SSRIs and hair side-effects: possible?

[daredevil14]

I started today taking Faverin (fluvoxamine) at the regular dose and will gradually increase it in the next few weeks. Does it affect, in any way (positive or negative), hair? I don't see "Hair Loss" as an official side effect of all SSRIs but I've read online of some people complaining about hair thinning! My hair is wavy/curly and at BSL (or whatever it is for a guy).

And after my first half-pill today, I already felt some nausea. (Too early?!)

Let me hear your experiences!

[FireFromWithin]

I don't know of any and haven't experienced any. They've made a wonderful difference to my anxiety and mood though. It takes about 8 weeks for them to fully get up to does as it were in your system but I started feeling effects before that. I would postulate that it's good for my hair because I'm calmer and happier! I took a difficult exam today without a panic attack and without even touching my hair!

[swearnsue]

The medication itself hasn't had any effect on my hair that I can tell. The effect of finding proper medication makes me feel better and as a result I eat healthier, exercise more and by doing that my hair has improved.

Get past the first few weeks though, it's tough at first I had weird sensations and thoughts but after those first few weeks it gets much better.

[MonaMayfair]

They cause hair loss in some people as do most medications.

[tbonita]

I spent 3 years on various SSRIs (until I found my magic pill in Wellbutrin), and never experienced any shedding/dulling.

[Mustang Suzy]

Faverin (fluvoxamine) made me feel worse than I was without medication. Finally the VA switched me to Zoloft. I take it at night so I don't feel the nausea I felt when taking it in the morning. No noticeable hair side effects for either medicine. Good Luck Daredevil14.

[faellen]

I haven't been on fluvoxamine but I have take other SSRIs in the past and never experienced any hair related side effects. Fluvoxamine in the BNF (British National Formulary, don't know what country you're in but it's practically my bible for anything drug related!) isn't listed as having hair loss or thinning as a side effect. Nausea is normal for SSRIs though but should disappear once you've been taking the medication for a while (for me it was about 2 weeks).


They cause hair loss in some people as do most medications.

Really? *Most* medications? Do you have a source for this?

[monsoonstorm]

Various "brain meds" do cause thinning.

As with most meds though, you jump on the merry-go-round and hope for the best. It's pot luck. Most SSRI's give me horrible achey muscle pains/twitches/spasms. Every one I've tried has made me fat and destroyed my sex life (beyond it being broken in the first place). They also tend to take away the happiness along with the sadness (in me).

You balance the pro's and cons and see what you need.

I rather hate how they have become the default "treatment" now instead of therapy etc. I guess they are cheaper, easier, and if you treat the side effects too then even more profit to be made for those meds!

Yes I'm a hardened cynic ;-)

[Anje]

I'm pretty much the queen of SSRI side effects (acne, disruption of menstrual cycle, serotonin syndrome, obsessive suicidal thoughts, you name it), but I haven't ever had hair problems with any of the ones I've tried.

[daredevil14]

Thank you all for the valuable inputs. I am taking it for my severe Pure-O (OCD) as my main issue is with obsessive thoughts AND mental rituals rather than the traditional compulsions. I wish if I can try CBT but it's too expensive where I am working now.

Are there other heard cases where such meds DO change texture, properties, growth rate, etc... either positively or negatively...?

[Unofficial_Rose]

I'm on Citalopram (Celexa) for anxiety and depression. I've been on it for about 10 weeks and I think my hair is getting thicker. This is because it's not falling out as fast as it was as I'm less stressed! It had thinned quite a bit over last few years, starting to look better now.

Off topic: By the way, thanks to Anje for saying they cause disruption to menstrual cycle. I'm experiencing this for last two months, ws worried it was something else. So thanks again! :thumbsup:

[monsoonstorm]

Since it is sometimes used for OCD...

Lamictal is the biggie in the "lets nuke your hair" stakes. I was on it for years (not for OCD). That's when I started discovering "rats" in my drains. My hair also grew back wavier/curlier. Unfortunately even though I have switched from lamictal, I still shed silly amounts.

Personally, if I was you I would try my hardest to go the therapy route. Buy some books ("mind over mood" is a good one) and start working on it yourself at home. Unless your OCD is debilitating, I'm not sure it's worth the side effects.

*edit* pm'ing

[tbonita]

Since it is sometimes used for OCD...

