Current studies suggest a kind of addictive behaviour in trichotillomania. On this basis, it could be said that dopaminergic pathways play a role in it as much as serotonergic pathways. In a number of case studies bupropion treatment was found effective. In this report, we will present a case of trichotillomania, after multipl failed trials of other treatments, responding only to bupropion treatment. Forty four years old female patient. Her prominent complaints were hair pulling and feeling pleasure while pulling out hair and has lasted for 25 years, and those complaints increased especially in anxious periods. She did not benefit from ?uoxetine treatment, a dose of 40 mg/day, which she has used regularly for the last 3 years, and clomipramine treatment, a dose of 225 mg/day, which she has used for last 4 months. At her examination, her hair had a short-cut, large bald areas were apparent on the scalp, mood was euthymic, affect was coherent with her state, there were feeling of worthlessness secondary to the bald zones. NIMH-TIS scale score was 8 points. Complete remission has achieved with treatment of bupropion 300 mg/day and supportive psychotherapy. Remission state was intact during outpatient follow-up for eight months. The results about treatment of trichotillomania is insufficient for developing a treatment algorithm. Although, selective serotonin reuptake inhibitors are thought as a treatment option, some patients do not respond to SSRI treatment. The studies have reported that clomipramine treatment has decreased the intensity of hair pulling, and increased the resistance. Augmentation is an option in inadequate responses to treatment. There are positive treatment results with risperidone and olanzapine in some case reports. In few cases it has reported that bupropion could be a treatment option in the cases who did not respond to SSRI treatment. Our case is supporting this finding.
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