Escitalopram for the Treatment of Self-Injurious Skin Picking

Inclusion Criteria:

• Repetitive skin picking resulting in noticeable tissue damage and associated emotionaldistress and/or functional impairment.

• Age 18-65 years old.

• Duration of skin picking symptoms ≥ 6 months.

• MGH Skin Picking Scale score ≥ 10.

• Written informed consent.

• Females of childbearing potential must have a negative serum or urinary beta-HCG testand be willing to use acceptable methods of birth control during study tenure.

Exclusion Criteria:

• Pregnant women or females of childbearing potential who do not consent to use of amedically acceptable method of contraception.

• Women who are breastfeeding.

• Subjects who pose a serious suicidal or homicidal risk in the judgment of studyinvestigators.

• Serious or unstable medical illness including cardiovascular, hepatic, renal,respiratory, endocrine, neurologic, or hematologic disease.

• Subjects with a dermatologic disorder that causes pruritis.

• Patients on anticoagulant therapy.

• History of seizure disorder.

• Comorbid bipolar disorder, psychosis, organic mental disorder, borderline personalitydisorder or developmental disorder. Subjects with obsessive compulsive disorder (withprimary symptoms other than compulsive skin picking).

• History of substance dependence. If there is a history of substance abuse, subjectsshould be in remission for ≥ 6 months.

• Current treatment with cognitive behavioral therapy for skin picking.

• Current use of another SSRI medication.

• Other medications for medical disorders that might interfere with escitalopram.

• Current major depression or prescribed an antidepressant for major depression withinthe past 12 months.

• More than 1 adequate trial (at least 10 weeks at maximally tolerated dose) withanother prior SSRI.