Lamictal is the biggie in the "lets nuke your hair" stakes. I was on it for years (not for OCD). That's when I started discovering "rats" in my drains. My hair also grew back wavier/curlier. Unfortunately even though I have switched from lamictal, I still shed silly amounts.

Personally, if I was you I would try my hardest to go the therapy route. Buy some books ("mind over mood" is a good one) and start working on it yourself at home. Unless your OCD is debilitating, I'm not sure it's worth the side effects.

*edit* pm'ing
Aaahhh I've been on lamictal for years!!! I sometimes note more shedding than other times... A contributor?

[monsoonstorm]

My shedding was (is) fairly constant I think. It quite possibly varies by the time of month though. Lamictal and girly hormones don't mesh as I found out when I stopped taking the pill. It's less effective around your period. Depending on what you take it for, be careful if you change your birth control. I'd make sure you take Calcium/Vit D/B complex with Lamictal too, people on Lamictal are often deficient in those.

Other things Lamictal has left me with a legacy of:
- Sensitivity to various things. My face in particular stopped tolerating a wide range of products. Even "sensitive" products would bother me
- Sensitivity to sun. I never used to burn. Now I do.

Besides all of this, I actually liked Lamictal, even though it made me dumb. It also heightened my sense of smell... I was brilliant at being able to pick out all of the "notes" in wines. That stopped when I switched, I was surprisingly gutted :( On an associated note, my hangovers were 2 day migraines from hell! Now that I've switched that has changed. (and yes, I know, shouldn't drink on meds, yadda yadda :P )

I'd actually like to add it back to my regime but I need to get a referral because GP's here are useless.

[shutterpillar]

I never experienced any excessive shedding or hair loss while taking my SSRIs. I took Wellbutrin and Celexa together. The only side effect I experienced was nausea for the first week and then I felt mostly normal.
I was on those meds for a little over a year, and I am beginning to think I may need to go back on them again. I want to ride out the winter first and see if it's just related to the season change.

[chen bao jun]

I take celexa and my hair is jsut fine.
The only effect I've had from it is relief from crippling anxiety/depression.
I still have OCD but its more manageable.
Good luck.

[tbonita]

My shedding was (is) fairly constant I think. It quite possibly varies by the time of month though. Lamictal and girly hormones don't mesh as I found out when I stopped taking the pill. It's less effective around your period. Depending on what you take it for, be careful if you change your birth control. I'd make sure you take Calcium/Vit D/B complex with Lamictal too, people on Lamictal are often deficient in those.

Other things Lamictal has left me with a legacy of:
- Sensitivity to various things. My face in particular stopped tolerating a wide range of products. Even "sensitive" products would bother me
- Sensitivity to sun. I never used to burn. Now I do.

Besides all of this, I actually liked Lamictal, even though it made me dumb. It also heightened my sense of smell... I was brilliant at being able to pick out all of the "notes" in wines. That stopped when I switched, I was surprisingly gutted :( On an associated note, my hangovers were 2 day migraines from hell! Now that I've switched that has changed. (and yes, I know, shouldn't drink on meds, yadda yadda :P )

I'd actually like to add it back to my regime but I need to get a referral because GP's here are useless.
That's all really interesting stuff. I don't know if this is tmi alert, but I actually have my tubes tied and rarely have a menstrual cycle since doing it at 29. So I don't know if that would really apply... Idk I've been on some kind of combo w lamictal for years (that's always been the one constant) so it's hard for me to pinpoint what's doing what, you know? Is a multi vitamin not sufficient for those deficiencies?

Sorry if I hijacked this thread I know it's supposed to be about SSRIs and hair :/ it's just so rare I can vent about this stuff with people who've been there ...

[lapushka]

Really? *Most* medications? Do you have a source for this?

Yes that's a pretty dangerous thing to say. I'm on various different meds, and my hair has yet to fall out because of them.

[monsoonstorm]

That's all really interesting stuff. I don't know if this is tmi alert, but I actually have my tubes tied and rarely have a menstrual cycle since doing it at 29. So I don't know if that would really apply... Idk I've been on some kind of combo w lamictal for years (that's always been the one constant) so it's hard for me to pinpoint what's doing what, you know? Is a multi vitamin not sufficient for those deficiencies?

Sorry if I hijacked this thread I know it's supposed to be about SSRIs and hair :/ it's just so rare I can vent about this stuff with people who've been there ...

PM'ed you to avoid hijacking!

