Hair Loss Risk with Abilify, Cymbalta, and Hydroxyzine
Among these three medications, Cymbalta (duloxetine) and Abilify (aripiprazole) can cause hair loss, while hydroxyzine is not associated with this adverse effect.
Cymbalta (Duloxetine) and Hair Loss
Duloxetine is documented to cause hair loss as part of the broader class of antidepressants known to induce alopecia. 1
- Virtually all new generation antidepressants, including SNRIs like duloxetine, may on rare occasions lead to alopecia 1
- The mechanism typically involves telogen effluvium, where hair follicles prematurely enter the resting phase 2
- Hair loss from antidepressants is usually reversible upon discontinuation or dose reduction 1
- Common side effects of duloxetine include diaphoresis, dry mouth, nausea, and dizziness, with hair loss being a less frequently reported but recognized adverse effect 3, 4
Abilify (Aripiprazole) and Hair Loss
Aripiprazole is specifically documented to cause alopecia, though it occurs rarely. 1
- Among antipsychotics, haloperidol, olanzapine, and risperidone have been associated with hair loss on rare occasions, and aripiprazole falls into this category 1
- The incidence is low but clinically recognized in psychopharmacology literature 1
- Like other medication-induced alopecia, this is typically reversible with drug discontinuation 1
Hydroxyzine and Hair Loss
Hydroxyzine, an antihistamine and anxiolytic, is not documented in the literature as causing hair loss. 1
- Selected antihistamines have been associated with alopecia, but hydroxyzine is not among those commonly implicated 1
- The medication primarily causes sedation, dry mouth, and anticholinergic effects rather than hair-related adverse effects
Clinical Management Considerations
If hair loss occurs with either Cymbalta or Abilify, discontinuation or dose reduction almost always leads to complete hair regrowth. 1
- Drug-induced alopecia typically presents as diffuse, non-scarring hair loss that is reversible 5
- The diagnosis requires temporal association between medication initiation and hair loss onset, with exclusion of other triggers such as fever, severe illness, stress, or hormonal changes 2
- Hair loss may contribute to medication noncompliance, making it important to address proactively with patients 1, 6
- Management options include reassurance, dose reduction, medication switching, or in some cases continuing the medication with supportive hair care if the therapeutic benefit outweighs the cosmetic concern 6
Important Caveats
- The relationship between drug intake and hair loss has been definitively proven for only a few agents; many reports are based on isolated cases 7
- A thorough evaluation must exclude other common causes of telogen effluvium before attributing hair loss solely to medication 2
- The therapeutic value of mineral supplements for drug-induced alopecia remains unclear 1