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Hekmatjah J, Tareen K, Tareen RS. Citalopram-Associated Alopecia: A Case Report and Brief Literature Review. Curr Drug Saf 2019; 14:167-170. [DOI: 10.2174/1574886314666190215115857] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Revised: 02/11/2019] [Accepted: 02/11/2019] [Indexed: 11/22/2022]
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.
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Affiliation(s)
- Joshua Hekmatjah
- Western Michigan University, Homer Stryker M.D. School of Medicine, Kalamazoo, MI, United States
| | - Kinza Tareen
- Michigan State University, College of Human Medicine, Lansing, MI, United States
| | - Ruqiya Shama Tareen
- Department of Psychiatry, Western Michigan University, Homer Stryker M.D. School of Medicine, Kalamazoo, MI, United States
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Abstract
The aim of this study was to quantify the risk of hair loss with different antidepressants. A retrospective cohort study design using a large health claims database in the USA from 2006 to 2014 was utilized. A cohort of new user and mutually exclusive users of fluoxetine, fluvoxamine, sertraline, citalopram, escitalopram, paroxetine, duloxetine, venlafaxine, desvenlafaxine, and bupropion were followed to the first diagnosis of alopecia. The cohort was comprised of 1 025 140 new users of fluoxetine, fluvoxamine, sertraline, citalopram, escitalopram, paroxetine, duloxetine, venlafaxine, desvenlafaxine, and bupropion, with sertraline the most commonly prescribed (N=190 227) and fluvoxamine (N=3010) the least prescribed. Compared with bupropion, all other antidepressants had a lower risk of hair loss, with fluoxetine and paroxetine having the lowest risk [hazard ratio (HR)=0.68, 95% confidence interval (CI): 0.63-0.74, HR=0.68, 95% CI: 0.62-0.74, respectively] and fluvoxamine having the highest risk (HR=0.93, 95% CI: 0.64-1.37). Compared with fluoxetine, bupropion had the highest risk of hair loss (HR=1.46, 95% CI: 1.35-1.58, number needed to harm=242 for 2 years) and paroxetine had the lowest risk (HR=0.99, 95% CI: 0.90-1.09). The results of this large population-based cohort study suggest an increase in the risk of hair loss with bupropion compared with selective serotonin reuptake inhibitors and selective norepinephrine reuptake inhibitors, whereas paroxetine had the lowest risk.
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Liao S, Lv J, Zhou J, Kalavagunta PK, Shang J. Effects of two chronic stresses on mental state and hair follicle melanogenesis in mice. Exp Dermatol 2017; 26:1083-1090. [DOI: 10.1111/exd.13380] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/28/2017] [Indexed: 02/04/2023]
Affiliation(s)
- Sha Liao
- State Key Laboratory of Natural Medicines and Jiangsu Key Laboratory of TCM Evaluation and Translational Research; China Pharmaceutical University; Nanjing China
- Key Laboratory of Resource Biology and Biotechnology in Western China; Ministry of Education; Northwest University; Xi'an China
| | - Jinpeng Lv
- State Key Laboratory of Natural Medicines and Jiangsu Key Laboratory of TCM Evaluation and Translational Research; China Pharmaceutical University; Nanjing China
| | - Jia Zhou
- State Key Laboratory of Natural Medicines and Jiangsu Key Laboratory of TCM Evaluation and Translational Research; China Pharmaceutical University; Nanjing China
| | - Praveen Kumar Kalavagunta
- State Key Laboratory of Natural Medicines and Jiangsu Key Laboratory of TCM Evaluation and Translational Research; China Pharmaceutical University; Nanjing China
| | - Jing Shang
- State Key Laboratory of Natural Medicines and Jiangsu Key Laboratory of TCM Evaluation and Translational Research; China Pharmaceutical University; Nanjing China
