Research shows that amitriptyline is effective in treating mood disorders and chronic pain. However, like any medication, it can also have some unwanted side effects [1]. Antidepressants have a reputation for potentially causing hair thinning, especially with prolonged use. So does amitriptyline cause hair loss as well?
Few studies have been conducted to test the relationship between amitriptyline and hair loss because only a very low number of alopecia cases caused by this medication have been reported so far [2][3]. One found a 0.008% chance of developing significant amitriptyline hair loss in patients who were already predisposed to alopecia [4]. So while this drug may worsen hair shedding in some patients, it is a very rare occurrence. Keep reading this article to find out all you need to know about:
Amitriptyline is a type of antidepressant medication that works by increasing the levels of somea hormones and neurotransmitters called serotonin and norepinephrine [1][5]. It is designed and FDA and MHRA-approved to treat depression in adults. However, it is rarely used as a first-line treatment for this condition, due to its higher toxicity in overdose and generally poorer tolerability. This medicationit can also be prescribed to prevent and/or treat other conditions such as [1]:
Amitriptyline is normally available as oral tablets (10 mg – 150 mg) [1], but it can also be found in liquid form [5]. It can be purchased in generic form or under brand names such as Elavil or Vanatrip [6].
Amitriptyline has alopecia listed as a side effect of unknown frequency in The Prescribers’ Digital Reference, as do all antidepressants in its class [6]. Hair loss is also listed as a rare (1 in 1000) potential side effect on this medication’s information sheet [7].
However, research shows that only a few instances of hair thinning caused by this class of medication have been documented [2][3]. This can be the result of mild to moderate alopecia going unreported, as people don’t always make the connection between their medication and hair loss. But the very few scientific studies that looked into the connection between amitriptyline and alopecia found little evidence of its existence.
One study that tested the effect of 100 drugs on diffuse pattern hair loss in women revealed that only 4 out of the 225 participants with female pattern hair loss were taking amitriptyline [8]. However, there was no mention of whether this was the only medication they were taking and no direct causal link could be established between this drug and their alopecia.
Different research regarding the association between severe hair loss and psychotropic drugs in psychiatric inpatients revealed severe hair loss in only 1 in 100,000 amitriptyline patients (0.008%). Moreover, no cases were reported in those who had no other alopecia risk factors [4]. This suggests amitriptyline can very rarely trigger or worsen hair loss in patients already predisposed to alopecia.
Most studies conducted to test amitriptyline safety and side effects did not include hair loss among the potential adverse reactions they tested for [9][10][11][12][13]. This is likely due to the very rare occurrence of this event. And while some of these studies gave participants the chance to report side effects that were not on the pre-approved list, there is no mention of hair loss having been reported [14].
No, amitriptyline is not known to cause patchy hair loss. This type of alopecia is usually a sign of an autoimmune condition, such as alopecia areata, or a scalp infection. Antidepressants have only been reported to cause diffuse hair loss across your scalp.
If your hair loss is indeed caused by amitriptyline, it is normally temporary and should subside within 2-3 months of stopping treatment. However, never discontinue your medication without the approval and supervision of your prescribing physician, as it can have serious negative consequences for your physical and/or mental health.
Also, keep in mind that it is difficult to establish a definite cause-and-effect relationship between this drug and hair thinning thanks to the lack of evidence [3]. So if you are experiencing excessive hair shedding while taking amitriptyline, it is a good idea to see a trichologist. They can help you rule out other potential types of alopecia.
Medication-induced hair loss normally resolves a few months post-treatment cessation without requiring any treatment. However, if you are eager to speed this process along, you can try some of these scientifically proven ways to grow thicker hair naturally.
Alternatively, you could try using Minoxidil to increase blood flow to your hair follicles, stimulating growth. However, if you choose to take hair loss medication, be sure to get a recommendation from a hair doctor or your GP to avoid unwanted drug interactions.
While this type of hair loss is unlikely, you can’t prevent it from happening altogether. But you can take steps to get healthier hair that is less susceptible to falling out. This can mean eating a better diet for healthy hair, engaging in safer hair styling practices or using some of the best essential oils for hair growth.
