Citalopram-Associated Alopecia: A Case Report and Brief Literature Review

Author(s): Joshua Hekmatjah*, Kinza Tareen, Ruqiya Shama Tareen

Journal Name: Current Drug Safety

Volume 14 , Issue 2 , 2019

Become EABM
Become Reviewer

Graphical Abstract:


Background: Selective Serotonin Reuptake Inhibitors (SSRIs) are the first-line treatments for various psychiatric disorders. SSRIs offer an improved side effect profile compared to older treatments, which improves patients’ adherence and quality of life.

Case Report: Here we discuss a case of an uncommon, but a distressing side effect of citalopram. A 76-year old woman was referred to the psychiatry clinic for bizarre behavior. The patient was diagnosed with behavioral variant frontotemporal dementia and was started on citalopram 20 mg and aripiprazole 5 mg daily. At 3.5 months the patient complained of diffuse hair thinning on her scalp. Citalopram was considered the offending agent and was discontinued. Within a few months, the patient regained most of her hair. Although drug-induced alopecia is common among other SSRIs, it is relatively rare with citalopram.

Results and Conclusion: Early recognition, withdrawal of offending agent, and reassurance to the patient that hair loss is reversible can help alleviate patient distress and avoid relapse.

Keywords: Alopecia, SSRIs, adverse drug reactions, citalopram, VIGIBASE, Fluoxetine.

Popovic D, Vieta E, Fornaro M, Perugi G. Cognitive tolerability following successful long term treatment of major depression and anxiety disorders with SSRi antidepressants. J Affect Disord 2015; 173: 211-5.
Baldwin DS. The importance of long-term tolerability in achieving recovery Int J Psychiatry Clin Pract 2006; 10(sup1): 31-7
Jenike MA. Severe hair loss associated with fluoxetine use. Am J Psychiatry 1991; 148(3): 392.
Gautam M. Alopecia due to psychotropic medications. Ann Pharmacother 1999; 33(5): 631-7.
Bliss SA, Warnock JK. Psychiatric medications: Adverse cutaneous drug reactions. Clin Dermatol 2013; 31(1): 101-9.
Mercke Y, Sheng H, Khan T, Lippmann S. Hair loss in psychopharmacology. Ann Clin Psychiatry 2000; 12(1): 35-42.
Ruiz-Doblado S, Carrizosa A, Garcia-Hernandez MJ, Rodriguez-Pichardo A. Selective serotonin re-uptake inhibitors (SSRIs) and alopecia areata. Int J Dermatol 1999; 38(10): 798-9.
Abedini H, Farshi S, Mirabzadeh A, Keshavarz S. Antidepressant effects of citalopram on treatment of alopecia areata in patients with major depressive disorder. J Dermatolog Treat 2014; 25(2): 153-5.
Gupta S, Masand PS. Citalopram and hair loss. Prim Care Companion J Clin Psychiatry 2000; 2(2): 61-2.
Hedenmalm K, Sundström A, Spigset O. Alopecia associated with treatment with selective serotonin reuptake inhibitors (SSRIs). Pharmacoepidemiol Drug Saf 2006; 15(10): 719-25.
Seifritz E, Hatzinger M, Müller MJ, Hemmeter U. Hair loss associated with fluoxetine but not with citalopram. Can J Psychiatry 1995; 40(6): 362.
Naranjo CA, Busto U, Sellers EM, et al. A method for estimating the probability of adverse drug reactions. Clin Pharmacol Ther 1981; 30(2): 239-45.
Potter WZ, Ketter TA. Pharmacological issues in the treatment of bipolar disorder: Focus on mood-stabilizing compounds. Can J Psychiatry 1993; 38(3)(Suppl. 2): S51-6.
Lin RL, Garibyan L, Kimball AB, Drake LA. Systemic causes of hair loss. Ann Med 2016; 48(6): 393-402.
Warnock JK. Psychotropic medication and drug-related alopecia. Psychosomatics 1991; 32(2): 149-52.
Pillans PJ, Woods DJ. Drug‐Associated Alopecia. Int J Dermatol 1995; 34(3): 149-58.
Guzmán-Sánchez D, Asz-Sigall D. Alopecias due to drugs and other skin and systemic disorders. Curr Probl Dermatol 2015; 47: 97-106.
Goldstein BJ, Goodnick PJ. Selective serotonin reuptake inhibitors in the treatment of affective disorders-III Tolerability, safety and pharmacoeconomics J Psychopharmacol 1998; 12(4_suppl): 55-S87
Rebora A. Changes in growth and distribution of hair associated with psychotropic drug use. CNS Drugs 1997; 8(4): 323-34.
Ferguson JM. SSRI antidepressant medications: Adverse effects and tolerability. Prim Care Companion J Clin Psychiatry 2001; 3(1): 22-7.

Rights & PermissionsPrintExport Cite as

Article Details

Year: 2019
Published on: 22 May, 2019
Page: [167 - 170]
Pages: 4
DOI: 10.2174/1574886314666190215115857
Price: $65

Article Metrics

PDF: 78