I don’t know what to do :( 35F. Started after I took SSRIs

It unfortunate that this is probably a difficult topic to research on your own, since if you google it you get a bunch of sites basically saying yes SSRI can cause telogen effluvium (generic term for vague, unspecific hair loss) — and they don’t really tell you how it causes TE or how you can treat it.

It’s even more unfortunate that most of the scientific literature on the topic of hairloss and SSRI and telogen effluvium in general is lacking severely, specifically in mechanisms of action.

I don’t personally use SSRIs, but if I understand it correctly then i think the hairloss is caused by an increase in blood pressure via vasoconstriction that drastically and suddenly reduces nutrient delivery to hair follicles, causing hair to enter the telogen phase. The exact mechanism of action is unverified but I think it’s likely either cortisol, adrenal hormones, or a combination of the two that mediate various effects on receptor and upregulate blood pressure.

It also can greatly depend on what specific SSRI you’re taking, as most of them work slightly differently from each other.

As far as what you can do about it — switching to a different SSRI could help, but I’m not very knowledgeable about SSRIs and that may not be convenient.

I think it’s likely you could have success with with spironolactone, ketoconazole, minoxidil, or similar medications.

Spironolactone especially, it’s used by many women for hairloss, it’s an androgen receptor antagonist and diuretic so it can help with blood pressure and also hairloss related to certain hormones and is generally the go-to for hairloss in women along with maybe minoxidil and ketoconazole or cyproteroe acetate.

Depending on what SSRI you’re taking they may combine to have potentially negative effect on blood pressure but spironolactone and SSRIs are 2 of the most commonly prescribed medications in the word so any negative interactions should be already documented.

Sorry this is kind of a wall of text, I’m don’t have any experience with SSRI related hair loss but I still feel obligated to try and help.

/r/Hairloss Thread Link - i.redd.it