Telogen Effluvium Caused by Magnesium Valproate and Lamotrigine

The document reports two cases of telogen effluvium, a condition characterized by excessive hair loss, associated with the use of the anti-epileptic and mood-stabilizing drugs magnesium valproate and lamotrigine. In the first case, a 16-year-old girl experienced severe hair loss after starting a new course of magnesium valproate, which she had previously taken without side effects. The hair loss ceased and significant regrowth occurred after switching to lamotrigine. In the second case, a 24-year-old woman suffered chronic hair loss a few months after changing her medication to include magnesium valproate and increasing her dose of lamotrigine. The document suggests that patients who develop drug-induced hair loss may have a predisposition to the condition, which can be triggered by a change in therapy or new conditions. It also notes that alopecia may occur in up to 28% of patients using valproate at high doses and recommends starting with a low dose and gradually increasing it to minimize side effects.