If you are considering using hair loss medication such as Minoxidil preventively, be sure to get a recommendation from your trichologist first, as it can interfere with other medications you may be taking.
Theoretically, higher doses of medications can increase the risks of unwanted side effects. However, the chances of experiencing significant hair loss caused by amitriptyline are very slim. The low number of reported cases did not encourage any studies to be conducted into the effects of different amitriptyline doses on hair loss.
If your healthcare provider has recommended a certain medication dose, it is important to take it as prescribed. Remember that any hair loss experienced isn’t likely to be permanent, so you can start looking for solutions if you encounter this adverse effect.
Never abruptly stop taking any kind of psychiatric medication without the guidance of your prescribing physician. It can have a significant negative effect on your health. If you are experiencing adverse effects that bother you, such as hair loss, discuss this matter with your doctor and they will let you know whether there are other, equivalent but more hair-friendly treatment options for your condition.
Many types of medications can cause hair loss or modify your hair texture. Here are some of the most common [14]:
Normally, medication-induced hair loss is temporary and resolves itself without intervention 3-4 months after treatment cessation. However, in some cases, hair loss treatments such as Minoxidil or PRP hair treatment may be needed to restore hair growth. If more than 6 months have gone by since you stopped the medication that caused your hair loss and you see no signs of regrowth, it is best to seek a trichologist’s advice.
Some forms of drug-induced alopecia can be easy to spot, such as chemotherapy hair loss that can cause complete baldness on your head and in some cases, your face as well (alopecia totalis). However, in most cases, medication-induced hair loss is more discreet. It usually presents as diffuse hair loss, with thinning all over your scalp.
This is because treatments with this side effect cause disruptions in your hair growth cycle, pushing a higher-than-usual number of your follicles out of the growth phase and into the shedding phase. This leads to telogen effluvium. The good news is that in most cases, it is temporary and your hair growth will return once you have finished your treatment.
Sometimes, taking medications and losing your hair can be completely unrelated. You may simply be experiencing the first signs of hair thinning and balding. Here are some of the most frequent reasons your hair may be falling out:
Also known as female or male pattern baldness, this condition affects 85% of men [15] and almost half of women during their lifetime. It is caused by the excessive production of (or increased sensitivity to) a male hormone called dihydrotestosterone (DHT). This androgen binds to receptors in your hair follicles, making them shrink and eventually stop producing hair.
Common symptoms: In men, it usually manifests with a receding hairline, significant temple hair loss and a bald spot on the crown. In women, the hair loss is usually diffuse and there is a progressive widening of the midline parting.
Alopecia areata is an autoimmune condition, which means your white blood cells are attacking your hair follicles. It often resolves itself within a year but can recur later in life. More severe forms need specific treatment to improve (e.g. steroid creams).
Common symptoms: smooth, rounded bald patches on your scalp, broken hairs in the shape of exclamation marks, and in some cases, hair poliosis alongside new hair growth.
Medications are not the only things that can cause this condition, it can also be induced by powerful physical or emotional stress (e.g. illness, surgery, or mental trauma). When these events disrupt your hair growth cycle, hair follicles are pushed prematurely out of the growth phase and into the shedding phase.
Common symptoms: diffuse hair loss all over your scalp, and in some cases trichodynia.
Hair follicle infections, such as scalp folliculitis, can cause temporary hair loss, as can skin conditions such as scalp psoriasis. In most cases, the hair loss is caused by the inflammation that damages the hair follicles
Common symptoms: depending on the condition, you may experience scalp inflammation, redness, tenderness, flaking or crusting, bumps or pustules around your hair follicles, raised or thickened areas, and oozing lesions.
If you are concerned about your hair loss and unsure why it may be happening, book a consultation with one of our top-tier trichologists. They will get a detailed account of your medical history and perform all the necessary diagnostic tests to identify your type of alopecia. Based on the results, they will recommend the most effective, personalised treatment to stimulate your hair follicles for growth and reduce hair loss for your specific condition.
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