If you suffer from severe acne or are a medical professional, you are probably aware of how well the isotretinoin works. However, many people are hesitant to take this drug because of the numerous side effects such as damage to unborn children and depression.
Hoffman-LaRoche is the manufacturer of Accutane, the popular trade name acne drug. Recently, an Archives of Dermatology study indicated that isotretinoin does not cause depression. Christina Y. Chia, a doctor at the Saint Louis University Health Sciences Center and her colleagues studied patients with moderate to severe forms of acne who were taking isotretinoin to determine whether they suffered more depressive symptoms when taking the drug. This group of patients was compared to ones who received a topical retinoid or an oral/topical antibiotic. According to Dr. Chia, “The use of isotretinoin in the treatment of moderate-severe acne in adolescents did not increase depressive symptoms. On the contrary, our study shows that treatment of acne improves depressive symptoms.”
In 2000, there was still controversy surrounding the possible link between depression and isotretinoin. At that time, Dr. Susan S. Jick, a doctor at the Boston University School of Medicine, did not find any proof that the drug increases the risk of psychiatric disorders, depression or suicide for patients.
Despite the fact that many psychiatrists and dermatologists wholeheartedly support taking the drug, many politicians, medical professionals and parents disagree. For example, the Associate Director for Science and Medicine at the FDA Office of Drug Safety, Dr. David J. Graham, issued a warning that Accutane should be pulled from the market.
Furthermore, even though few studies exist that link isotretinoin with such problems, one doctor at the Emory University School of Medicine, Dr. Douglas Bremner, has shown that the drug treatment causes brain function changes. His study, which was published in the American Journal of Psychiatry, reveals that he also believes that the drug should not be taken by humans because of the dangers involved.
Isotretinoin has to influence the brain in order to cause depression, according to Dr. Bremner. Positron emission tomography (PET) was used to test the brain function of subjects before and after taking isotretinoin for a four-month period. The drug was linked with lower brain metabolism in the part of the brain that mediates depression symptoms, the orbitofrontal cortex. However, the two groups taking the antibiotic and isotretinoin treatments showed no differences in the severity of their depressive symptoms pre- and post-treatment.
Diane K. Wysowski is a doctor indicated in June 2000 in the FDA’s Adverse Event Reporting System database that isotretinoin was one of the top 10 drugs associated with suicide attempts and depression. Therefore, in 2001, she studied the potential of the drug to cause depression, the findings of which are posted in the Journal of the American Academy of Dermatology.
Based on these findings, Dr. Wysowski suggested that further studies of the drug be conducted. In addition, she asked her patients and their parents to report any mood swings or depressive symptoms such as unusual fatigue, inability to concentrate, loss of appetite, crying, sadness or withdrawal to their doctor. This is one way to help patients avoid possible dangerous side effects. Depending on the situation, their prescribing physician may recommend them to a psychiatrist or suggest that they stop taking the drug.
Regardless of whether you believe that isotretinoin is linked to depression, almost everyone agrees that further research on the drug’s possible side effects is required. According to Geoffrey Redmond, the doctor who wrote The Good News about Women’s Hormones, other possible treatment options include Retin-A and hormone therapy.