Accutane May Not Increase Depression
Study Shows Teens Taking the Acne Drug Had Less Depression Than Those Getting Other Treatments
May 16, 2005 — A small study fails to link the use of the controversial acne drug Accutane to severe depression or suicide. The findings are reported in the May issue of the journal Archives of Dermatology.
For years, critics have said Accutane can cause serious depression and increase suicide in teens. A U.S. congressman blames the drug for his teenage son’s suicide five years ago, as does a Florida mother whose 15-year-old son died in 2002 after intentionally flying a small plane into a Tampa, Fla., skyscraper.
But the drug’s manufacturer has long contended that Accutane does not increase the risk of depression and suicide, and a newly published study appears to back that up.
Teens in the study who took the drug showed far fewer signs of depression three and four months after beginning treatment than they did before starting Accutane.
“This certainly backs up what we have seen in our practices,” pediatric dermatologist Elaine Siegfried, MD, tells WebMD. “Most dermatologists are in agreement that Accutane is a miracle drug for acne. I have treated many thousands of patients with it, and I have never seen clinically significant mood alterations in any of my treated patients.”
Your Skin Might Not Be Perfectbut It Should Be Better
When I finished my course of the medication, I had the skin of my dreams. Despite some lingering scars, I was finally comfortable leaving the house without wearing foundation for the first time in almost a decade. Then after a summer of clear skin , I began breaking out again. While its nowhere near as bad as it was before, my skin isnt as flawless as I had imagined it would be. Im convinced its due to my new lifestyletrying tons of products, eating too much sugar, and not getting enough sleepbut Ciraldo notes that the effectiveness of isotretinoin can also depend on the dosage in relation to your weight. If you’re not satisfied, you can check in with your doctor about adjusting it.
Alcohol Tobacco And Other Drugs
Misusing alcohol, tobacco, and other drugs can have both immediate and long-term health effects.
The misuse and abuse of alcohol, tobacco, illicit drugs, and prescription medications affect the health and well-being of millions of Americans. SAMHSAs 2020 National Survey on Drug Use and Health reports that approximately 19.3 million people aged 18 or older had a substance use disorder in the past year.
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The Truth About Whether Accutane Can Actually Cause Depression
In a recent interview with Yahoo, actress Bella Thorne says that she thinks a controversial acne medication known for its potentially harmful side effects may have negatively affected her mental health. Accutane made me depressed, she said. Yahoo points out that Accutane was pulled from shelves in 2009, although several forms of the generic version, isotretinoin, still exist on the market. Thorne was referencing a common message about isotretinoin that you may have heard beforethat it can lead to depression or suicide. Here’s what you need to know about the risks of taking isotretinoin.
Isotretinoin is an incredibly potent medication and has potentially severe side effects, but its one of the most effective acne medications out there. Although it’s a type of retinoic acid, which is derived from vitamin A, it’s different than other retinoid treatments for anti-aging since it’s taken orally rather than applied topically. Isotretinoin affects the central nervous system in different ways, including by binding onto the retinoid receptors in the brain. Research has found a link between isotretinoin and the parts of the brain that are associated with depression, and other studies have looked at whether taking isotreninoin can lead to mental health symptoms associated with vitamin A toxicity, including depression.
Only A Small Number Of Users Get Accutane Depression
Despite the widely-held belief that Accutane causes depression , there is no clear, proven link between the two. For every study that has found a high risk of depression in those who take Accutane, there is another study that has shown there is zero risk.
However, with the number of users who have reported feeling depressed or having changes in their mood, it can be safe to say that Accutane does pose a risk of depression to a small number of users. As well, many report feeling depressed well after taking the medicine.
Depression in those who take Accutane is not very common. Again, the studies are mixed, with depression happening anywhere from 1% to 10% of people taking the medication. With such a small percentage, it cant be said for certain that Accutane causes depression.