[Iolanthe13]

I rather hate how they have become the default "treatment" now instead of therapy etc. I guess they are cheaper, easier, and if you treat the side effects too then even more profit to be made for those meds!

Yes I'm a hardened cynic ;-)

I agree with you that therapy is probably a better place to start, but six years of on-and-off therapy haven't had the positive effect that 3 weeks of Celexa did for me.

I will also say that my prescription (Celexa 30mg, aka citalopram) made me feel pretty strange for the first week or so (headache, particularly), but after that the only side effect I have had is needing to pee a little more often. It has really change my life for the better.

[Nedertane]

I'm taking Celexa at 40 mg, and it doesn't seem to have done anything to my hair that I can tell. It does seem like it's breaking and shedding slightly more at the moment, but I think that's my stress from the end of this semester. (O_O)

ETA: Oh, and about it being too early to feel nausea the first time taking the medication - I would probably say that's normal, and I think that happened with me as well. The psychiatrist who prescribed it to me told me that it would be the first side-effect I'd feel, but also probably the first to go away. That is pretty much what happened with me, so it kinda sounds like you're in my boat when it comes to the nausea.



I'm pretty much the queen of SSRI side effects (acne, disruption of menstrual cycle, serotonin syndrome, obsessive suicidal thoughts, you name it), but I haven't ever had hair problems with any of the ones I've tried.

Also, Anje, you've had acne from an SSRI? That's interesting because I used to get pretty bad cystic acne on my cheeks, but my face has been FANTASTICALLY clear since I've been on it.

[spaceagerock]

A few years ago I tried a number of anti-anxiety/depression meds after getting diagnosed with PTSD. I tried two different SSRIs (Sertaline & Citalopram) and didn't like either, mainly because they made me sleep about 20h/day. Then tried Mirtazapine, which ironically caused seratonine syndrome, and Venlaflaxine. I was on Venlaflaxine the longest, but didn't really like it either. I had severe nausea with all of them, so I got tried on Quetiapine on a low dose, but that was hell on Earth because I literally felt nothing *shudders*.

So... even though I was on a number of different meds, here's my thoughts re: hair. Personally my hair thinned something crazy (& I have fine hair), BUT I also lost about 10kg very, very quickly so I think that was the culprit. Today I've been off the meds for two years and last year I saw A LOT of the "medication-damaged" hair grow out (obiously some still to go). I didn't notice at the time the damage it was causing to my hair, but when it grew out I noticed that the texture of the hair was like straw, kinks everywhere and really brittle. So thinking from a purely hair point of view, for me the meds were really bad, but I didn't like them in the first place and resisted them throughout. And it has to be said that my hair is back to normal (actually better) now so it didn't take long for my hair to counter balance any negative effects.

Also, there's a book called Teach Yourself CBT (http://www.amazon.co.uk/Cognitive-Behavioural-Therapy-Teach-Yourself-ebook/dp/B004G5Z2P8) that I found really helpful.

[Anje]

Also, Anje, you've had acne from an SSRI? That's interesting because I used to get pretty bad cystic acne on my cheeks, but my face has been FANTASTICALLY clear since I've been on it.
Yeah, Zoloft gave me the worst cystic acne of my life. Admittedly, it's a rare one. Then I got the hot, dizzy, "I think I might collapse" feelings and got pulled off it fast.

Generally, take my experiences as stuff to be aware of. Getting treated for depression is important; I'm just an oddball who really cannot tolerate the drugs.

[MonaMayfair]

Yes that's a pretty dangerous thing to say. I'm on various different meds, and my hair has yet to fall out because of them.

Of course it's not a dangerous thing to say., that's just silly. I know what I'm talking about! Just because you've been lucky doesn't mean everyone is!
I've had a lot of illness induced hair loss myself (on and off for the last 5 years or so) so have spent a LOT of time researching this. Most medications have hairloss listed as a possible side effect. Exactly the same with any hormonal treatments like the pill or HRT (or the mirena coil etc)
I've read SO many instances on SO many different health forums of medications causing hair loss. Personally I avoid taking any kind of medication even ibuprofen (which DOES have hair loss as a possible side effect incidentally)
People sometimes don't make the connection because a lot of people aren't aware that TE typically starts 3 month after the trigger event.

