Isotretinoin Use and Subsequent Depression and Suicide

  title={Isotretinoin Use and Subsequent Depression and Suicide},
  author={Peter R. Hull and Carl D’Arcy},
  journal={American Journal of Clinical Dermatology},
  • P. Hull, C. D’Arcy
  • Published 2003
  • Medicine, Psychology
  • American Journal of Clinical Dermatology
AbstractThe growing number of reported cases of depression and suicide associated with isotretinoin (a retinoid receptor agonist) use in patients with acne has prompted concern among dermatologists, patients, and their relatives and has triggered new warnings from regulators including depression-related, patient-informed consent forms. In establishing a cause-effect relationship, it is useful to judiciously consider whether there is an association, what is the nature of that association, if… 
Affective psychosis following Accutane (isotretinoin) treatment
A series of cases of manic psychosis that developed in a 1-year period (2003) in association with isotretinoin treatment and resulted in suicidality and progression to long-standing psychosis are described, suggestive of an increase in the likelihood of an association between exposure to isotretinion and manic psychosis.
Depression and suicidal behavior in acne patients treated with isotretinoin: a systematic review.
Isotretinoin and the controversy of psychiatric adverse effects
No conclusion can be drawn about a causal relationship between istotretinoin and psychiatric adverse events, but several lines of evidence link retinoid signaling to theorized psychiatric pathogenesis, but are limited in their applicability to adult neurophysiology.
This review article evaluates the published articles about the psychiatric side-effects of isotretinoin and discusses the psychopathologic effects of isot retinoin.
Isotretinoin and neuropsychiatric side effects: Continued vigilance is needed
  • J. Bremner
  • Medicine, Psychology
    Journal of Affective Disorders Reports
  • 2021
Does isotretinoin cause depression and anxiety in acne patients?
The data support no causal relationship between isotretinoin use and depression in acne patients and psychiatrists are concerned about the potential psychiatric side effects of isot retinoin.
Important Controversies Associated with Isotretinoin Therapy for Acne
It appears that a very small subset of patients receiving isotretinoin for acne are at risk for depression, which is very manageable provided there is adequate patient awareness of the possibility, maximum communication between the patient and physician, and cessation of therapy if clinically important depression occurs.
Isotretinoin and psychiatric side effects: facts and hypothesis
It appears today that the link between suicides and severe depressions has not yet been clearly demonstrated, and one of the hypotheses could be that these psychiatric side effects are unpredictable idiosyncratic phenomena.
Acne, depression, and suicide.


An analysis of reports of depression and suicide in patients treated with isotretinoin.
Doctors are advised to inform patients prescribed isotretinoin of the possibility of development or worsening of depression and to advise patients to immediately report mood swings and symptoms suggestive of depression so that patients can be promptly evaluated for appropriate treatment.
Overview of existing research and information linking isotretinoin (accutane), depression, psychosis, and suicide.
  • J. O’Donnell
  • Medicine, Psychology
    American journal of therapeutics
  • 2003
There is no contesting that this drug is effective at clearing up the most severe forms of acne, but the public must be informed of the proper limited indication for its use, because depression and suicide can follow in patients with no prior history of psychiatric symptoms or suicide attempts.
Isotretinoin use and risk of depression, psychotic symptoms, suicide, and attempted suicide.
This study provides no evidence that use of isotretinoin is associated with an increased risk for depression, suicide, or other psychiatric disorders.
Suicide, depression, and isotretinoin: is there a causal link?
There is no evidence to support a causal connection between isotretinoin and major depression or suicide, and it is important for dermatologists to be aware of the risk factors for suicide and to monitor patients who exhibit depressive symptoms.
Isotretinoin treatment of a woman with bipolar disorder.
Physicians are being encouraged to be alert to the development of additional or new clinical psychiatric symptoms during isotretinoin use and to discontinue treatment when necessary, because of these possible side effects.
Case Report/Case Series:Acne, Isotretinoin Treatment and Acute Depression
  • C. Ng, Mei Mui Tarn, S. Hook
  • Psychology, Medicine
    The world journal of biological psychiatry : the official journal of the World Federation of Societies of Biological Psychiatry
  • 2001
The association between isotretinoin therapy and depressive symptoms in acne patients has generated much recent interest but has not been systematically explored. A 17-year-old man with acne vulgaris
Suicide in dermatological patients
Patients with dermatological non‐disease, and particularly women with facial complaints, may be extremely depressed and at risk of suicide, and facial scarring may be an ‘at risk’ factor for suicide, emphasizing the positive early therapeutic role of isotretinoin.
Use of isotretinoin (Accutane) in the United States: rapid increase from 1992 through 2000.
There has been a 2.5-fold increase in the number of dispensed prescriptions for isotretinoin in the United States in the last 8 years, and data reveal an increasing proportion of isot retinoin use for mild and moderate acne.
The psychological and emotional impact of acne and the effect of treatment with isotretinoin
Treatment with isotretinoin produced significant improvements across a wide variety of psychological functions, although the emotional status of patients appeared to be more resistant to change.
Drug-induced depression.
A small, but growing, literature confirms that certain drug exposures can contribute to the biopsychosocial etiology of depressive symptoms and disorders.