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Carvalho AF, Sharma MS, Brunoni AR, Vieta E, Fava GA. The Safety, Tolerability and Risks Associated with the Use of Newer Generation Antidepressant Drugs: A Critical Review of the Literature. PSYCHOTHERAPY AND PSYCHOSOMATICS 2017; 85:270-88. [PMID: 27508501 DOI: 10.1159/000447034] [Citation(s) in RCA: 365] [Impact Index Per Article: 52.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/28/2016] [Accepted: 05/24/2016] [Indexed: 11/19/2022]
Abstract
Newer generation antidepressant drugs (ADs) are widely used as the first line of treatment for major depressive disorders and are considered to be safer than tricyclic agents. In this critical review, we evaluated the literature on adverse events, tolerability and safety of selective serotonin reuptake inhibitors, serotonin noradrenaline reuptake inhibitors, bupropion, mirtazapine, trazodone, agomelatine, vilazodone, levomilnacipran and vortioxetine. Several side effects are transient and may disappear after a few weeks following treatment initiation, but potentially serious adverse events may persist or ensue later. They encompass gastrointestinal symptoms (nausea, diarrhea, gastric bleeding, dyspepsia), hepatotoxicity, weight gain and metabolic abnormalities, cardiovascular disturbances (heart rate, QT interval prolongation, hypertension, orthostatic hypotension), genitourinary symptoms (urinary retention, incontinence), sexual dysfunction, hyponatremia, osteoporosis and risk of fractures, bleeding, central nervous system disturbances (lowering of seizure threshold, extrapyramidal side effects, cognitive disturbances), sweating, sleep disturbances, affective disturbances (apathy, switches, paradoxical effects), ophthalmic manifestations (glaucoma, cataract) and hyperprolactinemia. At times, such adverse events may persist after drug discontinuation, yielding iatrogenic comorbidity. Other areas of concern involve suicidality, safety in overdose, discontinuation syndromes, risks during pregnancy and breast feeding, as well as risk of malignancies. Thus, the rational selection of ADs should consider the potential benefits and risks, likelihood of responsiveness to the treatment option and vulnerability to adverse events. The findings of this review should alert the physician to carefully review the appropriateness of AD prescription on an individual basis and to consider alternative treatments if available.
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Affiliation(s)
- André F Carvalho
- Department of Clinical Medicine and Translational Psychiatry Research Group, Faculty of Medicine, Federal University of Ceará, Fortaleza, Brazil
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Norton DJ, Cates C. Eyelash Loss Secondary to Escitalopram But Not to Sertraline: A Case Report. Prim Care Companion CNS Disord 2016; 18:15l01887. [PMID: 27722027 DOI: 10.4088/pcc.15l01887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Affiliation(s)
- Daniel J Norton
- West Suffolk Hospital, Bury St Edmunds, Suffolk, United Kingdom
| | - Carolyn Cates
- Eye Treatment Centre, West Suffolk Hospital, Bury St Edmunds, Suffolk, United Kingdom
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Diffuse Hair Loss Induced by Sertraline Use. Case Rep Psychiatry 2015; 2015:703453. [PMID: 26457219 PMCID: PMC4589582 DOI: 10.1155/2015/703453] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2015] [Revised: 08/27/2015] [Accepted: 09/02/2015] [Indexed: 11/17/2022] Open
Abstract
Hair loss is a rare side effect of psychotropic drugs. The most related drug class with this side effect is the mood stabilizers. Studies reporting the sertraline-induced alopecia are limited in number. Sertraline is a potent antidepressant which inhibits the serotonin reuptake from the presynaptic terminals selectively. The reason for hair loss could not be elucidated completely. Psychotropic drugs are usually considered to lead to hair loss through influencing the telogen phase of hair follicle. This paper reports a 21-year-old male with diffuse hair loss induced by sertraline use and improved by quitting the drug. To the best of our knowledge, there are no other case reports on sertraline-induced alopecia within 2 weeks.
