Hair Loss Associated With Escitalopram: Do SSRIs Affect Melatonin at the Hair Follicle?

This case report discusses a 22-year-old male patient who experienced hair loss as a side effect of the antidepressant escitalopram, a selective serotonin reuptake inhibitor (SSRI). The patient was initially prescribed escitalopram for major depressive disorder and later added bupropion to address cognitive impairment and smoking. After experiencing significant hair loss, which continued even after bupropion was discontinued, the patient switched to vortioxetine, another antidepressant, which led to the cessation of hair loss. The Naranjo Adverse Drug Reaction Probability Scale indicated a probable relationship between escitalopram and hair loss. The report suggests that SSRIs may affect hair and skin due to their impact on the telogen phase of hair production and the potential interaction with melatonin synthesis in hair follicles. The exact mechanism of escitalopram-associated hair loss is not fully understood, but the case contributes to the literature on rare side effects of SSRIs and the need for further research.