Habit Reversal Training or HRT, has been shown to be a successful adjunct to medication as a way to treat TTM.[10] With Habit Reversal Training, doctors train the individual to learn to recognize their impulse to pull and also teach them to redirect this impulse. As a part of the behavioral record-keeping component of HRT, patients are often instructed to keep a journal of their hair-pulling episodes. They may be asked to record the date, time, location, and number of hairs pulled, as well what they are thinking or feeling at the time. This can help the patient learn to identify situations where they commonly pull out their hair and develop strategies for avoiding episodes.
Treatment with Clomipramine, a tricyclic antidepressant, was shown in a small double-blind study to significantly improve symptoms.[11]
Fluoxetine (Prozac) and other similar SSRI drugs have limited usefulness in treating TTM, and can often have significant side effects.[12] According to F. Penzel, antidepressants can even increase the severity of the TTM
