.png)
Trichotillomania (TTM) is a type of psychiatric disorder, which is characterized by repetitive hair pulling. The individual suffering with this disorder pulls out hair in a chronic or compulsive manner from the scalp or eyebrows which results in excessive hair loss as well as personal distress. Hair pulling in individuals suffering from TTM leads to pleasure and relief in tension. TTM is reported to affect as much as 4% of the population with the highest incidence in childhood and adolescence. TTM has been classified as an impulse-control disorder (ICD). However, researchers suggest that based on the phenomenological and psychological overlaps with Obsessive compulsive disorder (OCD), TTM is best described as an obsessive–compulsive spectrum disorder (OCSD). Little is known about the etiology of hair pulling and its relationship to other OCSD. First-line therapy is cognitive behavioral therapy, with strongest support for the subtype habit-reversal training. The effect of medication on trichotillomania has not been systematically evaluated. In this presentation, we aimed to discuss a case diagnosed with TTM who had been tried to treat with SSRIs and an antipsychotic agent. A 14-year-old girl applied to Child and Adolescent Psychiatry Department of Dokuz Eylul University School of Medicine with hair pulling, irritability, anhedonia, appetite and sleep disturbance. These symptoms had been going on for two years. When she applied to another psychiatric outpatient unit one year ago, she began to use sertraline 50 mg and risperidone 0.5 mg per day. After our psychiatric evaluation, she was diagnosed with Trichotillomania and Major Depression, and Sertraline treatment was increased to 100 mg per day and Risperidone 0,5 mg per day was continued. Her symptoms like hair pulling, sadness, anhedonia, increased appetite and weight gain decreased in process but she continued to suffer from these symptoms. Then sertraline treatment was stopped and another SSRI şuoxetine was used. Her symptoms were not responded to şuoxetine. She did not continue her treatment. In our case, her complaints were resistant to medication. The effect of medication on trichotillomania has not been evaluated yet. Some effective behavioral and pharmacological interventions exist for the treatment of trichotillomania; randomized, controlled trials in adults with trichotillomania are very few. Many adults with trichotillomania continue to experience severe and impairing symptoms of hair pulling despite using all evidence-based treatments. There are currently no published randomized, placebo-controlled trials of any pharmacological agents for the treatment of pediatric trichotillomania. According to our experiences, trichotillomania treatment with SSRIs and antipsychotic agents had limited effect.