Association of suicide attempts with acne and treatment with isotretinoin: retrospective Swedish cohort study

Abstract

An increased risk of attempted suicide was apparent up to six months after the end of treatment with isotretinoin, which motivates a close monitoring of patients for suicidal behaviour for up to a year after treatment has ended. However, the risk of attempted suicide was already rising before treatment, so an additional risk due to the isotretinoin treatment cannot be established. As patients with a history of suicide attempts before treatment made new attempts to a lesser extent than did patients who started such behaviour in connection with treatment, patients with severe acne should not automatically have isotretinoin treatment withheld because of a history of attempted suicide.

Blue light therapy versus low dose isotretinon in mild to moderate acne

“…Isotretinoin administration for duration of 8.3 months in an initial dosage of 10 mg/day up to 0.43 mg/kg produced very good results in 62.8% and good results in 31.9% of the patients [13]. After treating patients with 0.3 to 0.4 mg/kg/day dosage for 6 months, complete remission of 94.4% achieved in patients [4]. However, complete clearing in the present study was (92.5%).…”

“…The downside of this drug is its toxicity [3]. Conventional dose of isotretinoin causes many side-effects such as teratogenicity, mucocutaneous events, increasing serum lipids and liver enzymes, gastrointestinal, ocular, and psychological side-effects [4]. For these reasons, low dose isotretinoin was tried in acne patients particularly mild to moderate cases.…”

Evidence on acne therapy

“…Such effects include teratogenicity and the possible risk of inflammatory bowel disease, depression and suicide, which have not been confirmed by population studies. [32][33][34][35][36][37] There is good evidence in the literature that several treatments using light sources can improve inflammatory acne over the short term, and that photodynamic therapy provides results that are more consistent than other such therapies. However, there is no consistent evidence regarding the long-term therapeutic response or in relation to conventional acne treatments.…”

Psycho-Emotional State of Children and Adolescents With Acne

“…Так, в ходе шведского ретроспективного когортного иссле-дования, включавшего более пяти тысяч лиц в возрасте от 15 до 49 лет с угревой болезнью, повышенный риск суицидальных попыток был выявлен на фоне применения изотретиноина [33]. Но, по всей видимости, депрессия, отмечающаяся в общей популяции пациентов с угревой болезнью в 8,8% случаев, не столь часто встречается среди подростков [34].…”