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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 4 of 4. This is the beginning of the thread.
Posted by Steeler Tookahn on August 7, 2000, at 6:39:48
My girlfriend has started losing her hair since she started taking Protriptoline. I have seen threads equating hair loss with SSRIs but was wondering if anyone else has experienced this with Protriptoline? She's also taking lithium and Premarin but the hair loss seems to have started once she started Protriptoline.
It would be a shame if she had to switch meds since this seems to be effective, but the loss is pretty severe.
Posted by Rach on August 7, 2000, at 8:09:21
In reply to Protriptoline and hair loss, posted by Steeler Tookahn on August 7, 2000, at 6:39:48
I had severe hair loss due to zoloft (SSRI, I know) in the first couple of months of using it. It's been 3 months now, and my hair loss has actually diminished. I now just have regular hair loss like everyone else. I am very relieved.
How long has your girlfriend been on her new meds? Perhaps it is a similar thing to what I have experienced, in that the loss will decrease and eventually cease as her body becomes used to the med.
Best Wishes!
Posted by Steeler Tookahn on August 7, 2000, at 12:38:00
In reply to Some good, but not necessarily on topic, news, posted by Rach on August 7, 2000, at 8:09:21
> I had severe hair loss due to zoloft (SSRI, I know) in the first couple of months of using it. It's been 3 months now, and my hair loss has actually diminished. I now just have regular hair loss like everyone else. I am very relieved.
>
> How long has your girlfriend been on her new meds? Perhaps it is a similar thing to what I have experienced, in that the loss will decrease and eventually cease as her body becomes used to the med.
>
> Best Wishes!Rach,
She started the Protriptoline in January. We were hoping the problem might abate naturally, as yours did, but it seems to be getting worse. We're going to try the Selenium/Zinc supplements that many have suggested on this board. Thanks for your input.
Posted by Sunnely on August 9, 2000, at 0:35:10
In reply to Protriptoline and hair loss, posted by Steeler Tookahn on August 7, 2000, at 6:39:48
> My girlfriend has started losing her hair since she started taking Protriptoline. I have seen threads equating hair loss with SSRIs but was wondering if anyone else has experienced this with Protriptoline? She's also taking lithium and Premarin but the hair loss seems to have started once she started Protriptoline.
Hi Steeler Tookahn,
The PDR (Physicians Desk Reference) notes alopecia (hair loss) as a side effect for all of the tricyclic antidepressants (including protriptyline or Vivactil) approved for use in the U.S. However, the rate of occurrence is unknown. It appears that only the more severe and clinically significant cases are reported. Mild to moderate cases of tricylic antidepressant-induced hair loss probably remain underreported.
Diagnosis of hair loss due to tricyclic antidepressant is not easy. Recovery of the hair loss with discontinuation of the drug and worsening of the hair loss upon re-exposure is the best evidence for incriminating a particular drug. Of course, other causes of hair loss must be investigated before a drug cause is clearly implicated.
As you may be aware, SSRIs have also been reported to cause hair loss. It appears to be more commonly associated with fluoxetine; more with women than men. Aside from the tricyclic antidepressants that are available in the US and the SSRIs, other antidepressants reported to cause hair loss include moclobemide (not available in the U.S.), tranylcypromine, lofepramine (not available in the US), dothiepin (not available in the US). It appears that hair loss have not been reported with trazodone, (structurally related to Serzone which has been reported to cause hair loss), and mianserin.
Other psychotropic drugs implicated to cause hair loss include lithium, carbamazepine (Tegretol), sodium valproate (Depakote, Depakene), and amphetamines, phenothiazines. Other drugs that can induce hair loss include anti-cancer, anticoagulants, antithyroid, and beta-blockers. Certain physiologic and medical conditions can cause hair loss such as postpartum, genetic propensity, infections (e.g., tinea, syphilis), endocrine disease (e.g., thyroid), defienciency states (e.g., iron, protein), trauma or traction (hot comb, permanent, tight braiding, curlers), and others such as fever, blood loss, surgery, childbirth, psychological stressors, crash diet.
It's a shame that the drug (protriptyline) which is helping your girlfriend with her depression (I presume) appears to be causing her to lose hair at the same time. I can understand the big dilemma confronting you at present (i.e., to stay with the drug or change). The combination zinc/selenium generally works for valproate-induced hair loss. This may be worth a try in her case. If everything else fails and the condition worsens, an alternative antidepressant may need to be tried. Fortunately, drug-induced hair loss generally recovers after discontinuation of the drug. However, it has been found to be irreversible in some cases.
Good Luck.
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