This article reports the preliminary findings of a two-phase trial examining the efficacy of venlafaxine in trichotillomania. Phase 1 is a 12-week, open-label, prospective trial of venlafaxine in trichotillomania. Venlafaxine was effective in significantly reducing the symptoms of trichotillomania; 8 of 12 patients were considered responders. The implications of the efficacy of venlafaxine in trichotillomania are discussed, including its important advantages over other available antidepressant and anxiolytic medications.