Alleviation of Alopecia after Switching from Escitalopram to Duloxetine: a Case Report

Headnote

ABSTRACT

Alleviation of alopecia after switching from escitalopram to duloxetine: a case report

Many psychotropic drugs, including SSRIs, lithium, carbamazepine, valproate, vigabatrin, antipsychotics, benzodiazepines, and tricyclic antidepressants have been implicated in cases with alopecia. Drugs may cause a variety of dermatological side effects, ranging from mild hair loss to total alopecia, from hypertrichosis to hirsutism. In this paper, we present a case where alopecia emerged due to escitalopram, and where this side effect was alleviated after switching to duloxetine; we also review the literature for antidepressantrelated alopecia.

Keywords: Alopecia, duloxetine, escitalopram

ÖZET

Seçici serotonin geri alým inhibitörleri (SSGÝ), lityum, karbamazepin, valproik asit (sodyum valproat), vigabatrin, antipsikotikler, benzodiazepinler, trisiklik antidepresanlar da dahil olmak üzere bir çok psikotrop ilacýn saç kaybý ile iliþkili olduðu bildirilmiþtir. Ýlaçlar hafif saç dökülmesinden saçlarýn tamamen kaybýna, hipertrikozisten hirsutizme kadar birçok saç hastalýðýna neden olabilir. Bu yazýda essitalopram kullanýmýyla geliþen ve duloksetin tedavisine geçilmesiyle saç dökülmesi yan etkisi gerileyen bir olgu sunulmuþ ve antidepresanlara baðlý alopesi ile ilgili alanyazýn gözden geçirilmiþtir.

Anahtar kelimeler: Alopesi, duloksetin, essitalopram

INTRODUCTION

It has been reported that a number of psychotropic drugs, including Selective Serotonin Reuptake Inhibitors (SSRIs), lithium, carbamazepine, valproic acid (sodium valproate), vigabatrin, antipsychotics, benzodiazepines, and tricyclic antidepressants are related to hair loss (1-4). These drugs can cause trichopathies ranging from slight to complete hair loss and from hypertrichosis to hirsutism. Reason for these trichopathies is usually an increase or decrease of the speed of follicle proliferation due to the drugs. A follicle is a structure inside of which hair grows. It has been reported that hair loss occurs when drugs push follicles in the growth phase into the dormant phase. It is known that the life span of a follicle is three months. Given that a follicle entering the dormant phase can no longer proliferate, it dies after three months and is shed. This is why drug-related hair loss is usually noticed in the third month (1,4). The term alopecia is used for all types of hair loss, from light hair loss to a total loss of body hair (1,4).

SSRIs are effective and safe drugs that have been used for many years to treat depression. Only few cases of SSRI-related alopecia have been reported in the literature. There are cases related...