Hair Loss as a Side Effect of Lamotrigine Treatment

“Mrs. G,” a 63-year-old woman, was treated as an inpatient from Aug. to Sept. 2003 because of a depressive episode from a previously diagnosed bipolar disorder. During hospitalization, therapy with lamotrigine was started, and the dose was later increased in an ambulant setting up to 150 mg daily. After her discharge, Mrs. G was visited regularly by the psychiatric ambulance. During this entire period, she did not receive any other pharmaceutical treatment except eye drops containing hypromellose. She reported an increase in hair loss 2 to 3 weeks after beginning lamotrigine treatment. The hemogram and other laboratory parameters did not show pathological findings. The result of the trichogram, a classical hair root examination made by an external consultant dermatologist in Nov. 2003, showed an increase of resting (telogen) and dystrophic hair at the expense of growing (anagen) hair. The hair loss was mainly located in the area of the temporal bone, which is characteristic for pharmacologically induced alopecia (3, 4) .

Because of the probable association of the reported alopecia with lamotrigine treatment, the treatment was discontinued, which resulted in a rapid regression of hair loss.