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Surveillance et détection des événements inhabituels en toxicovigilance : revue des méthodes pertinentes. Rev Epidemiol Sante Publique 2015; 63:119-31. [DOI: 10.1016/j.respe.2015.01.072] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2014] [Revised: 12/11/2014] [Accepted: 01/08/2015] [Indexed: 11/19/2022] Open
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8
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Dermatologic Side Effects of Psychotropic Medications. PSYCHOSOMATICS 2014; 55:1-20. [DOI: 10.1016/j.psym.2013.07.003] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/05/2013] [Revised: 07/09/2013] [Accepted: 07/10/2013] [Indexed: 12/21/2022]
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Mannocci A, Di Thiene D, Semyonov L, Boccia A, La Torre G. A cross-sectional study on dermatological diseases among male prisoners in southern Lazio, Italy. Int J Dermatol 2013; 53:586-92. [PMID: 24758231 DOI: 10.1111/j.1365-4632.2012.05762.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Prisoners have heightened health needs, and only recently has the importance of skin diseases in this group been recognized. The aim of this study was to estimate the prevalences of dermatological diseases among prisoners in the jails of southern Lazio and to investigate the determinants of these. METHODS A cross-sectional study was carried out in three jails in southern Lazio. Retrospective data collection for sociodemographic characteristics, lifestyle habits, and health status was realized using patients' charts. RESULTS The study sample consisted of 2653 male prisoners detained during 1995-2000. A total of 7.9% of the sample were found to have dermatological disease. The most common diseases were nonspecific dermatitis (3.1%), acne (1.5%), mycosis (1.4%), and scabies (0.7%). Multiple regression analyses were conducted to establish the associations of skin diseases with substance addiction status and age. In addition, a highly significant association emerged between length of detention and rate of dermatological disease. CONCLUSIONS This study shows that habitual offenders, foreign inmates, prisoners serving long sentences, and prisoners who are illiterate are the most affected by dermatological disease. The conditions of detention may be the main reason; preventative strategies such as limiting overcrowding and the provision of electronic case sheets and a centralized database to collect and maintain patient clinical data might be effective in improving public health in jails.
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Affiliation(s)
- Alice Mannocci
- Clinical Medicine and Public Health Unit, Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
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Omazzi B, Prada A, Borroni G, Sacrini F. Irreversible alopecia universalis during treatment with pegylated interferon-ribavirin for chronic hepatitis C virus infection: Case report and published work review. Hepatol Res 2012. [PMID: 23181541 DOI: 10.1111/j.1872-034x.2012.01036.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Hair disorders that have been described in association with pegylated interferon-ribavirin combination treatment include canities, hypertrichosis, telogen effluvium, and the most common cutaneous side-effect by far, alopecia. Alopecia is a heterogeneous disease characterized by hair loss on the scalp or any hair-bearing surface with a wide range of clinical presentations, from a single patch of hair loss to complete loss of hair on the entire body (alopecia universalis). Although some cases of reversible alopecia universalis associated with pegylated interferon-ribavirin combination therapy have been reported in the published work, irreversible alopecia universalis has not yet been reported in relation to pegylated interferon and ribavirin combination treatment. For the first time, we report a case of irreversible alopecia universalis during pegylated interferon-ribavirin combination therapy in a man infected with hepatitis C virus in the absence of clinical or biochemical evidence of immunological disorders or thyroid dysfunction at any time before, during or after antiviral therapy.
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Affiliation(s)
- Barbara Omazzi
- Division of Gastroenterology, G. Salvini Hospital, Rho, Alcohol Addiction Unit, ASL Provincia di Milano 1, Abbiategrasso, Division of Dermatology, IRCCS Istituto Clinico Humanitas, Rozzano, Italy
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Pitchot W. Hair loss associated with escitalopram but not with venlafaxine: a case report. Prim Care Companion CNS Disord 2011; 13:11l01146. [PMID: 22132360 DOI: 10.4088/pcc.11l01146] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
Affiliation(s)
- William Pitchot
- Department of Psychiatry, University of Liège, Liège, Belgium.
