Can medication help you stop pulling your hair?

Research into medication for trichotillomania has moved forward considerably, but there still isn’t one medication that reliably stops hair pulling for everybody.

The picture in 2026 is more interesting than that.

Some treatments have produced encouraging results, N-acetylcysteine (NAC) now has replicated evidence supporting it, and memantine has produced impressive results in a recent clinical trial. At the same time, medications routinely prescribed to people with trichotillomania aren’t necessarily the medications with the best evidence for treating the hair pulling itself.

Throughout this page, we distinguish between scientific research 🧑‍🔬 and lived experience 🙋‍♂️, including our own survey evidence from people who have actually tried treatments for hair pulling.

Is there a medication specifically for trichotillomania?

At present, there is no medication specifically approved as a first-line pharmacological treatment for trichotillomania.

That doesn’t mean medication can’t help.

The important question isn’t simply whether a medication has ever been used for trichotillomania, but how good the evidence for it actually is.

And this is where newer research has helped enormously.

What does the latest research say? 🧑‍🔬

A 2025 Trichotillomania Treatment Update concluded that NAC and memantine could be considered suitable first-line pharmacological options because of their potential benefit, favourable safety profiles and relatively low risk of adverse effects.

The same review described the evidence for medications including fluoxetine, clomipramine, olanzapine and naltrexone as limited and variable.

Research has since moved on again.

A major 2026 review and meta-analysis of randomised clinical trials examined both psychological and medication treatments for trichotillomania. Twenty-nine trials were included in its standard meta-analysis and 30 in its network meta-analysis.

When the researchers considered both the size of treatment effects and whether results had been replicated, strong support emerged for three interventions:

Behavioural therapy incorporating Habit Reversal Training

Acceptance and Commitment Therapy-enhanced Habit Reversal Training

and

N-acetylcysteine (NAC).

That distinction is important.

A treatment can produce an exciting result in one clinical trial. Replication asks whether researchers can demonstrate that benefit again.

So, as of 2026, NAC has particularly interesting medication evidence behind it.

N-Acetylcysteine (NAC) 🧑‍🔬

N-acetylcysteine — usually shortened to NAC — is a supplement rather than a conventional psychiatric medication.

NAC influences the brain’s glutamate system and also helps replenish glutathione, an important antioxidant.

Interest in NAC for trichotillomania grew substantially following a randomised placebo-controlled trial involving 50 adults with trichotillomania.

After 12 weeks:

56% of people taking NAC were rated much or very much improved

compared with

16% taking placebo.

Interestingly, significant improvement wasn’t initially apparent until after nine weeks.

A 2024 systematic review of pharmacological interventions also identified NAC among the most successful treatments found in the trichotillomania literature.

A further NAC overview, published online in 2025 and in print in 2026, described NAC as a promising treatment for trichotillomania and skin-picking disorder. It also highlighted the lack of established pharmacological protocols and the importance of reliable professional information for people considering supplementation.

Most importantly, the 2026 meta-analysis found that NAC had sufficiently strong and replicated evidence to stand out among the pharmacological interventions studied.

That’s considerably more persuasive than simply saying that some people have found NAC helpful.

It still doesn’t mean NAC works for everybody.

NAC in children and teenagers 🧑‍🔬

The encouraging adult result was not reproduced in children and adolescents.

A randomised placebo-controlled study of young people with trichotillomania found no significant difference between NAC and placebo.

Approximately:

25% responded to NAC

compared with

21% receiving placebo.

The researchers specifically cautioned against assuming that medication shown to help adults with trichotillomania will necessarily produce the same results in children.

So when we’re talking about NAC, we need to distinguish clearly between:

encouraging evidence in adults

and

lack of demonstrated benefit in the existing controlled paediatric trial.

Memantine 🧑‍🔬

Memantine has produced one of the most striking recent results in BFRB medication research.

It is a prescription medication primarily used to treat Alzheimer’s disease and acts on the glutamate system.

In 2023, researchers conducted a double-blind placebo-controlled trial involving 100 adults with either trichotillomania or skin-picking disorder.

