Case Report

Hair Loss Associated with Sertraline: A Case Report

Hair Loss with Sertraline

Abstract

Sertraline is classified as a selective serotonin reuptake inhibitor (SSRI) that is extensively employed in the management of a range of psychiatric conditions, encompassing major depressive disorder and anxiety disorders. While the overall incidence of hair loss is not extensively documented, it is recognized as a possible
cutaneous reaction to SSRIs, including sertraline. In the present study, we report the case of a 16-year-old Iranian female of Persian ethnicity who had been treated for panic disorder. She developed severe hair loss
two weeks post-initiation of treatment with sertraline 50 mg per day. She stopped the medication after two months when she had lost 50% of her hair. The exact mechanism remains unclear, but it is suggested that SSRIs like sertraline may induce hair loss by pushing hair follicles into the telogen phase prematurely, leading to diffuse hair shedding. Management typically involves dose adjustment or discontinuation of sertraline, which has been shown to resolve hair loss in multiple cases. Understanding this phenomenon is crucial for both patients and healthcare providers. Although rare, this side effect can considerably affect a patient’s overall quality of life and compliance with therapeutic regimens.

[1] Jane Garland E, Kutcher S, Virani A, Elbe D. Update on the Use of SSRIs and SNRIs with Children and Adolescents in
Clinical Practice. J Can Acad Child Adolesc Psychiatry. 2016 Winter;25(1):4-10.
[2] Hamon M, Bourgoin S. Pharmacological profile of antidepressants: a likely basis for their efficacy and side effects?
Eur Neuropsychopharmacol. 2006;16:S625-S32. https://doi. org/10.1016/S0924-977X(06)70008-6
[3] Holper L, Hengartner MP. Comparative efficacy of placebos in short-term antidepressant trials for major depression: a secondary meta-analysis of placebo-controlled trials. BMC Psychiatry. 2020 Sep 7;20(1):437. https://doi.org/10.1186/
s12888-020-02839-y
[4] Mestre-Bach G, Potenza MN. Pharmacological management of gambling disorder: an update of the literature. Expert Rev Neurother. 2024 Apr;24(4):391-407. https://doi.org/10.1080/1 4737175.2024.2316833
[5] Van Tran H, Tran HNB, Ngo TH, Nguyen KT. Depression in type 2 diabetes mellitus: Prevalence, characteristics, associated factors, and treatment outcomes. eClinicalMedicine. 2024;16:100194. https://doi.org/10.1016/j.endmts.2024.100194
[6] Warnock JK, Morris DW. Adverse cutaneous reactions to antidepressants. Am J Clin Dermatol. 2002;3(5):329-39.
https://doi.org/10.2165/00128071-200203050-00005
[7] Turkoglu S. Fluoxetine-and sertraline-related hair loss in a teenager: a case report. Psychiatry Clin Psychopharmacol. 2013;23(1):77-80. https://doi.org/10.5455/ bcp.20120928030857
[8] Kıvrak Y, Yağcı İ, Üstündağ MF, Özcan H. Diffuse Hair Loss Induced by Sertraline Use. Case Rep Psychiatry. 2015;2015:703453. https://doi.org/10.1155/2015/703453
[9] Elyasi F. Hair loss associated with sertraline: Two case reports and review. Iran J Psychiatry Behav Sci. 2017;11(1):e4000. https://doi.org/10.5812/ijpbs.4000
[10] Bourgeois JA. Two cases of hair loss after sertraline use. J Clin Psychopharmacol. 1996 Feb;16(1):91-2. https://doi.
org/10.1097/00004714-199602000-00024
[11] Krasowska D, Szymanek M, Schwartz RA, Myśliński W. Cutaneous effects of the most commonly used antidepressant medication, the selective serotonin reuptake inhibitors. J Am Acad Dermatol. 2007 May;56(5):848-53. https://doi. org/10.1016/j.jaad.2006.10.020
[12] Wagner KD, Ambrosini P, Rynn M, Wohlberg C, Yang R, Greenbaum MS, et al. Efficacy of sertraline in the treatment of children and adolescents with major depressive disorder: two randomized controlled trials. JAMA. 2003 Aug 27;290(8):1033- 41. https://doi.org/10.1001/jama.290.8.1033
[13] Ghanizadeh A. Sertraline-associated hair loss. J Drugs Dermatol. 2008 Jul;7(7):693-4.
[14] Lin CJ, Robert F, Sukarieh R, Michnick S, Pelletier J. The antidepressant sertraline inhibits translation initiation by
curtailing mammalian target of rapamycin signaling. Cancer Res. 2010 Apr 15;70(8):3199-208. https://doi.org/10.1158/0008- 5472.CAN-09-4072
[15] Pejcic AV, Paudel V. Alopecia associated with the use of selective serotonin reuptake inhibitors: Systematic review. Psychiatry Res. 2022 Jul;313:114620. https://doi.org/10.1016/j. psychres.2022.114620
[16] Uzun O, Cansever A, Ozgen F. Hair loss due to sertraline use: a case report. Psychiatry Clin Psychopharmacol. 2003;13:27-9.
[17] Gupta S, Masand PS. Citalopram and Hair Loss. Prim Care Companion J Clin Psychiatry. 2000 Apr;2(2):61-2. https://doi. org/10.4088/PCC.v02n0208d
[18] Kocbiyik S, Batmaz S, Turhan L, Yuncu OA, Caykoylu A. Alleviation of alopecia after switching from escitalopram to duloxetine: a case report. Dusunen Adam J Psychiatry Neurol Sci. 2016;29(1):76. https://doi.org/10.5350/DAJPN2016290108
Files
IssueVol 9 No 3 (2024): May-June QRcode
SectionCase Report(s)
DOI https://doi.org/10.18502/crcp.v9i3.17241
Keywords
Hair loss Sertraline
Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
1.
Hosseini SH, Ghazvini H, Seyedhosseini Tamijani SM, Rafaiee R. Hair Loss Associated with Sertraline: A Case Report. CRCP. 2024;9(3):137-140.