Naltrexone for Trichotillomania Treatment

Monitoring and Safety

• Baseline liver function tests are mandatory, with repeat testing every 3-6 months due to potential hepatotoxicity at therapeutic doses, as recommended by clinical guidelines 1
• Assess for contraindications including acute hepatitis, liver failure, or concurrent need for opioid analgesics, according to clinical guidelines 1

Side Effects and Considerations

• Common side effects of naltrexone include headache, tachycardia, vivid dreams, nausea, and gastrointestinal symptoms 1, 2
• Hepatotoxicity can occur at supratherapeutic doses, emphasizing the need for careful monitoring 1

Treatment Considerations

• Naltrexone may be considered for patients who have failed or cannot tolerate N-acetylcysteine, or when comorbid conditions may benefit from opioid antagonism 1
• Patient preference should be discussed after reviewing the limited evidence base for naltrexone in trichotillomania treatment 3
• The established safety profile of naltrexone from its use in alcohol and opioid dependence is a consideration in its use for trichotillomania 3, 4