Isotretinoin (Accutane) and Depression: No Association

Abstract

Dermatology| January 01 2001 Isotretinoin (Accutane) and Depression: No Association AAP Grand Rounds (2001) 5 (1): 1–2. https://doi.org/10.1542/gr.5-1-1 Views Icon Views Article contents Figures & tables Video Audio Supplementary Data Peer Review Share Icon Share Facebook Twitter LinkedIn MailTo Tools Icon Tools Get Permissions Cite Icon Cite Search Site Citation Isotretinoin (Accutane) and Depression: No Association. AAP Grand Rounds January 2001; 5 (1): 1–2. https://doi.org/10.1542/gr.5-1-1 Download citation file: Ris (Zotero) Reference Manager EasyBib Bookends Mendeley Papers EndNote RefWorks BibTex toolbar search toolbar search search input Search input auto suggest filter your search All PublicationsAll JournalsAAP Grand RoundsPediatricsHospital PediatricsPediatrics In ReviewNeoReviewsAAP NewsAll AAP Sites Search Advanced Search Topics: depressive disorders, isotretinoin Source: Jick SS,Kremers HM,Vastlakis-Scaramozza C. Isotretinoin use and risk of depression, psychotic symptoms, suicide, and attempted suicide. Arch Dermatol. 2000;136:1231–1236. To investigate a proposed association between isotretinoin (Accutane) therapy and the risk of depression, psychotic symptoms, suicide, and attempted suicide, the authors analyzed information from the Canadian Saskatchewan Health Database and the United Kingdom General Practice Research Database (GPRD). In the Saskatchewan database, 7195 isotretinoin users and 13,700 antibiotic users aged 10 to 29 years were identified between 1983 and 1996; in the GPRD, 340 isotretinoin and 676 antibiotic users were identified over an unspecified time period. Medical histories for all subjects were available for 6 months to 5 years before and at least 12 months after initiating treatment. Prevalence rates of mental health disorders in acne patients who received isotretinoin were compared to those of acne patients taking antibiotics. In addition, prevalence rates of mental health disorders among patients taking isotretinoin were compared to prevalence rates in those same patients before the start of treatment. The study was funded by Hoffmann-LaRoche, Ltd., Accutane’s manufacturer. Relative risk (RR) estimates for developing depression or psychosis were calculated by comparing current or recent use of isotretinoin or antibiotics with nonexposure (defined as no use of either study drug for more than 6 months). The RR of depression or psychosis among current isotretinoin users was 1.0 (Saskatchewan Health Database) and 1.8 (GPRD) as compared to non-exposed patients. The RR of depression or psychosis among current antibiotic users was 1.3 (Saskatchewan) and 1.5 (GPRD). Compared with pre-treatment, the RR of depression or psychosis among current isotretinoin users was 1.2 (Saskatchewan) and 1.3 (GPRD). Using data from Saskatchewan, the RR for suicide or attempted suicide was 0.9 for current isotretinoin use when compared to nonexposed patients. None of these RRs were statistically significant and, therefore, the authors conclude that there is no evidence that isotretinoin use is associated with an increased risk for depression, suicide or other psychiatric disorders. The possibility that isotretinoin use, through mechanisms unknown, might be associated with an increased risk of mental health disorders (including depression and suicide) has been the subject of some debate1 and media reports, most recently a report on a nationally-televised program.2 Concern about this association led the FDA to include the following warning in the drug’s prescribing information: “Accutane may cause depression, psychosis, and, rarely, suicidal ideation, suicide attempts and suicide. Discontinuation of Accutane therapy may be insufficient; further evaluation may be necessary.”1 There seems little doubt that acne may have a significant impact on an adolescent’s emotional well-being. Before treatment, many adolescents with acne experience some psychosocial consequence of their disease that ranges from anxiety or embarrassment to lowered self-esteem, perceived social rejection or depression.3–,6 In general, successful treatment with conventional agents (eg, antibiotics) or isotretinoin is associated with reduced anxiety and depression.1,3–,7 The results of the present study, conducted using a large population-based sample, do not support an association... You do not currently have access to this content.