Isotretinoin, Acne and Depression: A Prospective Controlled Study
Introduction: Acne and isotretinoin, one of its treatment, have been linked to the occurrence of depression. Our aim was to study if isotretinoin is associated with depression in a sample of acne patients followed for 6 months comparing them with acne patients under other treatment modalities and control patients without acne.
Methods: One hundred individuals were included: 50 controls and 50 with acne (24 using and 26 not using isotretinoin). Patients and controls answered the Beck Depression Inventory (BDI) and the 12 Item-Short Form Health Survey for quality of life (SF-12). Acne patients repeated this evaluation in 90 and 180 days.
Results: No differences were found between controls and acne patients regarding BDI results but controls performed worse in the SF-12 mental domain (p=0.004). No differences were found within the acne group between those treated and not treated with isotretinoin in the comparison of the BDI and SF-12 (mental and physical domains) in days 0. 90 and 180 (all with p>0.05).
Conclusion: In this small sample isotretinoin treatment showed to be safe regarding the occurrence of depression.
- Williams HC, Dellavalle RP, Garner S. Acne vulgaris. Lancet. 2012; 379(9813): 361-72.
- Costa CS, Bagatin E, Martimbianco ALC, da Silva EMK, Lúcio MM, Magin P, et al. Oral isotretinoin for acne. Cochrane Database Syst Rev. 2018; 11: CD009435.
- Stanescu MA, Totan A, Mircescu D, Diaconescu S, Gabriel Bratu O, Fekete L, et al. Assessment of suicidal behavior in dermatology (Review). Exp Ther Med. 2020 ;20:73-7.
- Purvis D, Robinson E, Merry S and Watson P. Acne, anxiety,depression and suicide in teenagers: A cross-sectional survey of New Zealand secondary school students. J Paediatr Child Health 2006; 42: 793-6
- Hauk L. Acne vulgaris: treatment guidelines from the AAD. Am Fam Physician. 2017; 95: 740-1.
- Kontaxakis VP, Skourides D, Ferentinos P, Havaki-Kontaxaki BJ, Papadimitriou GN. Isotretinoin and psychopathology: a review. Ann Gen Psychiatry. 2009; 20: 8:2.
- Vallerand IA, Lewinson RT, Farris MS, Sibley CD, Ramien ML, Bulloch AGM, et al. Efficacy and adverse events of oral isotretinoin for acne: a systematic review. Br J Dermatol. 2018; 178:76–85.
- Huang YC, Cheng YC. Isotretinoin treatment for acne and risk of depression: A systematic review and meta-analysis. J Am Acad Dermatol. 2017;76:1068–76.
- Li C, Chen J, Wang W,Ai,M, Zhang Q, Kuang L. Use of isotretinoin and risk of depression in patients with acne: a systematic review and meta-analysis. BMJ Open 2019;9:e021549.
- Steer RA, Beck AT, Garrison B . Applications of the Beck Depression Inventory. In: Sartorius N, Ban TA, eds. Assessment of Depression. Geneva, Switzerland: World Health Organization, 1986; 121–42.
- Andrade T, Camelier AA, Rosa FW, Santos MP, Jezler S, Pereira e Silva JL. Applicability of the 12-Item Short-Form Health Survey in patients with progressive systemic sclerosis. J Bras Pneumol. 2007; 33:414-22.
- Magin P, Pond D, Smith W. Isotretinoin, depression and suicide: a review of the evidence. Br J Gen Pract. 2005; 55:134-8.
- Hu P, Wang Y, Liu J, Meng FT, Qi XR, Chen L, et al. Chronic retinoic acid treatment suppresses adult hippocampal neurogenesis, in close correlation with depressive-like behavior. Hippocampus. 2016; 26:911-23.
-- Patrick N Stoney, Peter McCaffery. A Vitamin on the Mind: New Discoveries on Control of the Brain by Vitamin A. World Rev Nutr Diet. 2016; 115:98-108.
- Samad TA, Krezel W, Chambon P, Borrelli E. Regulation of dopaminergic pathways by retinoids: activation of the D2 receptor promoter by members of the retinoic acid receptor-retinoid X receptor family. Proc Natl Acad Sci. USA 1997; 94: 14349–54.
Copyright (c) 2021 Journal of the Portuguese Society of Dermatology and Venereology
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
All articles in this journal are Open Access under the Creative Commons Attribution-NonCommercial 4.0 International License (CC BY-NC 4.0).