[Redvelvetdragon]

I'm on Paxil and Welbutrin (a little mixing on behalf of the doctor. It's helped a lot). I haven't noticed any thinning because of it. Though I had been in therapy before the meds, it doesn't stop seratonin reuptake issues. That's a physical issue. Also, I too had the running thoughts and the ritual thing (though it was fairly mild) and the Paxil nipped that in the bud right away.

At this point you have to think, what is this stress causing me in terms of thinning hair and health problems. It can have very serious effects on the body. Will taking meds improve my stress levels, make me happier and therefore my health improving?

I'm thankful that modern medicine can help people with this.

[faellen]

Of course it's not a dangerous thing to say., that's just silly. I know what I'm talking about! Just because you've been lucky doesn't mean everyone is!
I've had a lot of illness induced hair loss myself (on and off for the last 5 years or so) so have spent a LOT of time researching this. Most medications have hairloss listed as a possible side effect. Exactly the same with any hormonal treatments like the pill or HRT (or the mirena coil etc)
I've read SO many instances on SO many different health forums of medications causing hair loss. Personally I avoid taking any kind of medication even ibuprofen (which DOES have hair loss as a possible side effect incidentally)
People sometimes don't make the connection because a lot of people aren't aware that TE typically starts 3 month after the trigger event.

You still haven't given me a source (peer reviewed and current, if possible, NOT anecdotal evidence from forums) that states that most medications cause hair loss. As a healthcare student I'd be interested to read it, because it's not something I've come across. Except for the obvious medications that have hair loss as a side effect (e.g. certain chemo drugs, also, glucosamine, levothyroxine, levonorgestrel etc), I can't say ibuprofen springs to mind, I managed to find a couple of things about it on websites about hair loss/thinning being an EXTREMELY rare side effect yet there's nothing in my formulary (so it must be rare, especially if you're only taking a couple of pills now and then for a headache instead of long term treatment - and with NSAIDs you'd be more worried about your stomach anyway rather than your hair, lol!). I'll have to ask some of the pharmacy students.

Your post is only dangerous if you're advocating that others don't take any possibly essential medications at all in case of hair related side effects. And I'm sure that's not what you're saying at all.

[Elanadi]

I had more shedding than normal while on Zoloft; I'm now on a low dose of Prozac and my shedding is back down to very low amounts. I didn't notice any other hair effects. I also am queen of side effects, from high blood pressure, pre-diabetes, edema, flattening of emotions, becoming suicidal, horrendous night sweats, etc.. after doing a lot of research after my psychiatrist told me there was no way any of that was from the SSRI (!!!), it turns out the recommended dosage amount is way too high for a percentage of the population, and isn't necessary to get the intended treatment effects. I got the same benefit from 25mg of Zoloft as I did at 100mg, only without all of the intolerable side effects. Also, if the particular med you are on doesn't agree with you, try another. Every one reacts with each individual a little differently, so it may take some experimenting to find the right med and the right dose.

[daredevil14]

Out of all the SSRIs side effects brochures which I read, none lists "Hair Loss" as a side effect, not even on the rare ones! It's my 4th day now on Faverin (fluvoxamine) and my hair is still as it always was, tomorrow is the wash day so we shall see...

On a side note, the side effects which I had so far are mild nausea (1st day), sleepiness (2nd day) and loss of motivation & extra sleep hours (3rd day), I hope this is temporary especially for the last one. (Motivation!)

[MonaMayfair]

You still haven't given me a source (peer reviewed and current, if possible, NOT anecdotal evidence from forums) that states that most medications cause hair loss. As a healthcare student I'd be interested to read it, because it's not something I've come across. Except for the obvious medications that have hair loss as a side effect (e.g. certain chemo drugs, also, glucosamine, levothyroxine, levonorgestrel etc), I can't say ibuprofen springs to mind, I managed to find a couple of things about it on websites about hair loss/thinning being an EXTREMELY rare side effect yet there's nothing in my formulary (so it must be rare, especially if you're only taking a couple of pills now and then for a headache instead of long term treatment - and with NSAIDs you'd be more worried about your stomach anyway rather than your hair, lol!). I'll have to ask some of the pharmacy students.

Your post is only dangerous if you're advocating that others don't take any possibly essential medications at all in case of hair related side effects. And I'm sure that's not what you're saying at all.

