Expert: Peter J. Panagotacos, <B>M.D.</B> - 3/16/2005

Question
Thanks for the reply.  Your web site says Propecia can be of benefit, but it is for men only.  So my daughter tries another SSRI other than Zoloft -- hopefully without the hair loss side effect.  Both total hair loss episodes have been preceded by several weeks of seemingly "extra oily" hair despite daily shampooing.  Thus, hindsight suggests that such could be an indicator for us of an impending problem.  As a dermatologist, if we were to see such a similar recurrence (extra oily hair) in the future, is it then already too late to "do something" to prevent a 3rd total hair loss episode (such a immediately begin tapering off the SSRI to yet another Zoloft-alternative under her primary doctor's guidance)?

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Followup To
Question -
My daughter is on both Zoloft & Wellbutrin because of their less well-known benefit for treating dysautonomia as opposed to depression.  Unfortunately, she's experienced near total hair loss now twice over 14-mos.  A wide range of blood tests and even a scalp biopsy have been performed.  Appears to be consistent with adverse prescription drug side effect.  That being the case, which of the two would you consider the more likely "culprit" to try switching away from first?  And why?
Answer -
Between the two meds it is more likely to be Zoloft which is in the group of SSRI's and Wellbutrin is not. SSRI's in general can produce hair loss. I even have one page on my website on this  Prozac -Proscar -and  Propecia

http://www.hairdoc.com/prozac.html

Answer
Switching to a different SSRI may not solve the problem. If you see a shedding of several hundred hairs daily you can assume that something one month earlier caused these hairs to stop growing and gradually move up and out of the skin. The cause of that shedding could be due to the SSRI or due to stress of some sort. This can be quite a dilema .