While Accutane-induced depression can affect those who have zero histories of depression, a large number of people have had conditions that have placed them at risk. These pre-existing conditions include a family history of depression, bipolar disorder, or past drug abuse. If you have this history, you are more susceptible to side effects, including depression, and it can take longer than 2 or 3 weeks for the depression to go away.
Its important to point out that just because youre taking Accutane, or took it in the past, doesnt mean you will experience depression. Most who did become depressed while using it found that their symptoms disappeared as soon as they ceased taking it.
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Accutane And Birth Defects
Birth defects from isotretinoin can range from miscarriages to babies born with slits where ears should be.
Since 1985, isotretinoins label has contained a black box warning detailing its extremely high risk of severe birth defects. The label warns female patients who are or may become pregnant to avoid taking isotretinoin.
The boxed warning also lists possible birth defects that can happen with isotretinoin. These birth defects include anything from ear, eye and other face-related abnormalities to abnormal skull development.
Birth defects from isotretinoin can also affect the central nervous system, immune system , certain hormones , and heart.
Relevance To General Practice
In Australia and the UK isotretinoin is not prescribed by GPs., In the US, many family physicians choose not to prescribe it. Referral of patients with acne who would benefit from isotretinoin is the responsibility of the GP, and, therefore, the debate about isotretinoin and depression and suicide in the media,, is of vital interest. GPs are in a position not only to make suggestions or recommendations to patients regarding referral for consideration of isotretinoin treatment, but also to ensure patient decisions are based on a realistic understanding of the benefits and risks of therapy.
It would seem prudent to carefully monitor patients undergoing treatment with isotretinoin for evidence of depression or suicidal ideation. GPs are likely to be better equipped than dermatologists to do so,- and to further manage, or refer for specialist psychiatric care, any emergent psychiatric symptoms or psychological morbidity. A close partnership between dermatologist and GP on a shared-care basis is likely to be optimal in this situation.
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Always Use Protection When Having Sex
This warning is specific to female patients, since Accutane does not affect the reproductive system of men. Getting pregnant while on Accutane can lead to severe birth defects, ranging from cleft palate to heart defects and intellectual disabilities. Women on Accutane are required to participate in the ipledge program, essentially a safe-sex quiz, each month to prove they both understand the facts and are practicing two forms of approved birth control. It must be filled out every month in order to have your prescription filled. You must also have monthly negative pregnancy tests at your doctors office. Point being, an effective form of contraception is absolutely paramount for anyone who is sexually active while theyre on isotretinoin. Breastfeeding mothers are not recommended to take Accutanewhile there arent any studies that prove it can be passed from mom to baby via breast milk, there also isnt any definitive, conclusive evidence that says you cant.
Going On Isotretinoin As A Woman Is An Especially Complicated And Annoying Process
Isotretinoin puts your body through a lot, but for a woman it becomes even more complicated. There have been previous instances of the medication causing birth defects, so in order to obtain a prescription, you must register for iPledge. This is an FDA-regulated program that focuses on preventing women on isotretinoin from getting pregnant. To pick up your monthly prescription, you have to schedule a derm appointment to keep an eye on side effects, provide blood samples for blood pressure checks, take a pregnancy test, log into iPledge for a quiz confirming youre not pregnant, and verify youre on at least two methods of birth control.
It’s a huge undertaking. I’m afraid of needles, and getting my blood drawn monthly took a lot of getting used to. Be prepared to invest a lot of time into the process.
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What Is Samhsa’s National Helpline
SAMHSAs National Helpline, , or TTY: is a confidential, free, 24-hour-a-day, 365-day-a-year, information service, in English and Spanish, for individuals and family members facing mental and/or substance use disorders. This service provides referrals to local treatment facilities, support groups, and community-based organizations. Callers can also order free publications and other information.
Also visit the online treatment locator.
Is Clear Skin Worth Profound Depression
It started at fourteen, a cluster of tiny pimples in the center of my forehead, a third eye. My mother bought me Clearasil wash and Stridex pads and Oxy cream. None of it worked. Mysteriously, the patch cleared up in a few months, establishing a pattern that would go on for the rest of my life: awkward acne, resistant to treatment, that eventually cleared up for no apparent reason.
