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.