treatment

Onikofajisi olan erişkin bir hastada aripiprazol ekleme tedavisi

Öz

Tırnak yeme (onikofaji) sık görülen fakat hakkında az inceleme yapılmış bir bozukluktur. Sınıflandırılması ile ilgili farklı görüşler bulunan onikofaji, DSM-IV-TR\'e göre başka türlü adlandırılmayan dürtü kontrol bozukluğu olarak tanımlanmaktadır. Tedavisi ile ilgili bilgiler kısıtlıdır. Tedavisinde psikoterapi ile ilgili birkaç çalışma yanında farmakolojik tedavi ile ilgili sadece bir çalışma bulunmaktadır. Bazı çalışmalarda atipik bir antipsikotik olan aripiprazolün dürtü kontrol bozukluklarında faydalı olabileceği bildirilmiştir. Biz bu yazıda essitalopram tedavisine daha önce literatürde bildirilmemiş olan aripiprazol eklenmesiyle başarılı bir şekilde tedavi edilen onikofaji vakasını sunmayı amaçladık.

Anahtar Kelimeler

• Onikofaji, aripiprazol, ekleme tedavisi

References

1. Malone AJ, Massler M. Index of nailbiting in children. J Abnorm Psychol1952;47(2):193-202.
2. Foster LG. Nervous habits and stereotyped behaviors in preschool children. J Am Acad Child Adolesc Psy- chiatry 1998;37(7):711-7.
3. Ghanizadeh A. Association of nail biting and psychiatric disorders in children and their parents in a psychiatri- cally referred sample of children. Child Adolesc Psy- chiatry Ment Health 2008; 2(1):13.
4. Leonard HL, Lenane MC, Swedo SE, Rettew DC, Rapo- port JL. A double-blind comparison of clomipramine and desipramine treatment of severe onychophagia (nail biting). Arch Gen Psychiatry 1991;48(9):821-7.
5. Pacan P, Grzesiak M, Reich A, Szepietowski JC. Ony- chophagia as a spectrum of obsessive-compulsive disorder. Acta Derm. Venereol 2009;89(3):278-80.
6. Ak M, Gulsun M. Aripiprazole in the Treatment of Trichotillomania: A Case Report. Klinik Psikofarmako- loji Bülteni 2010; 20:176-8.
7. Klinik Psikofarmako
8. Sayyah M, Sayyah M, Boostani H, Ghaffari SM, Hoseini A. Effects of aripiprazole augmentation in treatment- resistant obsessive-compulsive disorder (a double blind clinical trial). Depress Anxiety 2012; 29(10):850- 4.

9. Fontenelle LF, Oostermeijer S, Harrison BJ, Pantelis C, Yücel M. Obsessive-compulsive disorder, impulse control disorders and drug addiction: common features and potential treatments. Drugs 2011; 71(7):827-40.
10. DeLeon A, Patel NC, Crismon ML. Aripiprazole: a com- prehensive review of its pharmacology, clinical effica- cy, and tolerability. Clin Ther 2004; 26(5):649-66.
11. White MP, Koran LM. Open-label trial of aripiprazole in the treatment of trichotillomania. J Clin Psychophar- macol 2011; 31(4):503-6.