A Double-Blind, Placebo-Controlled Study of N-Acetyl Cysteine in Pathologic Skin Picking
Overview
- Phase
- Phase 2
- Intervention
- N-Acetyl Cysteine
- Conditions
- Pathologic Skin Picking
- Sponsor
- University of Chicago
- Enrollment
- 66
- Locations
- 1
- Primary Endpoint
- Yale Brown Obsessive Compulsive Scale (YBOCS) Modified for PSP (NE-YBOCS)
- Status
- Completed
- Last Updated
- 3 years ago
Overview
Brief Summary
The goal of the proposed study is to evaluate the comparative efficacy of N-acetyl cysteine to placebo in pathologic skin picking. Thirty subjects with pathologic skin picking will receive 12 weeks of double-blind treatment with N-acetyl cysteine or matching placebo. The hypothesis to be tested is that N-acetyl cysteine will be more effective than placebo in patients with pathologic skin picking. The proposed study will provide needed data on the treatment of an often disabling disorder that currently lacks a clearly effective treatment.
Detailed Description
Pathologic skin picking involves repetitive, ritualistic, or impulsive picking of otherwise normal skin leading to tissue damage, personal distress, and impaired functioning. Although skin picking has been described in the medical literature for over one-hundred years, it remains a poorly understood psychiatric issue and often goes undiagnosed and untreated. Picking behavior does not by itself suggest a psychiatric disorder. Pathology exists in the focus, duration and extent of the behavior, as well as the reasons for picking, associated emotions, and resulting problems. Patients with PSP report thoughts of picking or impulses to pick that are irresistible, intrusive and/or senseless. These thoughts, impulses, or behaviors also cause marked distress for patients and significantly interfere with other activities. Unlike normal picking behavior, the pathologic form of skin picking is recurrent and usually results in noticeable skin damage. Thirty subjects with pathologic skin picking will receive 12 weeks of double-blind treatment with N-acetyl cysteine or matching placebo. The hypothesis to be tested is that N-acetyl cysteine will be more effective than placebo in patients with pathologic skin picking. The proposed study will provide needed data on the treatment of an often disabling disorder that currently lacks a clearly effective treatment.
Investigators
Eligibility Criteria
Inclusion Criteria
- •Men and women age 18-65;
- •Current diagnosis of pathologic skin picking as determined by criteria proposed by Arnold et al. (2001) for at least 6 months duration
Exclusion Criteria
- •Unstable medical illness or clinically significant abnormalities on prestudy laboratory tests or physical examination;
- •History of seizures;
- •Myocardial infarction within 6 months;
- •Current pregnancy or lactation, or inadequate contraception in women of childbearing potential;
- •Need for medication other than NAC with possible psychotropic effects or unfavorable interactions with NAC;
- •Clinically significant suicidality (score or 3 or 4 on item 3 of the Hamilton Depression Rating Scale);
- •Lifetime history of DSM-IV bipolar disorder type I, dementia, or schizophrenia or any other DSM-IV psychotic disorder;
- •Current or recent (past 3 months) DSM-IV substance abuse or dependence;
- •Illegal substance use within 2 weeks of study initiation;
- •Initiation of pharmacotherapy, psychotherapy, or behavior therapy from a mental health professional within 3 months prior to study baseline for the treatment of pathologic skin picking;
Arms & Interventions
N-Acetyl Cysteine
N-Acetyl Cysteine - 600mg tablets by mouth (dosing 1200mg - 3000mg qd)
Intervention: N-Acetyl Cysteine
Placebo
Matching placebo taken daily
Intervention: Placebo
Outcomes
Primary Outcomes
Yale Brown Obsessive Compulsive Scale (YBOCS) Modified for PSP (NE-YBOCS)
Time Frame: Once every three weeks during the 12 week study for each subject
The entire study for an individual subject will last 12 weeks. Every 3 weeks the subject will take the YBOCS for the duration of the 12 weeks. At each of these visits the outcome will be assessed. The minimum score is 0 and the maximum score is 40, with a higher score being more severe skin picking. There are two sub-scales: one for urges (ranges from 0 to 20) and one for behaviors (ranges from 0 to 20). The total of the scores of each of the sub-scales is the total YBOCS score. That is what will be reported.
Secondary Outcomes
- Skin Picking Self Assessment Scale (SP-SAS)(Once every three weeks for the duration of the 12 week study for each subject)