Treatment response

Various cognitive-behavioural therapies (especially habit reversal, but also self-monitoring, use of bitter tasting substances, competing responses, and negative practice training) are probably effective in onychophagia. (38) Only one study has evaluated the pharmacological treatment of onychophagia. This double-blind cross-over study demonstrated that clomipramine (mean dose 120 mg/day) was significantly better than desipramine (mean dose 135 mg/day) in eliminating nail-biting, reducing nail-biting severity and impairment, and in improving overall clinical progress. (39)

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