Venlafaxine-induced hair loss

Ms. A was a 50-year-old woman who had suffered from a severe major depressi ve episode of a melancholic subtype. She did not fulfill DSM-IV criteria fo r any other axis I or personality disorder. She was medically healthy and d id not take any medications. Her general practitioner began treatment with venlafaxine, 75 mg/day. After 15 days, her dose of venlafaxine was increase d to 150 mg/day. Four weeks later, Ms. A was much better. However, she repo rted moderate side effects, such as nausea and somnolence, that began after 2 days of treatment. After 2 weeks, she also noticed hair loss when she br ushed or washed her hair. Ms. A considered hair loss a moderate but disturb ing side effect and decided to discontinue the treatment after 3 months. He r hair loss stopped completely 1 month later. Ten months later, Ms. A developed a new major depressive episode. She began taking venlafaxine again; this was associated with a complete remission of the previous depressive episode. She started taking venlafaxine at a mean dose of 75 mg/day and then increased it to 150 mg/day after 2 weeks. Three weeks later, Ms. A decided to stop taking the medication again because of t he hair loss that she had observed 10 days after beginning treatment. A com plete remission was achieved with sertraline, 50 mg/day, without hair loss, which completely slopped 3 weeks after the discontinuation of venlafaxine.