How N-acetyl cysteine prevents hair pulling is not fully understood but is believed to act in the brain and reduces activity of a neurotransmitter called glutamate. It is believed that glutamate may play a role in the compulsion to pull hair. When levels of glutamate are reduced, the drive to pull hair also disappears.
There have been previous anecdotal reports and case series which have also reported that N-acetyl cysteine may reduce the urge to use illicit drugs like cocaine.
The dose of N-acetyl cysteine used in the study varied from 1.2 to 4 grams per day. Even though hair-pulling episodes declined, most individuals did not see a marked improvement in their quality of life.
So what about the individual who has trichotillomania?
One should understand that this is only one study that shows benefits of N-acetyl cysteine for hair pulling. The supplement is easily available without a prescription from any health food store and is relatively safe to ingest. The cost of N-acetyl cysteine is also substantially lower than all presently prescribed drugs for the disorder. Therefore, if you have a habit of puling your hair and would like to stop it, N-acetyl cysteine may not be a bad idea. Of course, if it does not work within two to three months, then the above study was hogwash.
Archives of general psychiatry, 2009-07-18