Commonly Prescribed Medications Associated With Alopecia

The document discusses the association between commonly prescribed antiepileptic medications and alopecia. It highlights that valproic acid (VPA), a frequently prescribed antiepileptic agent, can cause hair loss, which is usually reversible after discontinuation of the medication. The incidence of hair loss due to VPA varies from 3.5% to 12% in different studies. A systematic review and meta-analysis of 24 prospective clinical trials found an overall incidence of alopecia with VPA treatment of 11%. VPA was significantly associated with an increased risk of alopecia compared to other antiepileptic agents, particularly lamotrigine. In a study of 107 patients, hair loss was observed in 24.5% of the VPA group and only 1.9% of the lamotrigine group. The document suggests that a low starting dose of VPA with a gradual increase may minimize hair loss. The mechanisms of hair loss promotion by VPA include telogen effluvium, increased androgen levels, biotin deficiency, and deficiencies of trace elements such as copper, zinc, selenium, and magnesium. The document concludes that VPA should be added to the list of commonly prescribed medications associated with alopecia.