Augmentation of Venlafaxine with Aripiprazole in a case of treatment-resistant excoriation disorder

We present a case of a 21-year-old woman with excoriation disorder that was resistant to currently reported treatment options. Severe lesions were present on multiple sites of her body. The skin picking appeared to be associated with anxiety surrounding her current medical stay and medical condition. The addition of aripiprazole to the venlafaxine she was already taking resulted in resolution of her unconscious picking. This medication combination may be considered by clinicians in the future for treatment-resistant excoriation disorder as its side effect profile is favorable for patients who have failed first-line treatment options. Large-scale studies investigating the use of second generation antipsychotics combined with selective serotonin reuptake inhibitors/serotonin norepinephrine reuptake inhibitors for the treatment of excoriation disorder is recommended.