After eight weeks:

60.5% of people receiving memantine were rated much or very much improved

compared with

8.3% receiving placebo.

That’s a very large difference.

But there is an important limitation when we’re discussing hair pulling specifically.

The study combined participants with trichotillomania and participants with skin-picking disorder. We therefore cannot accurately say that 60.5% of people with trichotillomania improved.

Nevertheless, the result was strong enough for the 2025 treatment update to identify memantine alongside NAC as a potentially suitable pharmacological option.

The newer 2026 meta-analysis gives us another reason for caution: while memantine remains very promising, NAC currently has the advantage of replicated evidence.

Clomipramine 🧑‍🔬

Clomipramine is a tricyclic antidepressant and one of the older medications investigated specifically for trichotillomania.

Clinical research has found evidence that it can reduce hair-pulling symptoms, and previous meta-analysis found a significant benefit compared with control treatment.

However, the evidence comes from relatively small studies and hasn’t developed into the strong replicated evidence base we now have for NAC.

The 2025 treatment update describes the evidence for clomipramine as limited and variable.

Clomipramine may nevertheless be considered by a prescribing clinician, particularly where other symptoms or conditions are relevant.

Olanzapine 🧑‍🔬

Olanzapine is an antipsychotic medication which has also been investigated for trichotillomania.

A small randomised clinical trial produced an encouraging reduction in trichotillomania symptoms, and previous meta-analysis found a significant benefit compared with placebo.

However, this finding comes largely from one relatively small trial.

Olanzapine can also produce significant side effects, including increased appetite, weight gain, sedation and metabolic effects.

So an encouraging research result doesn’t automatically make a medication an appropriate treatment for everybody who pulls their hair.

The balance between possible benefit and possible harm matters too.

What about SSRIs? 🧑‍🔬

SSRIs include medications such as fluoxetine, sertraline and citalopram and are widely used for depression, anxiety and OCD.

Because trichotillomania is classified among obsessive-compulsive and related disorders, it might seem logical that SSRIs would reduce hair pulling.

Research hasn’t supported that assumption particularly well.

Reviews of medication trials have found little convincing evidence that SSRIs themselves substantially reduce trichotillomania symptoms.

That doesn’t mean an SSRI cannot be useful to somebody who pulls their hair.

If you also experience depression, anxiety or OCD, an SSRI might appropriately be prescribed for that condition. Treating it may also make managing your hair pulling easier.

But there is an important distinction between:

a medication helping somebody who happens to have trichotillomania

and

a medication being demonstrated to reduce hair pulling.

They aren’t necessarily the same thing.

Other medications 🧑‍🔬

Researchers have investigated or reported possible benefits from several other medications, including:

• aripiprazole
• naltrexone
• monoamine oxidase inhibitors
• topiramate
• riluzole
• inositol

A 2024 systematic review identified NAC, aripiprazole and monoamine oxidase inhibitors among the more successful pharmacological interventions found in its literature search.

However, much of the evidence outside the better-studied treatments comes from small studies, open trials or case reports.

That’s useful for identifying possibilities for future research.

It isn’t enough for us to tell you that these medications have been proven to stop hair pulling.

What are doctors actually prescribing? 🧑‍🔬

This is where the research gets particularly interesting.

A large real-world study published in 2025 examined prescription patterns among people diagnosed with trichotillomania using an international healthcare database.

It included 1,275 people in a European network and 109,741 in a United States network and investigated the use of 25 medications.

The researchers found that real-world prescribing differed substantially from treatment approaches proposed by experts.

In other words, what people with trichotillomania are actually prescribed isn’t necessarily the same as what current evidence would lead us to expect.

The researchers called for improved pharmacological standards and education.

For us, that’s an important reminder:

Commonly prescribed doesn’t automatically mean best supported by research.

Why does glutamate keep appearing?

Two treatments attracting particular interest — NAC and memantine — affect glutamate signalling, although they do so differently.

Glutamate is the brain’s principal excitatory neurotransmitter and plays an important role in communication between nerve cells.

This has led researchers to investigate whether altering glutamate activity might influence repetitive and compulsive behaviours.

That’s an exciting area of research.

