Escitalopram for the Treatment of Self-Injurious Skin Picking

Inclusion Criteria:

• Repetitive skin picking resulting in noticeable tissue damage and associated emotional distress 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 test and 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 a medically acceptable method of contraception.
• Women who are breastfeeding.
• Subjects who pose a serious suicidal or homicidal risk in the judgment of study investigators.
• 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 personality disorder or developmental disorder. Subjects with obsessive compulsive disorder (with primary symptoms other than compulsive skin picking).
• History of substance dependence. If there is a history of substance abuse, subjects should 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 within the past 12 months.
• More than 1 adequate trial (at least 10 weeks at maximally tolerated dose) with another prior SSRI.