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12
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Moret C, Isaac M, Briley M. Problems associated with long-term treatment with selective serotonin reuptake inhibitors. J Psychopharmacol 2009; 23:967-74. [PMID: 18635702 DOI: 10.1177/0269881108093582] [Citation(s) in RCA: 88] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Although the selective serotonin reuptake inhibitors (SSRIs), which are now widely used as a first-line treatment for depression and many other psychiatric conditions, are generally well tolerated, they are not devoid of side effects. Most short-term treatment-related side effects of SSRIs are transient and disappear after a few days or weeks. However, following long-term treatment with the SSRIs, some serious adverse events may occur. Some of them can be difficult to recognise because they can resemble residual symptoms of depression. The most serious can be life threatening. They all have a negative influence on the patient's quality of life and are frequently a prime reason for a lack of long-term compliance with the associated increased risk of recurrence of a depressive episode. This article is an overview of the more common adverse events, which are seen with non-acute treatment with the SSRIs.
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Affiliation(s)
- C Moret
- NeuroBiz Consulting & Communication, Castres, France.
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Aagaard L, Hansen EH. Information about ADRs explored by pharmacovigilance approaches: a qualitative review of studies on antibiotics, SSRIs and NSAIDs. BMC CLINICAL PHARMACOLOGY 2009; 9:4. [PMID: 19254390 PMCID: PMC2656469 DOI: 10.1186/1472-6904-9-4] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/16/2008] [Accepted: 03/03/2009] [Indexed: 11/29/2022]
Abstract
Background Despite surveillance efforts, unexpected and serious adverse drug reactions (ADRs) repeatedly occur after marketing. The aim of this article is to analyse ADRs reported by available ADR signal detection approaches and to explore which information about new and unexpected ADRs these approaches have detected. Methods We selected three therapeutic cases for the review: antibiotics for systemic use, non-steroidal anti-inflammatory medicines (NSAID) and selective serotonin re-uptake inhibitors (SSRI). These groups are widely used and represent different therapeutic classes of medicines. The ADR studies were identified through literature search in Medline and Embase. The search was conducted in July 2007. For each therapeutic case, we analysed the time of publication, the strengths of the evidence of safety in the different approaches, reported ADRs and whether the studies have produced new information about ADRs compared to the information available at the time of marketing. Results 79 studies were eligible for inclusion in the analysis: 23 antibiotics studies, 35 NSAID studies, 20 SSRI studies. Studies were mainly published from the end of the 1990s and onwards. Although the drugs were launched in different decades, both analytical and observational approaches to ADR studies were similar for all three therapeutic cases: antibiotics, NSAIDs and SSRIs. The studies primarily dealt with analyses of ADRs of the type A and B and to a lesser extent C and D, cf. Rawlins' classification system. The therapeutic cases provided similar results with regard to detecting information about new ADRs despite different time periods and organs attacked. Approaches ranging higher in the evidence hierarchy provided information about risks of already known or expected ADRs, while information about new and previously unknown ADRs was only detected by case reports, the lowest ranking approach in the evidence hierarchy. Conclusion Although the medicines were launched in different decades, approaches to the ADR studies were similar for all three therapeutic cases: antibiotics, NSAIDs and SSRIs. Both descriptive and analytical designs were applied. Despite the fact that analytical studies rank higher in the evidence hierarchy, only the lower ranking descriptive case reports/spontaneous reports provided information about new and previously undetected ADRs. This review underscores the importance of systems for spontaneous reporting of ADRs. Therefore, spontaneous reporting should be encouraged further and the information in ADR databases should continuously be subjected to systematic analysis.
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Affiliation(s)
- Lise Aagaard
- Department of Pharmacology and Pharmacotherapy, Section for Social Pharmacy, Faculty of Pharmaceutical Sciences, University of Copenhagen, Denmark.
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Current awareness: Pharmacoepidemiology and drug safety. Pharmacoepidemiol Drug Saf 2007. [DOI: 10.1002/pds.1369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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