Quetiapine Induced Hair Loss in an Adolescent Case (original) (raw)
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A case with alopecia related to risperidone use
Anatolian Journal of Psychiatry, 2016
Alopecia involves the loss of some or all of the hair from the head and sometimes other parts of body. The etiology contains a lot of factors including drug use and psychotropic agents at sometimes. New generationl antipsychotics are less frequently accused, compared to the other psychotropic agents. In the literature, olanzapine, risperidone, ziprasidone, loxapine, quetiapine and haloperidol are the reported drugs associated with alopecia. Alopecia which may be seen rarely, was observed in our patient with schizoaffective disorder, thus in this report the patient's followup, treatment process and approach to alopecia cases were described.
Diffuse Hair Loss Induced by Sertraline Use
Case Reports in Psychiatry, 2015
Hair loss is a rare side effect of psychotropic drugs. The most related drug class with this side effect is the mood stabilizers. Studies reporting the sertraline-induced alopecia are limited in number. Sertraline is a potent antidepressant which inhibits the serotonin reuptake from the presynaptic terminals selectively. The reason for hair loss could not be elucidated completely. Psychotropic drugs are usually considered to lead to hair loss through influencing the telogen phase of hair follicle. This paper reports a 21-year-old male with diffuse hair loss induced by sertraline use and improved by quitting the drug. To the best of our knowledge, there are no other case reports on sertraline-induced alopecia within 2 weeks.
Forensic Science International, 2018
Drug analysis in hair is useful when seeking to establish drug intake over a period of months to years. Segmental hair analysis can also document whether psychiatric patients are receiving a stable intake of antipsychotics. This study describes segmental analysis of the antipsychotic drug quetiapine in postmortem hair samples from long-term quetiapine users by ultra-high performance liquid chromatography-tandem mass spectrometry (UHPLC-MS/MS) analysis. The aim was to obtain more knowledge on quetiapine concentrations in hair and to relate the concentration in hair to the administered dose and the post-mortem concentration in femoral blood. We analyzed hair samples from 22 deceased quetiapine-treated individuals, who were divided into two groups: natural hair colour and dyed/bleached hair. Two to six 1 cm long segments were analyzed per individual, depending on the length of the hair, with 6 cm corresponding to the last six months before death. The average daily quetiapine dose and average concentration in hair for the last six months prior to death were examined for potential correlation. Estimated doses ranged from 45 to 1040 mg quetiapine daily over the period, and the average concentration in hair ranged from 0.18 to 13 ng/mg. A significant positive correlation was observed between estimated daily dosage of quetiapine and average concentration in hair for individuals with natural hair colour (p = 0.00005), but statistical significance was not reached for individuals with dyed/bleached hair (p = 0.31). The individual coefficient of variation (CV) of the quetiapine concentrations between segments ranged from 3 to 34% for individuals with natural hair colour and 22-62% for individuals with dyed/bleached hair. Dose-adjusted concentrations in hair were significantly lower in females with dyed/bleached hair than in individuals with natural hair colour. The quetiapine concentrations in post-mortem femoral blood and in the proximal hair segment, segment 1 (S1), representing the last month before death were also investigated for correlation. A significant positive correlation was observed between quetiapine concentrations in blood at the time of death and concentrations in S1 for individuals with natural hair colour (p = 0.003) but not for individuals with dyed/bleached hair (p = 0.31). The blood concentrations of quetiapine ranged from 0.006 to 1.9 mg/ kg, and the quetiapine concentrations in S1 ranged from 0.22 to 24 ng/mg. The results of this study suggest a positive correlation of quetiapine between both concentrations in hair and doses, and between proximal hair (S1) and blood concentrations, when conditions such as hair treatments are taken into consideration.
Indian Journal of Pharmacy Practice
Hair loss (alopecia) is an occasional side effect associated with psychotropic drugs use. Fluvoxamine is a synthetic antidepressant which acts as a selective serotonin reuptake inhibitor as well as sigma-1 receptor agonist. Psychotropic drugs are considered to cause hair loss by affecting the telogenic phase of hair follicle. Here we present a case of a 28 year old male patient reported with diffuse hair loss after administration of fluvoxamine and condition remitted after cessation of the drug. Our report suggests the possibility of developing alopecia with fluvoxamine use.
Portuguese Journal of Dermatology and Venereology
Drugs are a relatively common cause of diffuse, nonscarring hair loss. They may interfere with the normal hair cycle, either by an abrupt cessation of the mitotic activity of matrix cells, causing anagen effluvium, or by an interruption of the anagen and a premature passage to the telogen phase, originating telogen effluvium. It is essential to obtain a complete history, including previous diseases and medications, focusing on the past 3 months, in order to rule out possible drug-induced alopecia. This review encompasses the most frequently involved drugs, including mechanisms of action and clinical characteristics of drug-induced alopecia. The correct recognition of drug-induced alopecia is essential since the main approach is to stop the offending agent, whenever it is possible.
