Past Issues

Mirtazapine for the Treatment of Drug-resistant Pathological Skin Picking

Bor-Shien Kuo, Chia-Hung Tang, Tzu-Yun Wang, Carol Sheei-Meei Wang, Hong-Chen Yeh

Objective: Pathological skin-picking (PSP) is a common disorder, and some
pharmocotherapies for PSP have been reported. But the appropriate treatment is
limited. We are reporting the use of mirtazapine to successfully treat a refractory
PSP case. Case Report: This 42-year-old woman patient with mental retardation
had suffered from treatment-refractory PSP for at least ten years. She had received
behavioral therapies and various pharmacologic agents, including several kinds of
antidepressants, topiramate, and lamotrigene. But she had got only minimal improvement.
After receiving mirtazapine 30 mg/day for one week, the patient’s PSP
was dramatically improved. Conclusion: Mirtazapine showed to have improved
PSP in this patient. More well-designed studies are needed to defi nitely prove the
effect and neurobiologic actions of mirtazapine in PSP.
Key Word mirtazapine, pathological skin-picking, impulsivity
Editorial Committe, Taiwanese Journal of Psychiatry
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