Is Wellbutrin making my hair fall out?
November 21, 2010 2:21 PM   Subscribe

My doctor doesn't think it's possible, but could Wellbutrin make my hair fall out?

I've been taking Wellbutrin for about three weeks, at a low dose--100 mg 2x day. I've been depressed for a long time, but started taking meds due to an unexpected breakup. I basically had a little emotional breakdown. I've been stressed before, but never at that level and for that long. I don't even remember October, because I basically slept for 15 hours a day, cried when I was awake, and barely ate anything (mainly pop tarts and pizza).

I started the Wellbutrin and felt better. Then I noticed my hairbrush had more hair in it than usual. My hair is fine to begin with, and not that thick. I didn't think about it until I noticed the brush was full of hair again, a few days after I had cleaned it. I put my hair in a ponytail and it's definitely thinner, by about 1/2. (I'm a woman, late 30s, but I've never lost hair before. This is definitely tied to recent events, but I'm not sure if it's stress or the new meds.)

So, this is not cool. I'm seeing my psychiatrist this week, but she's already expressed that she doesn't think the Wellbutrin is at fault. But do a Google search and there are tons of people claiming that they experienced the same side effect. I know, anecdote does not equal data, but it's got me worried.

It seems like the hair loss has slowed down now. I've amped up my vitamins (extra Biotin), I've added flaxseed and evening primrose oil to my diet, I'm eating better and I've started using Nioxin, which has definitely helped in the past. But every time I brush my hair (very gently!) and see little strands come out, I feel nervous.

I can't lose any more hair. I also would like to keep taking Wellbutrin, since I've had the best response to it of all drugs (and the fact that I'm not totally freaking out about this seems to suggest that the meds are working). I don't know what to do. Has anyone else gone through this? Did your hair eventually grow back?
posted by anonymous to Health & Fitness (20 answers total) 2 users marked this as a favorite
Could the hair loss be from the original stress rather than from the Wellbutrin? The Mayo Clinic says stress can cause hair loss, for among other reasons, this one:

Telogen effluvium. In this condition, emotional or physical stress pushes large numbers of growing hairs into a resting phase. Within a few months, the affected hairs may fall out suddenly when simply combing or washing your hair.
posted by bluedaisy at 2:25 PM on November 21, 2010 [3 favorites]

Hi, this is not specific to Wellbutrin, but more of a validation of what's going on. I've had a couple of doctors, with new psych meds, completely disbelieve me say that the new meds are making my hair fall out. I am recently on a higher dosage of meds, and yes, my hair is falling out, and yes, it is upsetting me a whole lot.

One doctor did believe me - some psych meds can deplete selenium? she recommended taking a men's multivitamin, since it always has more selenium in it. otherwise, don't know what to tell you .. the last med I took that caused this, the hair that grew back (some of it did!) came in curly! so I have this interesting combination curly/straight going on in different parts.

it sounds like you're doing a lot to take care of it, which is great. The only other thing I can mention is that a lot of people suggest that shampoo with ketoconazole (antifungal in some dandruff shampoos) can also encourage hair growth.
posted by circle_b at 2:26 PM on November 21, 2010

You say that Nioxin has helped in the past... So has this happened before?

IANAD but your diet was definitely lacking in nutrients and you were under an incredible amount of stress (and probably still are), and I think those are more likely culprits for the hair loss.

Feel better!
posted by eldiem at 2:34 PM on November 21, 2010 [1 favorite]

Hie thee to the store and buy Centrum vitamins (Centrum Senior IIRC). You'll be taking them for the mineral part.

Some meds do deplete of certain minerals-that's the brand of vitamin/mineral supplement recommended to me by a doctor to protect against hair loss. And Welbutrin was one of the meds.
posted by St. Alia of the Bunnies at 2:35 PM on November 21, 2010 [1 favorite]

My sister experienced significant hair loss a few years ago, which has now grown back since getting her anemia under control. Have you had any bloodwork done lately?
posted by GEB's fun world at 2:37 PM on November 21, 2010

Telogen effluvium. In this condition, emotional or physical stress pushes large numbers of growing hairs into a resting phase. Within a few months, the affected hairs may fall out suddenly when simply combing or washing your hair.

Yeah, the actual hair loss from stress often post-dates the stress by a few weeks to a few months. Then it all grows back around the same time too (since the growth cycles have become synched) giving you an even layer of fuzz that creeps down to meet the rest of your hair. I've been told by a few doctors that having it all grow back at the same time is a good indicator of stress-based hair loss and it's when it doesn't grow back you need to worry. Going on meds like Wellbutin generally comes after a particularly stressful time so it could just be a coincidence for most people, or it could actually be a physical side effect (I have no idea).

I've had the stress mass falling out happen twice in the past two years (just finished my PhD) and yeah, it sucks and looks alarming to see those handfuls of hair each day. But no one else ever noticed and it grew back just fine. I've also had reasonable amounts of hair fall out from chronic anaemia and that grew back too. It does take time though, the growth cycle doesn't always move that fast so you might not see fuzz for three or four more months. If you think that something else weird may be going on or you get actual bald spots appearing then a dermatologist might be a good person to consult.
posted by shelleycat at 2:46 PM on November 21, 2010 [1 favorite]

After a major injury (a month or so after) lots of my hair began to fall out.

