Link Acne Drug with Depression: True, False, Possible…

One of the most wide-known cases, when the medications was directly linked to the potential development of the depressive disorder is Accutane, drug used in treating severe forms of acne, in case other drugs have not been able to treat the condition. It is very effective as an acne-cure. However, the regular use of this drug has been associated with depression amongst the users. A number of suicide cases have been linked to the use of this drug.

The powerful drug manufactured by Roche Pharmaceuticals was first approved in the year 1982 as a medication to treat persistent acne problems, targeting the severe conditions associated with forward in the treatment of acne vulgaris, the most egregious and resistant form of the disease. But Accutane has been linked to serious health risks, including: strokes, suicide, depression, inflammatory bowel disease, Pancreatitis, and Crohn’s disease.

It is very potent and can cause severely birth defects if taken by women who are pregnant or of childbearing potential. Women using this drug must sign consent forms and promise to use at least two contraceptive procedures to prevent pregnancy during the course of using this drug. Accutane’s most common side effects are gastrointestinal. According to the Food and Drug Administration, the gastrointestinal adverse reactions include: "…inflammatory bowel disease, hepatitis, Pancreatitis, bleeding and inflammation of the gums, colitis, ileitis, nausea, other nonspecific gastrointestinal symptoms."

The long list of the possible side effects is provided at
People from different social strata have been long up in arms against the free availability of this particular drug. They are convinced that it creates suicidal tendencies among teenagers many of whom go to the extent of actually becoming suicidal.

In February of 1998 the manufacturer of Accutane, Roche Laboratories, issued a letter to physicians in which they added the following to the WARNINGS section of Prescribing Information for Accutane: Psychiatric disorders: 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.

A study published in Experimental Biology and Medicine offers a possible explanation for how the acne drug Accutane (isotretinoin) may cause depression. The authors speculate that it decreases the availability of serotonin, a neurotransmitter which is believed to be involved in the regulation of mood.

Using cell cultures, scientists from the University of Bath (UK) and University of Texas at Austin (USA) were able to observe the effect of the drug on serotonin-producing cells. They found that the cells significantly increased production of proteins and cell metabolites that are known to reduce the availability of serotonin. A reduction in serotonin, say the scientists, could be a cause of depression in patients using the drug.

However, there is not enough evidence to prove that Accutane is the reason behind such occurrences. Recently, a study was conducted to establish a link between the drug and teenage suicides. The study confirmed to an extent that there was nothing like accutane depression. The teenagers on the drug did not show any significant mood swing compared to others treated with different drugs.

These findings were far from conclusive. According to a scientist, the sample group was rather small. The sample group should not have been less than 1000 if a relation were to be established comprehensively. A more recent research found that Accutane induces some changes in the frontal lobe region of the brain, which is identified as the centre of our emotions. Therefore, there is the possibility of a causative link between Accutane use and depression.

A different Canadian study has also found no association between the acne medication isotretinoin, which is sold in the U.S. under the brand name Accutane, and depression.

This study, which was conducted in a community dermatology clinic, looked at acne patients who were beginning treatment with isotretinoin. The control group were treated with either oral antibiotics or medication applied to the skin. The Center for Epidemiologic Studies Depression scale and the Zung Depression Status Inventory were used to assess depression both at the beginning of treatment and at the end of two months.
At the end of the two month period, the researchers found that neither depression assessment indicated any association between treatment with isotretinoin and depression.

The authors conclude that denying patients with significant acne treatment with isotretinoin, which is a very effective treatment, may not be warranted at this time as it does not appear to be associated with depression.

Why the Controversy?
While countless case reports suggest a relationship between Accutane use and depression, proving this connection has been difficult. Some studies suggest acne itself is more likely to cause depression in sufferers than Accutane use. Others have found no definitive link between Accutane use and an increased risk of depression.

Many acne sufferers find they are depressed because of their acne, and isotretinoin helps to clear their skin, making them feel less depressed and more confident.

Accutane is a miracle cure for acne treatment, a claim that most users will uphold. However, it is advisable to use the drug with caution, at least until the drug is proven innocuous beyond reasonable doubt.

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