Selective serotonin reuptake inhibitors (SSRIs) are widely used anti-depressants. Some of the common ones are Fluoxetine, Sertraline, Citalopram amongst others. One of the rare side effects listed of these SSRIs is alopecia (hair loss).
The exact prevalence of hair loss with SSRI treatment has not been determined as it is difficult to quantify. It is difficult to diagnose hair loss due to drug use because no special method exists to arrive at this diagnosis. The exact mechanism that causes this has not been elucidated. It is thought to be a direct toxic effect termed telogen effluvium where the drug affects the growing stage of the hair follicle.
Another mechanism postulated is the imbalance of melatonin around the hair follicle (as human skin can convert serotonin to melatonin). Of the cases reported and data published, it seemed that there reduction in dose reduced hair loss in a patient.
It was also seen that drug-induced hair loss generally resolved (with recovery of hair growth) within 2 months after discontinuation of the drug. Alopecia induced by medications is generally characterized by a diffuse, non-scarring hair loss and its reversibility after stopping drug. Dosage reduction, drug stopping or pursuing therapy with another agent remains the most promising management option.
The patient and clinician should discuss the risk and benefits of continuing, stopping, or changing the dose or medication. No antidepressants should be stopped without consulting ones doctor.