THURSDAY, Nov. 11 (HealthDay News) -- Severe acne may
significantly increase suicide risk, and patients taking
isotretinoin (Accutane) for the skin condition should be monitored
for at least a year after treatment ends, Swedish researchers
"Treatment with Accutane actually entails an increased risk of suicide attempts," said lead researcher Anders Sundstrom, a pharmacoepidemiologist at the Karolinska Institute in Stockholm.
However, depression caused by the acne, rather than the drug
itself, is probably the culprit, he said.
The risk of suicide is very small, Sundstrom stressed. There
could be one suicide attempt among 2,300 people taking Accutane,
and that assumes that the drug caused the suicide attempt, he
For the study, published online Nov. 12 in
BMJ, Sundstrom's team collected data on 5,756 people treated for severe acne with Accutane from 1980 to 1989. The average age of the men was 22; the average age of women was 27.
Linking these patients to hospitalization and death records from
1980 to 2001, they found that 128 of the patients were hospitalized
because of a suicide attempt.
Suicide attempts increased in the several years before Accutane
was started, but the highest risk was seen in the six months after
treatment ended, Sundstrom's group found.
It's possible that patients whose skin improved became
distraught if their social life didn't benefit, the researchers
Also, Accutane takes time to work and acne can worsen before it
gets better, Sundstrom said. "It takes a long time to get rid of
the acne, and for the self-image to get better might take even a
longer time," he said.
Acne so severe that it is treated with Accutane is not a trivial
disease, said Parker Magin, a senior lecturer at the University of
Newcastle in New South Wales, Australia, and co-author of an
accompanying journal editorial. "It is a disease associated with
significant psychiatric morbidity," Magin said.
It's impossible to say whether the drug or the skin disease is
responsible for the increased suicide attempts, he said.
Magin agrees physicians must monitor patients taking Accutane
for evidence of psychiatric problems. And since the risk exists
before and after taking the drug, "we have to be vigilant for
longer than the six months people might be on the medication,"
Patients with severe acne who do not get treated and those who
are treated unsuccessfully should also be watched for psychiatric
disturbances, the researchers said.
Isotretinoin, which has been used to treat severe acne since the
1980s, is also sold under the brand names Roaccutane, Amnesteem,
Claravis, Clarus and Decutan.
Accutane has been linked to birth defects, and in 2005 the U.S.
Food and Drug Administration approved a program requiring doctors
to enroll patients who take it in a national registry to guard
against serious side effects.
To register, patients must acknowledge the risks associated with
the drug, including depression and suicidal feelings. Moreover,
women must have a pregnancy test within seven days before filling
their prescription. Women must also agree to use two methods of
birth control and adhere to pregnancy testing on a monthly
For more information on acne, visit the
U.S. National Library of Medicine.
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