Seriously, I can't imagine why I should be bothered to defend what I said which was that most medications cause hairloss in SOME people. Just read the leaflet that comes with the medication, it's there in black and white as a possible side effect.
I first had TE after having a general anaesthetic. Some people have operations and don't have half their hair fall out and some people do.
Then a TE caused by thyroid imbalance turned into CtE which is basically TE that goes into remission fro a few months (if you're lucky) but doesn't end.
And what is "anecdotal evidence" but to give your own experience, many, many of which I've read over the last few years? Everyone responds differently. You may want to belittle someone who avoids ibuprofen because they have CTE and don't wish to exacerbate it, but once you're prone to TE anything can make it worse very easily. Not to mention the painful burning, soreness and itching that comes with the excessive shedding. And there's no "cure"
This isn't something I usually talk about on here because it distresses me so much.
She asked. I answered.
I won't bother in future.
Here is a link about various medications
http://www.heralopecia.com/interact/showthread.php/39-Comprehensive-List-of-Drugs-that-Cause-Hair-Loss

[lapushka]

Just read the leaflet that comes with the medication, it's there in black and white as a possible side effect.

Not on any of my meds, it doesn't. That's actually the *first* I've heard of it. I'm not going to discuss what I take online, so don't ask. But I've checked, and it isn't on there. So to just generalize seems a little *much* if you ask me.

[MonaMayfair]

Not on any of my meds, it doesn't. That's actually the *first* I've heard of it. I'm not going to discuss what I take online, so don't ask. But I've checked, and it isn't on there. So to just generalize seems a little *much* if you ask me.

I cant imagine why you think I'd ask what meds you take, I couldn't be less interested.
I've never spoken about this on here before, and it's upsetting very much me to do it now (I try to speak about it in real life only when strictly necessary) but I do have a few serious health problems of long standing (one since I was 14) and have been in constant pain since then.
All the meds I've been prescribed list hair loss as a possible symptom. It's the first thing I look for. I can't imagine why you feel you need to be argumentative about this just because we have had different experiences, but it reinforces my experience that this site is far from the empathetic nurturing place it pretends to be.
I shan't be coming back here any more. My life is quite crappy enough, I don't need to come onto a forum to be treated with hostility and reduced to tears.

[lapushka]

I cant imagine why you think I'd ask what meds you take, I couldn't be less interested.
I've never spoken about this on here before, and it's upsetting very much me to do it now (I try to speak about it in real life only when strictly necessary) but I do have a few serious health problems of long standing (one since I was 14) and have been in constant pain since then.
All the meds I've been prescribed list hair loss as a possible symptom. It's the first thing I look for. I can't imagine why you feel you need to be argumentative about this just because we have had different experiences, but it reinforces my experience that this site is far from the empathetic nurturing place it pretends to be.
I shan't be coming back here any more. My life is quite crappy enough, I don't need to come onto a forum to be treated with hostility and reduced to tears.

This is "just" a disagreement. Your experience doesn't have to be my experience. It have major health issues and have to take quite a bit of medication, and hair loss is *not* listed as a side-effect on any of them. This is *my* experience, which is why you can (absolutely) not generalize, like you did.

But anyway, that's the last I'm saying about this.

[faellen]

Seriously, I can't imagine why I should be bothered to defend what I said which was that most medications cause hairloss in SOME people. Just read the leaflet that comes with the medication, it's there in black and white as a possible side effect.
I first had TE after having a general anaesthetic. Some people have operations and don't have half their hair fall out and some people do.
Then a TE caused by thyroid imbalance turned into CtE which is basically TE that goes into remission fro a few months (if you're lucky) but doesn't end.
And what is "anecdotal evidence" but to give your own experience, many, many of which I've read over the last few years? Everyone responds differently. You may want to belittle someone who avoids ibuprofen because they have CTE and don't wish to exacerbate it, but once you're prone to TE anything can make it worse very easily. Not to mention the painful burning, soreness and itching that comes with the excessive shedding. And there's no "cure"
This isn't something I usually talk about on here because it distresses me so much.
She asked. I answered.
I won't bother in future.
Here is a link about various medications
[url]http://www.heralopecia.com/interact/showthread.php/39-Comprehensive-List-of-Drugs-that-Cause-Hair-Loss

You really don't have to tell me to read patient information leaflets, I have a ton - and, like I say, I have a very reliable information source in the BNF. That's why I asked for a source as I was interested in reading it, as it wasn't something I'd previously heard of. I wasn't belittling you in any way, and I'm sorry that you are offended but I dislike over generalised statements in regards to medication and I don't see how your experiences of CTE help the OP who asked for advice about fluvoxamine for OCD. I just wanted a source, that's all, no need to reduce yourself to tears! Really!

