Is alopecia a side-effect of amitriptyline?/nA 43-year-old female with a history of depression, who

Fråga: Is alopecia a side-effect of amitriptyline? A 43-year-old female with a history of depression, who started taking amitriptylin (Tryptizol) 125 mg daily in December 1993, developed generalised alopecia after two months of treatment.

Sammanfattning: Tricyclic antidepressants may induce alopecia in rare cases.

Svar: A similar question was answered in Drugline in 1988. Since it was a long time ago, we did a new search in Medline. We found a few case reports describing drug-induced alopecia related to imipramine and desipramine treatment.

Alopecia is a condition characterised by either generalised or localised hair loss most commonly involving the scalp. It generally recovers after discontinuation of the drug (1). This side-effect is also mentioned in the product information concerning Tryptizol in FASS 1994, as a rare side-effect, occurring in less than 1/1000 patients(2). Two cases of alopecia have been reported to the Medical Product Agency in Sweden during treatment with amitriptyline and imipramine, one case of each respectively. Mild to moderate drug-induced alopecia may not require a change in medical regime if the patient is followed closely. Clinically, significant hair loss induced by tricyclic antidepressant drugs is a possible and rare event (2).