Is this a bad time to begin Citalopram?

March 8, 2008 2:35 AM

Is this a bad time to begin Citalopram?

I've been battling depression for a while now and finally decided to get some help. I'm hoping to see a therapist in the next few weeks and my GP has started me on Citalopram, which I began yesterday.

Here's the tricky part. A few weeks ago my wife noticed some bald patches on my head which a dermatologist has now tentatively diagnosed as alopecia (still waiting for blood work to come back to see if it might be something else).

Since that time, my hair has been falling out like crazy. I barely even touch it and it comes out in my hand. It's now looking like there's a good chance I'll be bald within the coming weeks. I've always had a very thick head of hair which I've worn fairly long and so this is coming as a real shock.

I've read about how the first few weeks of Citalopram can be rough with depression worsening. In fact, just reading the pamphlet that came with the medicine as it talked about all of the potential side effects scared the hell out of me. And now I'm wondering if going through this while also dealing with my new potential baldness could be a nasty combination. On the other hand, I'm sure this hair loss is going to add quite a bit of anxiety to my life so maybe it's better to sweat through the next few weeks to reach the benefits?

Advice appreciated. Thanks.

posted by anonymous to health & fitness (9 comments total)

It's good to be aware of the possible side effects, but chances are you'll get a few of the milder ones. When I was taking Seroxat, my appetite was affected and I had some odd minor visual hallucinations (visual trails mostly, and slight dizziness – odd rather than frightening). I think it's wise to take your GPs advice in this case, as hair loss can be stress-related.

The thing is, though, the most important parts of your question are incidental. You've decided to get help, you're going to see a therapist, you're concerned about your mental health and you're worried about the effects of hair loss on your anxiety. I reckon that this awareness and reflection is going to have a much more positive and healthy effect on you than the negative effects of hair loss and starting medication. That's not to say that these aren't serious, but your awareness of your own mental state will allow you to deal with these stresses, and seek further help if it's needed.

It may seem an odd thing to say, but congratulations on realising that you need help. Part of the symptoms of depression is often the thought that you are hopeless and beyond help. You've made the big first step. I apologise if this sounds a bit patronising, but I do mean it sincerely.
posted by liquidindian at 2:55 AM on March 8, 2008

Just one opinion, and I'm not a doctor, but has any consideration been given to the possibility that the hair loss and depression might have a common cause, like a mineral deficiency? It seems to me that it would make sense to rule that possibility out before starting the antidepressants which take a long time to work and in my experience are a pain to start and stop.
posted by tomcooke at 4:41 AM on March 8, 2008

That is anxiety producing and I would vote for taking the AD, if nothing else to help you deal with the depression and anxiety. The first six weeks on a new AD (while you are giving it a chance to work), it's possible to worry and think, "Is THAT a side effect? Wait! Is THAT a side effect?" Try to avoid over thinking that although it can be difficult.

Also, seconding tomcooke's comment. I am also not a doctor but I do have hypothyroidism which, when left untreated, makes me lose my hair and causes depression. Make sure that any doctors who are examining you know that you are also experiencing depression and that the depression preceded your noticing of the hair loss.
posted by jeanmari at 5:01 AM on March 8, 2008

Citalopram (more commonly known as Celexa ... Citalopram is a generic) is what my psychiatrist calls a "clean" SSRI. It's known for having pretty few side effects. I don't think you'll be affected negatively by it.
posted by SpecialK at 6:27 AM on March 8, 2008

As SpecialK pointed out, Citalopram is a generic for Celexa. It's been four years or so since I was on it - I have since moved on to something else - but - with the understanding that side effects affect everyone differently, I will talk a little bit about what I experienced when going on the medication.

I seem to recall that my doctor started me off on half dosage for a couple of weeks before I moved up to taking a full pill. My side effects were definitely what I would consider mild. I started grinding my teeth a little bit (this never seemed to go away while I was on Celexa), and for the first week or so when I was taking it at half-dosage, I felt a mild to moderate increase in my relative level of anxiety. The seem to recall describing it to a friend at the time as just feeling very tightly wound.
posted by kbanas at 6:37 AM on March 8, 2008

I began having positive results from Citolapram immediately. I wouldn't worry too much about the risk of contrary effects - worry worsens depression, after all! Take it, under strict guidance, and stay in close contact with your doctor about the effects. Go from there.
posted by IAmBroom at 7:43 AM on March 8, 2008

A low functioning thyroid can cause both depression and hair loss. Anxiety can cause hair loss so you might be adding to your own hair loss with the anxiety. Please get your thyroid levels checked. It is a simple blood test. A low functioning thyroid causes lots of vague problems that can be chalked up to other things, it can be hard to figure out because most doctors don't think about it as their first course of action.
posted by 45moore45 at 8:29 AM on March 8, 2008

I just started on citalopram a couple of months ago. My main symptoms were a extraordinary hunger (lasted about a week), and a few weeks of having a metallic taste in my mouth. The improved mood started about week three, and by week six or seven I felt completely normal.

Totally worth it. Don't wait.
posted by happyturtle at 2:51 PM on March 8, 2008

I don't know about the drug specifically, but I found this bit about hair shedding very useful when I went off birth control and started shedding alarming quantities of hair. Turned out to actually be new growth pushing it out! (The new hairs are 1"-2" long now, though, an effect not unlike a baby bird with a mullet.)
posted by bunji at 9:09 PM on March 8, 2008