Acne, Accutane and suicide risk
If you -- or your kid -- has severe acne that hasn't responded to the usual treatments, you may find yourself facing a decision as to whether to take isotretinoin, a drug marketed as Accutane, Decutan, Clarus and other brands, that is highly successful at treating stubborn acne.
Isotretinoin comes with a mile-long list of potential side effects, including dire warnings about the birth defects it could cause if a woman taking it were to become pregnant. To avoid such situations, elaborate prescribing regulations are in place, requiring, among other things, contraceptive use and monthly pregnancy tests.
But the most chilling of the drug's possible side effects is its poorly understood relationship with suicide risk. Some evidence has suggested that people taking isotretinoin are at increased risk of suicide, but science has had trouble pinning down that association.
Research published Friday in the BMJ adds a compelling -- though not entirely reassuring -- wrinkle to the conversation. In short, it turns out that severe acne itself may be a suicide risk factor, and taking isotretinoin can either exacerbate that risk or reduce it.
Researchers at the Karolinska Institute tracked 5,756 men and women -- whose mean age upon starting to use isotretinoin, interestingly, was 22 and 27, respectively -- during the years before and after their isotretinoin use and during their treatment. They found suicide attempts rose slightly during the three years before treatment, then rose more six months after treatment began.
Based on the findings, the authors suggest that acne itself may have led to depression and suicide risk before treatment; both the depression and desire to commit suicide may have abated when the treatment proved successful. However, they surmise, those patients for whom treatment wasn't as successful -- or whose social lives didn't improve as expected after their acne was eradicated -- may have felt even more depressed and suicidal.
The study, then, suggests that acne, not the powerful drug used to treat it, may be to blame for patients' increased suicide risk.
Have you or a loved one had experience with isotretinoin? How did that go? What do you think of this study's findings?
Jennifer LaRue Huget
| November 15, 2010; 7:00 AM ET
Categories: Acne, Chronic Conditions, Contraception, Psychology, Reproductive Health, Teens, drug safety
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