Abstract
Isotretinoin (13-cis-retinoic acid) is an effective treatment for severe cystic or recalcitrant acne vulgaris. However, concerns have been raised regarding its potential association with depression and suicidal behavior. We have explored the proposed relationship between isotretinoin use and the risk of depression and suicide in patients with acne vulgaris. Rates of depression among users ranged from 1 to 11% across studies, with similar rates compared with oral antibiotic. Clinical studies comparing depression before and after treatment never demonstrate any statistically significant increase in depression, except for one recent study. However, isolated clinical case reports indicate a possible clinical relationship between depressive symptoms and isotretinoin. In these conditions, it appears today that the link between suicides and severe depressions has not yet been clearly demonstrated. One of the hypotheses could be that these psychiatric side effects are unpredictable idiosyncratic phenomena, whose ...
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