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Nail Biting Pharmacotherapy: a Review

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Abstract

Purpose

Onychophagia, or habitual nail biting, is a common disorder, especially in children and young adults. Multiple factors contribute to its development, from emotional triggers to genetics and underlying psychiatric conditions. Nail biting can have a significant impact on one’s quality of life, and its complications are not limited to cosmetic distortion. In severe cases, uncontrolled onychophagia can cause serious physical, dental, and psychosocial consequences. In this article, we review the use of N-acetyl cysteine (NAC), selective serotonin reuptake inhibitors (SSRIs), tricyclic antidepressants (TCAs), lithium, and silymarin as possible treatment modalities for chronic nail biting.

Recent Findings

There are many established behavioral and psychological interventions for the treatment of onychophagia, albeit modest in efficacy. And up until today, there is minimal evidence that supports effective pharmacotherapy. However, several of these drugs show promising results that warrant further exploration.

Summary

NAC was found to be more effective than placebo in the short term, while SSRIs showed contradictory results. TCAs (especially clomipramine), lithium, and silymarin have also exhibited potential in curbing nail biting behavior to different extents. Further studies are required to outline a definite treatment modality for onychophagia, along with corresponding therapeutic doses.

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Authors and Affiliations

  1. Beirut Arab University, Beirut, Lebanon

    Rim Taleb MD, MHPE, Zeina El Obaji MD, Zeinab Abraham MD & Razan El Sayed MD

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  1. Rim Taleb MD, MHPE
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  2. Zeina El Obaji MD
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Correspondence to Rim Taleb MD, MHPE.

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Rim Taleb declares that she has no conflict of interest. Zeina El Obaji declares that she has no conflict of interest. Zeinab Abraham declares that she has no conflict of interest. Razan El Sayed declares that she has no conflict of interest.

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Taleb, R., El Obaji, Z., Abraham, Z. et al. Nail Biting Pharmacotherapy: a Review. Curr Treat Options Psych 9, 73–84 (2022). https://doi.org/10.1007/s40501-022-00257-3

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