Can Luvox (fluvoxamine) cause hair loss in a patient with a history of hair loss while taking Celexa (citalopram) and Cymbalta (duloxetine)?

Can Luvox (Fluvoxamine) Cause Hair Loss?

Yes, fluvoxamine can cause hair loss, though it appears to be a rare adverse effect, and given your history of hair loss with citalopram and duloxetine, you may be at increased risk for this side effect with fluvoxamine as well. 1

Evidence from FDA Drug Label

• The FDA label for fluvoxamine explicitly lists alopecia as an infrequent adverse event (occurring between 1/100 and 1/1000 patients) under skin-related side effects. 1
• This official documentation confirms that hair loss is a recognized, though uncommon, side effect of fluvoxamine treatment. 1

Risk Factors Based on Your History

• Your prior hair loss with citalopram (Celexa) suggests you may have increased susceptibility to SSRI-induced alopecia, as research demonstrates that alopecia risk varies between individuals and appears more common in women. 2
• Studies show that alopecia associated with SSRIs typically develops 6 weeks after treatment initiation, affecting primarily the frontal scalp area. 3, 4
• The overall reporting rate for SSRI-induced alopecia ranges from 4.5 to 20.1 reports per million patient-years, with significant variation between different SSRIs. 2

Comparison Between SSRIs

• Sertraline shows the highest association with hair loss among SSRIs, with statistically significant reporting rates in both Swedish and international adverse drug reaction databases. 2
• Citalopram (which you previously took) demonstrated a reporting rate of 4.5 per million patient-years and showed significant association with alopecia in international databases. 2
• Fluvoxamine has less published data on hair loss compared to other SSRIs, but the FDA label confirms it occurs. 1
• Case reports document hair loss with fluoxetine, paroxetine, and sertraline, with some patients experiencing resolution after switching between SSRIs. 3, 5, 6, 4

Duloxetine (Cymbalta) Context

• While you mentioned hair loss with duloxetine, the SNRI class guidelines do not list alopecia as a common adverse effect, though individual susceptibility varies. 7
• Your experience with both an SSRI (citalopram) and SNRI (duloxetine) causing hair loss suggests you may have a predisposition to antidepressant-induced alopecia regardless of medication class. 7

Clinical Monitoring Recommendations

• Monitor for hair loss starting at 6 weeks after initiating fluvoxamine, as this is the typical onset period for SSRI-induced alopecia. 3, 4
• Hair loss typically presents as diffuse thinning in the frontal scalp area rather than patchy alopecia. 3, 4
• If hair loss develops, cessation of the medication typically results in regrowth, as documented in multiple case reports. 3, 5, 4

Alternative Considerations

• Escitalopram may represent a lower-risk SSRI option if you need to switch, as it has the least effect on cytochrome P450 enzymes and fewer reported adverse effects overall, though hair loss can still occur. 8
• Consider ruling out other causes of hair loss through laboratory testing (thyroid function, ferritin, vitamin D, zinc levels) before attributing symptoms solely to medication. 7

Important Caveats

• The risk of hair loss must be weighed against the benefits of treating your underlying psychiatric condition, as untreated anxiety or depression significantly impacts quality of life. 7
• Hair loss from SSRIs is typically reversible upon discontinuation, unlike some other medication-induced alopecias. 3, 5, 4
• Never abruptly discontinue fluvoxamine if hair loss develops; taper slowly over 10-14 days to avoid discontinuation syndrome. 8