[faellen]

Oh, and daredevil14, sorry forgot to reply to you! I'm glad that your side effects have been mild so far. Hopefully you should experience less side effects as time goes on. I hope the fluvoxamine works for your OCD. I also recommend CBT as others have, it really worked for me (despite it costing so much! Teach yourself CBT book sounds good! :)), but I know the medication can give you that extra helping hand.

[daredevil14]

Thanks all for your input and thank you faellen, hoping for a good outcome! :)

(CBT is definitely out of my options since it's too costy where I live and work now, almost 13% of my salary for 1 session!)

[monsoonstorm]

As a couple of us have said, there are some very good CBT books available.

It's not a difficult concept, you certainly don't need a degree to be able to put the basics in to practice. My CBT therapist told me to buy the book, I would work through it at home and basically go through things with her afterwards (kind of like having a tutor I guess...)

[Hairheart]

I used Effexor for about 9 months for 8 or so years ago, and yes, my hair thinned out a lot. But, I'm also very sensitive to any kind of medication, also childbirths and contraceptives. The reason I decided to quit the SSRI was mainly my hair, but also the fact I lost all of my feelings, even the good ones. I became an emotional zombie. No worries or anxiety, but also zero happiness, not to mention my libido went AWOL. Pretty much the reason why my marriage went down the drain. I couldn't feel love for anyone, I even became grossed out about "sweet love story's" in movies, where I just didn't understand anymore how people could feel attraction for one another. It was crazy! So I just decided one day to quit cold turkey. That was a trip in itself. It took around 2 weeks before those horrible brain zaps stopped, every time I moved my head or only the eyes it felt like I got struck by a bolt of lightning, I really heard the crackling sounds in my head. Not fun. But, my libido came back within a few days. With a vengeance, I might add...

I think hair loss or bad growth is a very common complaint from SSRI's. But, severe depression can cause the same effect too. It's so hard to tell.

Oh, another side effect was bad night sweats, I used to wake up every night several times, drenched in sweat.

[Liz_park]

You still haven't given me a source (peer reviewed and current, if possible, NOT anecdotal evidence from forums) that states that most medications cause hair loss. As a healthcare student I'd be interested to read it, because it's not something I've come across. Except for the obvious medications that have hair loss as a side effect (e.g. certain chemo drugs, also, glucosamine, levothyroxine, levonorgestrel etc), I can't say ibuprofen springs to mind, I managed to find a couple of things about it on websites about hair loss/thinning being an EXTREMELY rare side effect yet there's nothing in my formulary (so it must be rare, especially if you're only taking a couple of pills now and then for a headache instead of long term treatment - and with NSAIDs you'd be more worried about your stomach anyway rather than your hair, lol!).

Hey there! I have a bit of pharmacology knowledge, and some experience working in clinical trials, so I just thought I would jump in here.

Faellen, there may not be a peer-reviewed publication on hair loss from various medications available, but this doesn't mean that certain medications don't cause hair loss. I study adverse drug reactions, and I can tell you that some of the most obvious and serious "side-effects" (we call them adverse drug reactions or ADRs) are not yet reported in the literature even when they are well known in the medical community. There are several reasons for this.

First of all, most of the ADRs reported on a label come from the drug company itself, and they get the information from their clinical trials. When a drug is still in clinical trials, the clinical trial period where we watch the patients closely is usually a rather short period of time -- 16 weeks or 24 weeks is a standard period for a phase 2 (small target population) or phase 3 (larger target population) clinical trial. So if the changes take longer to see, we may not see them until post-marketing analysis when people start using the drug for years. Another limitation of clinical trials is that they are done in thousands of people, as opposed to the millions of people who will take the drug in the general public. Many ADRs appear after a drug is on the market, and most are never reported. People rarely report ADRs to anyone but their doctors. And doctors do not formally report the ADRs to their regulatory board (FDA) because it's extremely time consuming to do so. Even if an ADR is reported to the FDA, it takes many reports, and sometimes an academic peer-reviewed article for the FDA to make a label change. And label changes are usually only made for more seriously debilitating (like permanent vision or hearing loss) or life-threatening ADRs. They probably wouldn't change a label for mild-moderate hair loss. In short, it's very unlikely that hair loss would be on the label of a drug, unless it was an extreme reaction (total hair loss) or a very common reaction (mild loss that would be picked up in a phase 3 trial with 1000 people in it).

