Trazodone and Hair Loss Risk
Trazodone can cause hair loss, though it occurs rarely, and given your history of hair loss with citalopram (Celexa) and duloxetine (Cymbalta), you may be at increased risk for experiencing this side effect with trazodone as well.
Evidence for Trazodone-Induced Hair Loss
- Trazodone is documented to cause alopecia on rare occasions, though the exact incidence is not well-established 1
- In a systematic review of psychopharmaceuticals and hair loss, trazodone was identified among antidepressants that "may on rare occasions lead to alopecia" 1
- The mechanism of drug-induced hair loss from antidepressants typically involves telogen effluvium, where hair follicles prematurely enter the resting phase, leading to diffuse hair shedding 1-3 months after medication initiation 2, 3
Your Specific Risk Profile
Your prior history of hair loss with two different antidepressants (citalopram and duloxetine) suggests individual susceptibility to medication-induced alopecia, which increases your likelihood of experiencing this side effect with trazodone:
- Individual patient susceptibility plays a significant role in whether drug-induced hair loss occurs 3, 4
- Patients who have experienced hair loss with one medication may be more prone to this reaction with other agents in the same or different classes 3
- Both SSRIs (like citalopram) and SNRIs (like duloxetine) can cause hair loss, and cross-reactivity with other antidepressants including trazodone is possible 1
Clinical Characteristics if Hair Loss Occurs
If you develop hair loss on trazodone, expect the following pattern:
- Hair shedding typically begins 1-3 months after starting the medication 2, 3
- The pattern is usually diffuse, non-scarring alopecia affecting the entire scalp rather than localized patches 2
- Hair loss is almost always completely reversible upon medication discontinuation or dose reduction 1, 4, 5
- Recovery typically occurs within 3-6 months after stopping the medication, with hair regrowing at approximately 1 cm per month 2
Management Approach
If you notice hair loss while taking trazodone:
- Discontinuation of the medication or dose reduction almost always leads to complete hair regrowth 1, 5
- Consider whether the therapeutic benefit of trazodone outweighs the cosmetic concern of temporary hair loss
- Topical minoxidil may be considered as adjunctive therapy for persistent hair loss, though this adds complexity 6
- Rule out other potential causes of hair loss including thyroid dysfunction, stress, illness, or nutritional deficiencies before attributing it solely to trazodone 3
Important Caveats
- The temporal association between starting a medication and hair loss does not always prove causation—other triggers like stress, illness, or hormonal changes must be excluded 3
- Given your documented pattern of hair loss with multiple antidepressants, discussing alternative non-pharmacologic treatments or medications from different classes with your prescriber may be warranted
- Monitor for hair changes starting 1-3 months after initiation, as this is when telogen effluvium typically manifests 2, 3