Etminan Mahyar, Sodhi Mohit, Procyshyn Ric M, Guo Michael, Carleton Bruce C
Departments of Ophthalmology and Visual Sciences.
Psychology.
Int Clin Psychopharmacol. 2018 Jan;33(1):44-48. doi: 10.1097/YIC.0000000000000191.
The aim of this study was to quantify the risk of hair loss with different antidepressants. A retrospective cohort study design using a large health claims database in the USA from 2006 to 2014 was utilized. A cohort of new user and mutually exclusive users of fluoxetine, fluvoxamine, sertraline, citalopram, escitalopram, paroxetine, duloxetine, venlafaxine, desvenlafaxine, and bupropion were followed to the first diagnosis of alopecia. The cohort was comprised of 1 025 140 new users of fluoxetine, fluvoxamine, sertraline, citalopram, escitalopram, paroxetine, duloxetine, venlafaxine, desvenlafaxine, and bupropion, with sertraline the most commonly prescribed (N=190 227) and fluvoxamine (N=3010) the least prescribed. Compared with bupropion, all other antidepressants had a lower risk of hair loss, with fluoxetine and paroxetine having the lowest risk [hazard ratio (HR)=0.68, 95% confidence interval (CI): 0.63-0.74, HR=0.68, 95% CI: 0.62-0.74, respectively] and fluvoxamine having the highest risk (HR=0.93, 95% CI: 0.64-1.37). Compared with fluoxetine, bupropion had the highest risk of hair loss (HR=1.46, 95% CI: 1.35-1.58, number needed to harm=242 for 2 years) and paroxetine had the lowest risk (HR=0.99, 95% CI: 0.90-1.09). The results of this large population-based cohort study suggest an increase in the risk of hair loss with bupropion compared with selective serotonin reuptake inhibitors and selective norepinephrine reuptake inhibitors, whereas paroxetine had the lowest risk.
本研究的目的是量化不同抗抑郁药导致脱发的风险。采用回顾性队列研究设计，利用美国2006年至2014年的一个大型医保索赔数据库。对一组使用氟西汀、氟伏沙明、舍曲林、西酞普兰、艾司西酞普兰、帕罗西汀、度洛西汀、文拉法辛、去甲文拉法辛和安非他酮的新用户及相互排斥的用户进行随访，直至首次诊断为脱发。该队列由1025140名使用氟西汀、氟伏沙明、舍曲林、西酞普兰、艾司西酞普兰、帕罗西汀、度洛西汀、文拉法辛、去甲文拉法辛和安非他酮的新用户组成，其中舍曲林的处方量最大（N = 190227），氟伏沙明的处方量最小（N = 3010）。与安非他酮相比，所有其他抗抑郁药导致脱发的风险较低，氟西汀和帕罗西汀的风险最低[风险比（HR）= 0.68，95%置信区间（CI）：0.63 - 0.74；HR = 0.68，95% CI：0.62 - 0.74]，氟伏沙明的风险最高（HR = 0.93，95% CI：0.64 - 1.37）。与氟西汀相比，安非他酮导致脱发的风险最高（HR = 1.46，95% CI：1.35 - 1.58，2年危害所需人数 = 242），帕罗西汀的风险最低（HR = 0.99，95% CI：0.90 - 1.09）。这项基于大规模人群的队列研究结果表明，与选择性5-羟色胺再摄取抑制剂和选择性去甲肾上腺素再摄取抑制剂相比，安非他酮导致脱发的风险增加，而帕罗西汀的风险最低。