The other thing I should say about ADRs. Drugs are designed to be effective and have limited ADRs in most people. But there is always a subset of the population that takes the drug in which it a) is not effective, b) causes ADRs or c) both. So just because a drug works for one person, and doesn't cause hair loss, doesn't mean that it will work for the next person or that they won't have hair loss. There are many classes of drugs that cause hair loss in a small percentage of people. Drugs from the steroid group, for example. Another class would be analgesics or pain meds. Many medications interfere with the body's ability to metabolize vitamins and minerals to some degree. Hair is very sensitive to these changes, in some people more than others. So in a sense, what MonaMayfair was saying was completely correct -- most medications can cause hair loss in some people. Even if the event is "very rare" as you say, when the drug is taken by 2 million people in North America, you can have hundreds or thousands of people who develop the problem, which is nothing to sniff at.

I hope that helps make things a bit more clear :)

And MonaMayfair, I am sorry to hear that you have had a hair-related ADR. Life is hard enough without the medication you're on messing with your hair.

[MonaMayfair]

Hey there! I have a bit of pharmacology knowledge, and some experience working in clinical trials, so I just thought I would jump in here.

Faellen, there may not be a peer-reviewed publication on hair loss from various medications available, but this doesn't mean that certain medications don't cause hair loss. I study adverse drug reactions, and I can tell you that some of the most obvious and serious "side-effects" (we call them adverse drug reactions or ADRs) are not yet reported in the literature even when they are well known in the medical community. There are several reasons for this.

First of all, most of the ADRs reported on a label come from the drug company itself, and they get the information from their clinical trials. When a drug is still in clinical trials, the clinical trial period where we watch the patients closely is usually a rather short period of time -- 16 weeks or 24 weeks is a standard period for a phase 2 (small target population) or phase 3 (larger target population) clinical trial. So if the changes take longer to see, we may not see them until post-marketing analysis when people start using the drug for years. Another limitation of clinical trials is that they are done in thousands of people, as opposed to the millions of people who will take the drug in the general public. Many ADRs appear after a drug is on the market, and most are never reported. People rarely report ADRs to anyone but their doctors. And doctors do not formally report the ADRs to their regulatory board (FDA) because it's extremely time consuming to do so. Even if an ADR is reported to the FDA, it takes many reports, and sometimes an academic peer-reviewed article for the FDA to make a label change. And label changes are usually only made for more seriously debilitating (like permanent vision or hearing loss) or life-threatening ADRs. They probably wouldn't change a label for mild-moderate hair loss. In short, it's very unlikely that hair loss would be on the label of a drug, unless it was an extreme reaction (total hair loss) or a very common reaction (mild loss that would be picked up in a phase 3 trial with 1000 people in it).

The other thing I should say about ADRs. Drugs are designed to be effective and have limited ADRs in most people. But there is always a subset of the population that takes the drug in which it a) is not effective, b) causes ADRs or c) both. So just because a drug works for one person, and doesn't cause hair loss, doesn't mean that it will work for the next person or that they won't have hair loss. There are many classes of drugs that cause hair loss in a small percentage of people. Drugs from the steroid group, for example. Another class would be analgesics or pain meds. Many medications interfere with the body's ability to metabolize vitamins and minerals to some degree. Hair is very sensitive to these changes, in some people more than others. So in a sense, what MonaMayfair was saying was completely correct -- most medications can cause hair loss in some people. Even if the event is "very rare" as you say, when the drug is taken by 2 million people in North America, you can have hundreds or thousands of people who develop the problem, which is nothing to sniff at.

I hope that helps make things a bit more clear :)

And MonaMayfair, I am sorry to hear that you have had a hair-related ADR. Life is hard enough without the medication you're on messing with your hair.

Thankyou very much Liz. I was very glad to read your post. I have known all these things for years, but it seems a lot of people are completely unaware. When I originally posted in this thread, I was attempting to make the OP aware of the possible (and not uncommon) consequences of taking this medication. They may well suffer no side effects, of course, but others have not been so lucky.

[daredevil14]

Thank you Liz for the valuable explanation.

Now I have washed my hair and combed it twice since I started my AD, I haven't noticed anything irregular yet! The only issue is the extreme sleepiness and "painful" yawning.

