Can Efexor (venlafaxine) cause alopecia?/nA 50-year-old woman has been treated with Efexor (venlafa

Fråga: Can Efexor (venlafaxine) cause alopecia? A 50-year-old woman has been treated with Efexor (venlafaxine) 300 mg per day for the last 2.5 months. She has had diffuse hair loss during the last three months and now her hair is markedly thinner. Other drugs are Litarex (lithium), Imovane (zopiclone) and Propavan (propiomazine).

Sammanfattning: There are case-reports supporting that venlafaxine could cause alopecia as an adverse effect. However, there is no documentation in the literature supporting this.

Svar: Venlafaxine is an antidepressant drug which inhibits the re-uptake of serotonin and noradrenaline.

We could not find any documentation in Drugline, Medline or common pharmacological handbooks indicating that alopecia could be an adverse effect of venlafaxine.

FASS (The Swedish catalogue of approved medical products) mentions alopecia as a less common (1/100-1/1000) adverse effect (1). After personal communication with the manufacturer representative it was concluded that it was not more common in the venlafaxine treated group than in the placebo group (2).

FASS doesn´t say anything about alopecia as an adverse effect of any of the concomitant drugs (1).

However, the files of SADRAC (Swedish Adverse Drug Reactions Advisory Committee) contained four reports, three of them classified as possible concerning defluvium in connection with venlafaxine treatment (3).

In WHO´s database Intdis there were 16 reports concerning alopecia. However, these reports are not evaluated because of the differences in the reporting-systems of the participating countries (4).

We recommend this case be reported to SADRAC (The Swedish Adverse Drug Reactions Advisory Committee).