The Risks and
Side Effects of Prescription Acne Medications
Yoram Barak, Yonit Wohl, Yifa Greenberg, Yosefa Bar Dayan, Tali Friedman, Gideon Shoval, Haim Y Knobler
Affective psychosis following Accutane (isotretinoin) treatment
International clinical
psychopharmacology. 01/02/200502/2005; 20(1):39-41.
This case study reports a series of cases of manic psychosis that developed in conjunction with isotretinoin treatment. The relationship between isotretinoin and psychopathology is unclear and controversial. Reportedly, more than 5% of people with moderate acne have pre-existing suicidal ideation and improvement of acne with treatment, often reduces associated depression. Additionally, some studies have found that isotretinoin users are no more likely than those taking antibiotics for acne to experience depression or commit suicide.
The cases in this study were identified from a group of five hundred soldiers in the Israeli military over a one-year period in 2003. The soldiers had all been evaluated in a military dermatology clinic for severe acne. Five of the soldiers developed manic psychosis while being treated with isotretinoin (with an average 7.6 months of exposure to the drug). In three cases, this was accompanied by a suicide attempt, and in three cases, the psychosis lasted for longer than 6 months.
All of the five subjects had a family or personal history of mental health problems including: obsessive-compulsive disorder, neurological insult or family history of a major psychiatric illness.
This case study suggests the likelihood of an association between exposure to isotretinion and manic psychosis. The populations most at risk would be those with a family or personal history of psychiatric morbidity.
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