Journal of Analytical Toxicology, 2002
Hair samples of psychiatric patients were analyzed by liquid chromatography-tandem mass spectrometry (LC-MS-MS) for the neuroleptics clozapine, flupentixol, haloperidol, penfluridol, thioridazine, and zuclopenthixol. In the study, these neuroleptics were administered to the patients regularly for a minimum of six months. Sample preparation was performed by washing, powdering with a ball mill, extraction of drugs from hair by ultrasonication with methanol, cleanup by solid-phase extraction and subsequent LC-MS-MS analysis using multiple reaction monitoring (MRM). Calibration was performed for all drugs in the range of 0.05 to 10 ng/mg using spiked hair powder and doxepin-d3 as internal standard. Twenty to 50 mg of hair powder was used and the detection limits of LC-MS-MS were below 0.05 ng/mg for all drugs tested. Therapeutic dosage, number of subjects, hair color, and detected amounts of drugs were as follows: dozapine (150-400 mg/day; n = 3, light brown, medium brown, black; 0.47-0.92 ng/mg), haloperidol (150 rag/3 weeks; n = 1, black/gray; 12.2 ng/mg), penfluridol (20-30 rag/week; n = 2, medium brown, black; 0.08 ng/mg; not detected in one case), thioridazine (100-400 rag/day; n-4, light brown, medium brown, black; 0.33-9.91 ng/mg, not detected in one case). Besides the active drugs also the desmethyl-metabolites of clozapine and thioridazine were detected by LC-MS-MS. However, flupentixol (5 rag/day; light brown hair) and zuclopenthixol (350 rag/3 weeks; light brown hair) were not detected by these methods in one case each, although the drugs were administered regularly to these patients. The comparison of dosage and hair color in two cases with thioridazine and penfluridol suggests that other interindividual factors may have an influence on drug concentration in hair.
Forensic Science International, 2020
Segmental hair analysis provides information regarding previous long-term drug exposure, which is useful in the evaluation of cause of death for individuals with mental disorders. The aim was to analyze postmortem concentrations of the antipsychotic drug aripiprazole and its active metabolite dehydroaripiprazole in hair segments from individuals with known aripiprazole intake. Hair samples were collected during autopsy. Each sample was segmented into one to six 1 cm segments, depending on the length of the hair shaft. Pulverized hair was extracted and analyzed using a previously published ultra-high-performance liquid chromatography-tandem mass spectrometric method. The 10th-90th percentile of aripiprazole concentrations in all hair segments (n = 78) from 17 individuals were 0.024 ng/ mg-11 ng/mg with a median of 2.3 ng/mg, and the 10th-90th percentile concentrations of dehydroaripiprazole were 0.020 ng/mg-11 ng/mg, with a median of 2.6 ng/mg, in all hair segments (n = 71). The metabolite-to-parent drug ratios ranged from 0.21 to 1.5, with a median of 0.72. The administered doses were calculated for each individual based on aripiprazole prescription data and pharmacy pickups, giving dose estimates of 1 mg-32 mg daily. A positive significant correlation was observed between concentrations in hair and blood, whereas no trends were observed between the concentrations in hair and the estimated doses. Besides aripiprazole, other antipsychotic drugs were found in several hair segments, indicating a high degree of polypharmacy among all subjects. The present study establishes concentrations of aripiprazole and dehydroaripiprazole in hair segments from 17 deceased individuals with long-term aripiprazole use. In addition, hair analysis demonstrates the possibility of evaluating polypharmacy.
Atomoxetine-Related Hair Loss in a Teenager: A Case Report
Klinik Psikofarmakoloji Bülteni-Bulletin of Clinical Psychopharmacology, 2010
Bir ergende atomoksetin kullanımı ile ilişkili saç dökülmesi: Bir olgu bildirimi Atomoksetin dikkat eksikliği hiperaktivite bozukluğu tedavisinde stimülan olmayan, noradrenalin geri alım inhibisyonu yapan yeni bir tedavi seçeneğidir. Atomoksetinin klinik kullanımı sırasında en çok karşılaşılan yan etkiler; baş ağrısı, karın ağrısı, iştah azalması, halsizlik, bulantı, kusma ve baş dönmesidir. Bu olgu sunumunda, atomoksetin başlanması ardından özgeçmişinde ve aile öyküsünde olmadığı halde, yaygın saç dökülmesi gözlenen bir erkek ergeni bildiriyoruz. Bildiğimiz kadarıyla, bu olgu sunumu atomoksetin ile ilişkili saç dökülmesi bildiren ikinci bildirimdir.
Australian and New Zealand Journal of Psychiatry, 2003
We report a case of a DSM-IV manic episode developing in a patient with schizophrenia, presumably related to the addition of quetiapine.