Consider that a similar issue might be causing other reports of wellbutrin leading to hair falling out? Stress-> Wellbutrin -> hair falling out
posted by the young rope-rider at 2:49 PM on November 21, 2010

yeah, it's considered "uncommon" between 1:1000 - 1:100, but hair loss is indeed a possible side effect of Wellbutrin.

This is one of the things that frustrate me regarding many psychiatrists, the minimizing of concern for possible side-effects. Yes, the rate is pretty small, but that means as many people as one out of one hundred are experiencing hair loss because of the drug, which is not unheard of small. This minimization tends to undermine trust in the doctor, I mean here you are on an effective anonymous blog asking about this rather than trusting in the psychiatrist and the (yes) evidence of your experience.

Now, what this means is you have to balance the worthiness of the drug with the side effects. If the drug is truly helping you and in general making your life much better, continue your supplements, perhaps even think about getting a nice, natural looking wig. And realize that you don't have to (likely should not) stay on the drug the rest of your life, once stopping your hair will grow back. Hopefully the supplements work, and you will be able to take both the feel-better dug and the keep-my-hair vitamins.

I hope you continue to mend and get strong.
posted by edgeways at 2:54 PM on November 21, 2010

You have to think of this logically. By far the most likely cause of your hair loss is stress. The next most likely cause - by a long shot - is the Wellbutrin (I would ignore posters that suggest you might have anemia or some other illness...people with depression are quite prone to hypochondria, so don't go down that slippery slope). So until you feel certain that it is not the stress, I wouldn't go blaming the Wellbutrin just yet. A 1% or .1% chance is still a long shot.

You have to be particularly careful about what you read on the Web about Wellbutrin. People blame it for just about every condition under the sun. Some call it "legal speed" because it's a dopamine reuptake inhibitor...they have an incorrect grasp of the chemistry.

Don't go on and off Wellbutrin to "test" its effect on your hair...your mood will yo-yo quite badly. It the situation keeps improving, you won't have anything to worry about. It it gets worse and stays worse, then you might want to consider your options...but be careful.
posted by hiteleven at 3:05 PM on November 21, 2010

Only three weeks on Wellbutrin does not sound like enough time to be seeing hair loss from the med, given the pacing of human hair growth. If the Wellbutrin was making hair go dormant and shed, hair loss would only barely be picking up now, because the medication would take some time to have that effect and even if after that the hair went rapidly from anagen or catogen phase to telogen, you're still talking about at least a week or more to start noticing it on your brush.

On the other hand, you've been very stressed and had some major dietary deficiencies since October or earlier. Eight weeks from the start of major stress sounds just about right for hair loss to start. My money is on your hair loss abating soon if you fix your diet and keep taking the meds. If you give it another month or two and it still accelerates, then maybe you need to re-examine the Wellbutrin.

Another idea- were you perhaps so stressed out that you didn't even brush your hair at all for weeks on end until you went on the medication? Then you started to take care of yourself again and wham, several weeks worth of dead hair comes off your head all at once because you weren't taking it off in smaller amounts with regular brushing before.

If you believe internet reports about Wellbutrin causing hair loss, consider this; everybody who goes on Wellbutrin is either very stressed out or maybe a smoker. Neither of those things are good for hair, but because things you do have a delayed effect on hair, it seems like it's the medication. I agree with everybody who says the medication is the least likely problem here.
posted by slow graffiti at 3:14 PM on November 21, 2010

My guess is it's the stress. Correct me if I'm wrong, but when there's a triggering event like that for hair loss, isn't it basically that it interrupts the cycle and it takes a while for it to fall out after that? Like, a couple of months. So, the Wellbutrin is too close in time to have been at fault.
posted by J. Wilson at 3:15 PM on November 21, 2010

I can't speak to your specific concerns regarding Wellbutrin but in college my hair seemed to be falling out at an alarming rate. It wasn't obvious to anyone but me. I was told by a doctor that it might have been due to my sleeping up next to the radiator (but I guess it could have been stress). At any rate, it came back as full as ever afterwards.
posted by Morrigan at 3:29 PM on November 21, 2010

Although it's possible that it's the Wellbutrin, "I barely ate anything" = recipe for hair loss right there.

Also stress, for sure. But the most common cause of temporary hair loss among women is changes in eating habits.
posted by Sidhedevil at 3:37 PM on November 21, 2010 [2 favorites]

yeah, it's considered "uncommon" between 1:1000 - 1:100, but hair loss is indeed a possible side effect of Wellbutrin.

My drug go-to (here) echoes edgeways, but it's important to realize that this frequency is NOT compared to placebo (probably because frequency was low enough that statistical significance was low).

I expect alopecia to be relatively more frequent in cases of depression, so it's not really unexpected that, of a group limited to those suffering depression (Wellbutrin users!), alopecia is a relatively common complaint (although, speaking absolutely, still very uncommon).

Zyban is the same drug, but was tested for smoking cessation rather than for depression, and the incidence of alopecia (hair loss) was lower than with Wellbutrin. (Depression and smoking have high comorbidity, btw.)

