The Pharmaceutical Journal
Vol 274 No 7350 p606
21 May 2005

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Isotretinoin does not increase depression

Treating adolescents who have moderate to severe acne with isotretinoin (Roaccutane) does not increase symptoms of depression, a new study suggests.

The researchers used a standardised scale to assess baseline depression symptoms of 132 adolescents with moderate to severe acne. For three to four months 59 of the subjects were treated with isotretinoin 1mg/kg daily and 73 were treated with maximal conservative therapy, consisting of a topical antibiotic, topical retinoid and twice daily administration of an oral antibiotic. The adolescents’ depression symptoms were then reassessed.

At baseline, 14.3 per cent of subjects in the isotretinoin group had scores indicating depression, compared with 19.2 per cent in the conservative treatment group. Of the 101 subjects available for follow-up after three to four months, the proportion of subjects classified as being depressed had decreased to 8.2 per cent in the isotretinoin group and 15.4 per cent in the conservative treatment group.

The researchers point out that isotretinoin has been associated with depression and suicide but a causal link has not been established. Conversely, previous research has found that treatment of acne with the drug improves symptoms of depression, although in this study the researchers found no statistical difference in the reduction of depression between the two treatment groups.

The researchers acknowledge the limitations of their study, such as the small sample size, and say that further studies of patients who experience depression induced by isotretinoin are warranted (Archives of Dermatology 2005;141:557).