But it would be much too simplistic to conclude:

“Hair pulling is caused by too much glutamate.”

We don’t have evidence to say that.

Scientific research 🧑‍🔬 and lived experience 🙋‍♂️

Research tells us what happens to groups of people under controlled conditions.

Lived experience tells us something different.

Our own surveys allow us to hear from people who have actually tried medication and supplements for hair pulling.

That can help us ask questions such as:

• Did you notice fewer urges?
• Did your pulling actually reduce?
• How long did it take before you noticed anything?
• Did the benefit last?
• Were the side effects worth it?
• Would you use the treatment again?

And perhaps most importantly:

What happened to you, rather than to the average research participant?

Throughout our medication information we therefore distinguish between:

🧑‍🔬 Scientific research — evidence from published studies.

🙋‍♂️ Lived experience — what people with trichotillomania tell us happened when they actually tried the treatment.

Neither replaces the other.

Sometimes they agree beautifully.

Sometimes they don’t.

Both are worth listening to, as long as we’re clear about which one we’re reporting.

Medication alongside behavioural treatment

The newest research gives us a particularly useful message here.

The 2026 meta-analysis found strong replicated evidence not only for NAC but also for:

Behavioural therapy incorporating Habit Reversal Training

and

Acceptance and Commitment Therapy-enhanced Habit Reversal Training.

So medication doesn’t have to be viewed as the opposite of behavioural treatment.

For some people, medication or supplementation may reduce urges enough to make behavioural strategies easier to use.

For others, behavioural treatment may be sufficient without medication.

And for somebody else, a combination may work best.

The useful question isn’t necessarily:

“Which one should I choose?”

It may be:

“What combination gives me the best chance of changing my hair pulling?”

Before trying medication or supplements

Please discuss prescription medication, changes to existing medication and appropriate supplementation with a suitably qualified healthcare professional.

This is particularly important for children and teenagers, during pregnancy or breastfeeding, when taking other medication, or when you have other physical or mental health conditions.

NAC being sold as a supplement doesn’t make it automatically suitable for everybody.

And if a treatment doesn’t work for you, that doesn’t mean you’ve failed.

Even treatments that perform well in research don’t work for every participant.

References

Grant, J.E., Odlaug, B.L. & Kim, S.W. (2009). N-Acetylcysteine, a glutamate modulator, in the treatment of trichotillomania: a double-blind, placebo-controlled study.

Bloch, M.H. et al. (2013). N-Acetylcysteine in the treatment of pediatric trichotillomania: a randomized, double-blind, placebo-controlled add-on trial.

Farhat, L.C. et al. (2020). Pharmacological and behavioral treatment for trichotillomania: An updated systematic review with meta-analysis.

Lee, D.K. & Lipner, S.R. (2022). The potential of N-acetylcysteine for treatment of trichotillomania, excoriation disorder, onychophagia, and onychotillomania: An updated literature review.

Grant, J.E. et al. (2023). Double-blind placebo-controlled study of memantine in trichotillomania and skin-picking disorder. American Journal of Psychiatry.

From tugs to treatments: a systematic review on pharmacological interventions for trichotillomania (2024). Clinical and Experimental Dermatology, 49(8), 774–782.

Nina Domínguez, L. et al. (2025). Trichotillomania Treatment Update. Actas Dermo-Sifiliográficas, 116(2), T152–T158.

Krajewski, P.K. et al. (2025). Exploring pharmacological treatment for trichotillomania: do we need better education? International Journal of Dermatology, 64(1), 92–100.

DuBois, M.C. et al. (2025). Trichotillomania and its treatment: an updated review and recommendations. Expert Review of Neurotherapeutics, 25(11), 1335–1345.

Goldin, D., Salani, D.A. & Valdes, B. (2026; published online 2025). N-Acetylcysteine (NAC) for Trichotillomania and Excoriation Disorder: An Overview. Journal of Psychosocial Nursing and Mental Health Services, 64(1), 15–23.

Fisak, B. et al. (2026). The efficacy of psychotherapeutic and pharmacological interventions for trichotillomania: A review and meta-analysis. Journal of Psychiatric Research.