What medications cause hair loss
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Medications That Cause Hair Loss: An Overview
Hair loss, or alopecia, can be a distressing side effect of various medications. Understanding which drugs are commonly associated with hair loss and the mechanisms behind this phenomenon can help in managing and mitigating this issue.
Mechanisms of Drug-Induced Hair Loss
Anagen Effluvium and Telogen Effluvium
Medications can disrupt the hair growth cycle in two primary ways: anagen effluvium and telogen effluvium. Anagen effluvium occurs when drugs cause an abrupt cessation of mitotic activity in rapidly dividing hair matrix cells, leading to hair loss within days to weeks of drug administration. This is commonly seen with antineoplastic agents used in cancer treatment . Telogen effluvium, on the other hand, involves the premature transition of hair follicles into the resting phase, resulting in hair loss that becomes evident 2 to 4 months after starting the medication. This type of hair loss is associated with a broader range of drugs, including anticoagulants, retinoids, interferons, and antihyperlipidemic drugs .
Common Medications Associated with Hair Loss
Anticancer Agents
Anticancer drugs are among the most well-known culprits of hair loss. These medications target rapidly dividing cells, including those in hair follicles, leading to anagen effluvium. The hair loss is usually reversible after discontinuation of the treatment .
Psychotropic Drugs
Many psychotropic medications, including mood stabilizers, antidepressants, and antipsychotics, can cause hair loss. Lithium, valproic acid, and carbamazepine are notable examples, with lithium causing hair loss in 12-19% of long-term users and valproic acid affecting up to 28% of patients at high doses . Antidepressants such as tricyclics, SSRIs, and SNRIs have also been implicated in drug-induced alopecia .
Antihypertensive and Cardiovascular Drugs
Certain antihypertensive medications, including beta-blockers and ACE inhibitors, have been reported to cause hair loss. The exact prevalence and mechanisms are less well-documented compared to other drug classes .
Other Medications
A variety of other drugs have been associated with hair loss, including anticoagulants, retinoids, interferons, and immunosuppressants. The relationship between these drugs and hair loss is often dose-dependent and influenced by individual susceptibility .
Case Reports and Specific Instances
Mirtazapine and Quetiapine
There have been specific case reports linking hair loss to the use of mirtazapine, a noradrenergic and specific serotonergic antidepressant (NaSSA), and quetiapine, an atypical antipsychotic. These cases highlight the importance of monitoring for hair loss in patients starting these medications and considering alternative treatments if necessary .
Topiramate
Topiramate, a medication used for migraine prophylaxis, has also been reported to cause hair loss. In one case, an 18-year-old female experienced significant hair loss after three months of treatment, which resolved upon discontinuation of the drug.
Conclusion
Drug-induced hair loss is a multifaceted issue influenced by the type of medication, dosage, and individual patient factors. While the condition is usually reversible upon discontinuation of the offending drug, it can significantly impact a patient's quality of life and medication compliance. Awareness and early intervention are key to managing this side effect effectively.
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