[swearnsue]

Wishing you the best, Daredevil! The first 2 or 3 weeks are weird, but then you will start to feel better in general and some of those side effects fade away. If not on this particular medication, another one that is similar.

I think I tried 4 different ones before finding the right one. With a name like Daredevil, I know you will keep trying!

[Liz_park]

Now I have washed my hair and combed it twice since I started my AD, I haven't noticed anything irregular yet! The only issue is the extreme sleepiness and "painful" yawning.

Best of luck Daredevil14!

[Firefox7275]

Correlation is not causation, just because someone happens to experience thinning when on a particular med long term is NOT proof of cause and effect. Any drug that has been on the market a while should have all the side effects officially reported. It's absolute nonsense that most drugs have hair loss as a side effect. Ask a good pharmacist if you want an accurate response, not unqualified strangers on a forum.

Note that anyone can have an allergic reaction to any medication to the active or another ingredient and there is always a small chance that shedding might be part of that allergic response. In that case you would normally know you were allergic since you would have other symptoms. This is not the same as a known side effect of the drugs normal action.

[Liz_park]

Correlation is not causation, just because someone happens to experience thinning when on a particular med long term is NOT proof of cause and effect. Any drug that has been on the market a while should have all the side effects officially reported. It's absolute nonsense that most drugs have hair loss as a side effect. Ask a good pharmacist if you want an accurate response, not unqualified strangers on a forum.

Note that anyone can have an allergic reaction to any medication to the active or another ingredient and there is always a small chance that shedding might be part of that allergic response. In that case you would normally know you were allergic since you would have other symptoms. This is not the same as a known side effect of the drugs normal action.

I totally agree with you that correlation is not causation. And you should certainly consult a knowledgable pharmacist or doctor about any drug questions you have.

Okay, I don't want to hijack the thread but...

As someone who works in pharmacology and works closely with drug regulatory boards, I can tell you that most adverse drug reactions adverse drug reaction (ADRs or side-effects) are not reported properly to the regulatory boards and do not appear on the label. In fact, health accreditation boards estimate that 95% of ADRs are never reported. Drug companies are required to report any adverse drug reactions during their clinical trial -- but some trials only last 16 weeks, and only have 1000 or so patients in them and so there are many ADRs that are never picked up in these clinical trials. Many ADRs never even appear until the drug is approved and is used in a much larger and varied population, and has been on the market for a few years. In North America, we have a passive reporting system once a drug has hit the market. This system relies on volunteer health professional reporting, which is extremely ineffective. Doctors and pharmacists are too busy and do not have time to fill out the necessary paperwork to formally report an ADR. And the average patient experiencing these ADRs has no recourse in terms of reporting it to a regulatory board.

I work primarily with chemotherapy drugs that cause all kinds of serious life-threatening ADRs. Some of these drugs were created in the 1960s, so they have been on the market for decades, and the ADRs are STILL not on the label. We are now working to create label changes on these drugs, and I can tell you that to do so you need to 1) study hundreds of patients with the ADR 2) publish results in a reputable journal 3) replicate your work two or three times before the FDA will even consider a label change. If the FDA needs to be convinced of serious and measurable ADRs such as permanent hearing loss, severe heart damage, and neurological damage so serious that the patient cannot walk properly or use their fingers, I'm afraid they are not going to be all that interested in something like increased hair shedding (even though LHCers may be very interested).

Mild to moderate changes in hair that occur in a small percentage of people that weren't picked up in clinical trials are very unlikely to be on the label. It's extremely unlikely to be in the literature at all unless it's a severe reaction or unless it happens in a large proportion of people. Hair changes would be a difficult ADR to study, especially if it happens over time, because so many things can effect hair (diet, stress, even some evidence that season can influence it) and because changes in hair can happen so slowly. Difficult-to-study ADRs are not studied often, as it is difficult to get funding to study them, and are even less often published, even if they are well-known in the the medical community.

And there is nothing "normal" about "side effects". ADRs are a very, very unfortunate part of medicine.

If you would like references for this or more information, just send me a little message! I have lots of papers on the topic :)

[Elanadi]

Great post, Liz_park! I found that a lot of side effects aren't listed on the medication documentation. I mentioned a few side effects I was having from one of the SSRIs to my psychiatrist, who assured me there was absolutely no way I was having them because they were not listed as known side effects on the official medication documentation. :rolleyes: I expected a little more common sense from someone with a degree in psychiatry, but I think a lot of people assume ALL side effects are listed.