Based on this, I would suspect that your doctor is correct: that your hair loss is related to stress and depression, rather than to the medicine used to treat that depression.

You have every right to insist that your doctor take you off Wellbutrin or change you to a different medication, if that's what you want. It sounds as if you feel that Wellbutrin is helping you though. Any change of medication will take a while to kick in, though, and may still cause alopecia. (Curious about the status of this side effect, I checked Effexor and Elavil: both cause alopecia in frequencies greater than or equal to Wellbutrin.)

What I would recommend is staying on the Wellbutrin, getting your depression firmly under control, and waiting for a couple of months (after you and your doctor agree that your depression is under control). At that point, you're going to be in a better position to judge whether Wellbutrin was responsible for your hair loss or whether your stresses and depression were responsible.
posted by nathan v at 3:46 PM on November 21, 2010 [2 favorites]

I think you should do your due diligence and see a medical doctor. Half of a pony tail is significant volume, but you might be overestimating because you're freaking out a bit. But you should double-check, just to cover your bases. That said:

I've recently become fairly certain that I shed a bunch in the autumn, after however many years of annual panic and the forgetting about it. I mentioned it to Mr. Llama and he thinks I'm shedding a lot too. It's possible it's seasonal dryness and a trick of the light, but there's more hair in the shower drain and as I said, Mr. Llama confirmed it and he's no more likely to say 'Yes, love, I think you're losing hair' than any other man is to a woman.

Perhaps I eat differently in the fall. I don't know. It must grow back, because I don't notice the same thinness or loss other times of the year. I'm in my early forties.

Just saying there's lots of reasons other than Wellbutrin to suspect, so I think if I were you I'd do a quick Dr visit, then eat well and leave it alone for six months and see your stylist for a haircut that adds some volume. Wellbutrin kills appetite for a lot of people, too, so again it might not be a direct effect of the Wellbutrin it might be an indirect effect.
posted by A Terrible Llama at 3:47 PM on November 21, 2010

(I know a psychiatrist is a medical doctor, I mean a doctor-doctor. GP type doctor. )
posted by A Terrible Llama at 3:48 PM on November 21, 2010

Absolutely!!!!! I was on it and my hair felt out rapidly. I convinced my doctor to take me off of it because of the hair loss (she doubted the drug was the cause, but I was convinced). My hair stopped falling out within weeks and slowly grew back.

Unfortunately, nothing works on my depression like Wellbutrin, so she convinced me to try again. What do you know - my hair fell out in massive amounts all over again - at least 1/3 the volume of my hair if not more. She took me off of it and finally believed me. She said that it clearly was the cause of my hair loss given that we tried it twice with the same side effect, which disappeared when I wasn't on it.

After some research, I found that between 1 in 100 and 1 in 1000 people experience hair loss on Wellbutrin. I guess that makes it a rare side effect in the drug world, but for those of us who are the 1, it sucks.

There aren't any other medications in the same class as Welbutrin (no others that work the same way), but I've had some success with Pristiq and Abilify. Good luck and you aren't imagining it if you're anything like me.
posted by cecic at 4:11 PM on November 21, 2010

This is just my experience but whenever I take Welbutrin I lose hair. However, the hair loss stops after a little while (a month or so), so -- at least for me -- it is a temporary side effect.
posted by patheral at 5:30 PM on November 21, 2010

Nathan v, except there's a problem with assuming that Wellbutrin or stress has anything to do with this at all if it is indeed one of the effluviums. If my doctor automatically assumed my hair loss was a direct cause of stress without so much as running some lab work to rule out physical causes first I'd be really pissed and, seek a second opinion. It's actually a very common reaction to women losing their hair, "there there dear stop being sooo stressed!" as he pats your hand. For women hair loss is a much more complicated matter than it is for men and, can be indicative of anything from PCOS to thyroid problems to hyperglycaemia to vitamin/mineral deficiencies to, worst case scenario, the early stages of female patterned hair loss. Yes stress plays a role as does Wellbutrin, but until other avenues have been exhausted I wouldn't assume either is the reason. For all we know her poor diet could be what precipitated it.

Anon, the frustrating bit is you won't know whether its one or the other until you stop taking the medication and, sadly a lot of psychiatric medications have it as a side effect so it might be difficult to find something else that works for you if you choose to go down that path. And, if you haven't done it already (looks like you might have that under control based on what you're currently taking) get some lab work done to make sure there isn't a underlying physical cause.

Btw, hair loss can be an immediate response to a stressor, or it can be delayed for months and, smoking doesn't contribute to losing your hair. In men testosterone and, DHT causes hair follicles to shrink and eventually die. In women those hormones play a role too, but its more complicated for us, truth is the medical establishment is kinda at a loss when it comes to the fairer sex.
posted by squeak at 8:52 AM on November 22, 2010

When I was on Wellbutrin, my hair fell out too. And I had horrible acne.

I suspect Wellbutrin messes with the hormonal system. I'm on St. John's Wort now and am not having side effects, and it's working well for my mood.
posted by xenophile at 2:07 PM on November 22, 2010

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