Acne drug not linked to increased suicide risk

May 16 2005

A recent study has found that the popular acne-fighting drug Accutane, which has been linked to birth defects, did not cause depression in a group of adolescents.

Accutane was one of five drugs cited by veteran Food and Drug Administration (FDA) scientist David Graham at a congressional hearing last year as approved drugs that ought to receive closer scrutiny.

The FDA is monitoring the drug to determine if it causes depression and suicide. The agency also ordered creation of a registry to ensure pregnant women, or women who may become pregnant, do not take it because of a risk of birth defects.

Roche's drug Accutane, is also sold in generic versions as isotretenoin.

In the study Accutane was given to 59 patients and it was found that their overall incidence of depression declined.

Among those taking the drug, only a few new cases of depression showed up, which was about the same as in a control group receiving a more conservative acne therapy.

Study author Dr. Christina Chia of Saint Louis University Health Sciences Center, says that the use of isotretenoin in the treatment of moderate-severe acne in adolescents did not increase depressive symptoms, and on the contrary, the study showed that treatment of acne improves depression.

Chia's comments echo previous arguments by the drug's manufacturer and some other researchers that acne itself can be a cause "significant psychological stress."

A wrongful death lawsuit involving a young pilot who was taking the drug and crashed his small plane into a building in Tampa, Florida, in 2002, initiated the controversy over Accutane, which is taken by millions. Critics say the drug is over-prescribed.

In the study, 132 subjects aged between 12 and 19 were tested for depression before and three or four months after taking the drug. In the group who took the drug, the percentage found to be depressed dropped to 8 percent from 14 percent. The depression rate in the control group stayed about the same.

Another recent study published this month in the American Journal of Psychiatry, showed that brain scans on adults taking the drug showed a decrease in brain metabolism in an area of the frontal cortex that is associated with mediating depressive symptoms.

The study team concluded that the drug can cause depression in a small percentage of people and suggested screening for psychiatric disorders before it is prescribed.

The study is published in the Archives of Dermatology.