Then I turned 30. Suddenly the acne was persistent, no longer limited to my face, consistently covering my back, often my chest. This is somewhat common for many women: changing hormones, the body saying *Hurry the fuck up and breed*. I tried more creams, more washes, antibiotics, hormone blockers, supplements, a change in diet. Nothing worked. There was one option left.
Isotretinoin, commonly referred to as Accutane, is the only proven cure for acne. Id toyed with taking it before but concluded my acne wasnt bad enough to account for the risks. Its an extreme medication, essentially poisoning the body with Vitamin A, the side effects numerous and severe. Chapped, flaky lips are a guarantee. It is likely your skin will experience the same. Other possibilities include excessive thirst, greater sensitivity to sunlight, hair loss, nosebleeds, rashes. And then there are the extremes, things like developing Crohns disease, permanent muscle or eye damage, or death. But the effects that scare me most: depression, suicidality, psychosis.
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Acute Depression And Isotretinoin
Dr Marius Rademaker, Specialist Dermatologist, Health Waikato, Hamilton
Isotretinoin is an extremely effective anti-acne preparation. However, in a small number of patients it may be associated with symptoms of a major depressive episode. Symptoms resolve rapidly on discontinuation of the medicine. After a period off medication, it is worthwhile recommencing therapy at a lower dose.
Review Articleisotretinoin And Neuropsychiatric Side Effects: Continued Vigilance Is Needed
Isotretinoin is higly effective for the treatment of acne.
Isotretinoin is in the family of compounds called retinoids that include the active form of Vitamin A.
Isotretinoin is an isomer of the active form of Vitamin A, retinoic acid, and both are highly teratogenic.
A number of cases of neuropsychiatric side effects including depression, suicidality, violence, aggression, anxiety and psychosis have been associated with isotretinoin use with evidence for a causal rol.
Isotretinoin use has declined in recent years but considerable caution is needed in its use.
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Doctors Urged To Reconsider Controversial Acne Drug
- University of California – Riverside
- Acne treatment including the highly effective acne medication isotretinoin should be made more readily available despite reports of its association with depression and teen suicide, a study recommends.
Acne treatment including the highly effective acne medication isotretinoin should be made more readily available despite reports of its association with depression and teen suicide. That’s the implication of a study just published in the Journal of the American Academy of Dermatology.
Isotretinoin has been linked to depression and suicide. But UCR researcher Misaki Natsuaki, one of the study’s authors, said severe acne itself, when left untreated, poses a serious risk for depression and anxiety.
Natsuaki’s research team conducted the first meta-analysis, analyzing 42 studies involving more than one million people, to resolve sometimes-conflicting data related to studies of how acne is related to depression and anxiety. The studies showed a significant association with acne and mental health.
“Acne may not cause physical pain or impairment, but you do not want to leave acne untreated because that’s a risk for mental health,” said Natsuaki, an associate professor of psychology and director of the UCR Developmental Transitions Laboratory. “Undertreatment of acne itself is related to depression and anxiety, especially in females.”
Data Extraction And Quality Assessment
Two authors independently assessed the titles and abstracts for eligibility and extracted data in standardised electronic tables. The following data were extracted from included studies: publication year, author, study design, sample size, participant sex and age, severity of acne, compared groups, dose and duration of isotretinoin, and depression assessment tool. The quality of included studies was assessed using the nine-star NewcastleOttawa Scale. This scale evaluated the study quality based on three parameters: selection, comparability, and exposure or outcome . A maximum of four points was assigned for the item of selection, two points for comparability and three points for exposure/outcome. Studies were deemed as high quality for a score of 89, moderate quality for a score of 67 and low quality for a score 5.
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Emerging Trends In Substance Misuse:
- MethamphetamineIn 2019, NSDUH data show that approximately 2 million people used methamphetamine in the past year. Approximately 1 million people had a methamphetamine use disorder, which was higher than the percentage in 2016, but similar to the percentages in 2015 and 2018. The National Institute on Drug Abuse Data shows that overdose death rates involving methamphetamine have quadrupled from 2011 to 2017. Frequent meth use is associated with mood disturbances, hallucinations, and paranoia.
- CocaineIn 2019, NSDUH data show an estimated 5.5 million people aged 12 or older were past users of cocaine, including about 778,000 users of crack. The CDC reports that overdose deaths involving have increased by one-third from 2016 to 2017. In the short term, cocaine use can result in increased blood pressure, restlessness, and irritability. In the long term, severe medical complications of cocaine use include heart attacks, seizures, and abdominal pain.
- KratomIn 2019, NSDUH data show that about 825,000 people had used Kratom in the past month. Kratom is a tropical plant that grows naturally in Southeast Asia with leaves that can have psychotropic effects by affecting opioid brain receptors. It is currently unregulated and has risk of abuse and dependence. The National Institute on Drug Abuse reports that health effects of Kratom can include nausea, itching, seizures, and hallucinations.
Preventing And Managing Side Effects Of Accutane
It is often recommended to stop taking any brand of Isotretinoin as soon as you notice the onset of any symptom.
But to avoid any of these, it is best to stay away from this form of treatment.
This is because the side effects can sometimes become permanent, even after completing your treatment or when you stop taking medications.
However, if you have already started receiving treatment with Accutane or would like to begin. Here are precautions to be aware of
- Isotretinoin must not be taken during pregnancy, that is it should be avoided by women who are pregnant or trying to become pregnant. This is because there is a higher risk of stillbirth, premature birth, defects at birth and loss of pregnancy.
- A consent sheet is signed before you can begin treatment. During this process, you will be informed ahead of the risks involved. You will also need to visit your doctor every month to discuss your condition and side effects you may be experiencing.
- Isotretinoin is only prescribed by doctors or pharmacies registered with the iPLEDGE Program to individuals who have also been registered.
- Do not donate blood if you are currently undergoing treatment with Isotretinoin.
- Do not give out your medications to someone else, even if you have the exact or similar symptoms.
- Male patients with a pregnant partner or partners hoping to become pregnant are advised to speak with their doctors. This is because there may be traces of Isotretinoin in the semen that may harm the ftus.
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Sexual Function And Fertility
Accutane does not appear to affect fertility. However, scientists have found a link between Accutane and sexual side effects, such as:
- erectile dysfunction
People should discuss any exercise they do with their doctor before starting this drug.
Accutane may stop long bone growth in teenagers who are still growing.
All The Evidence They Need
The lack of clinical proof has done nothing to change the views of those who blame Accutane for the suicide of a loved one.
Rep. Bart Stupak is among the drug’s most outspoken critics. Stupak’s 17-year-old son, B.J., shot himself in May of 2000, and Stupak says he believes Accutane is responsible. The legislator has been working to get tighter controls on Accutane ever since.
The mother of a teenager who killed himself by flying a Cessna airplane into a Florida high-rise office building in January 2002 is also convinced that Accutane caused her son’s death.
And a grieving father in Ireland has reportedly spent more than $1 million of his own money attempting to prove that Accutane is linked to suicide. Liam Grant’s 19-year-old son, also named Liam, took his own life in 1997 while studying engineering at Dublin University.
The elder Grant is now suing Roche and hopes to force the drug company to release confidential information about Accutane.
SOURCES: Chia, C. Archives of Dermatology, May2005 vol 14: pp 557-560. Elaine Siegfried, MD, pediatric dermatologist, St.Louis. J. Douglas Bremner, MD, department of psychiatry, Emory University,Atlanta. Kathleen Quinn, spokeswoman, FDA. Shelley Rosenstock, executivedirector of public affairs, Hoffmann-La Roche.