Depression screening using health questionnaires in patients receiving oral isotretinoin for acne vulgaris

Schrom, Kory P; Nagy, Terri; Mostow, Eliot N.

doi:10.1016/j.jaad.2016.02.1148

Cited by 19 publications

(16 citation statements)

References 24 publications

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“…This drug significantly improves the results of acne treatment, but its application is associated with such adverse side effects as the ability to cause mental disorders, e.g., depression or suicidal thoughts, and even incidents of suicide have been reported. Nevertheless, improvement in mood and an increase in the quality of patients' lives after its application have been observed (Schrom et al, 2016 ).…”

Section: Conventional Treatment Of Acnementioning

confidence: 99%

Prospects of Phage Application in the Treatment of Acne Caused by Propionibacterium acnes

et al. 2017

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Propionibacterium acnes is associated with purulent skin infections, and it poses a global problem for both patients and doctors. Acne vulgaris (acne) remains a problem due to its chronic character and difficulty of treatment, as well as its large impact on patients' quality of life. Due to the chronic course of the disease, treatment is long lasting, and often ineffective. Currently there are data regarding isolation of P. acnes phages, and there have been numerous studies on phage killing of P. acnes, but no data are available on phage application specifically in acne treatment. In this review, we have summarized the current knowledge on the phages active against P. acnes described so far and their potential application in the treatment of acne associated with P. acnes. The treatment of acne with phages may be important in order to reduce the overuse of antibiotics, which are currently the main acne treatment. However, more detailed studies are first needed to understand phage functioning in the skin microbiome and the possibility to use phages to combat P. acnes.

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Section: Conventional Treatment Of Acnementioning

confidence: 99%

Prospects of Phage Application in the Treatment of Acne Caused by Propionibacterium acnes

et al. 2017

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“…12,15 At least half of all patients treated with ITT permanently clear after 1 treatment course. 16 Because of potential serious side effects, ITT is only indicated for acne when it is severe and does not respond to oral or topical antibiotic or topical retinoid (recalcitrant acne) or for acute-onset severe acne with systemic complaints (acne fulminans) 17 ; nevertheless, it is being increasingly prescribed for mild or moderately severe acne. 18 ITT is associated with significant adverse effects, the most common of which are dry mucous membranes, headache, alopecia, hypertriglyceridemia, and joint and muscle pain.…”

mentioning

confidence: 99%

Association of Isotretinoin With Depression and Suicide: A Review of Current Literature

Oliveira¹,

Sobreira²,

Velosa

et al. 2017

J Cutan Med Surg

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Acne vulgaris, a condition that can affect people at any age, is the most common cause of referral to a dermatologist. Isotretinoin (ITT) is the most effective treatment available, but serious adverse effects, including a possible association with depression and suicide, limit its use. We review the current literature regarding the association of ITT with depression and suicide. Case reports and database studies show a clear association, and this association is biologically plausible. Although prospective studies have opposite results, limitations make them unsuitable to identify a subgroup of patients who may be at risk of developing depression or suicidal ideation with ITT. Overall, it seems some people might be at risk, particularly those with a personal or family history of mental disorder, but further studies are needed to identify those patients who would benefit from an early referral to a mental health professional when ITT is initiated. Currently, no conclusions can be drawn, and it seems appropriate to regularly screen all patients on ITT for depressive symptoms and suicidal ideation and promptly refer them to a mental health professional if any are found.

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“…Thus, there is good reason to assume that screening for gene polymorphisms that increase susceptibility for isotretinoin-induced apoptosis and isotretinoin-associated depression may, in the future, be helpful to identify individuals with increased isotretinoin-mediated apoptotic signalling. At present, depression screening using health questionnaires may be an appropriate method to detect susceptible individuals, who should be closely monitored during treatment with isotretinoin (132).…”

Section: Resultsmentioning

confidence: 99%

Apoptosis May Explain the Pharmacological Mode of Action and Adverse Effects of Isotretinoin, Including Teratogenicity

Melnik

2017

Acta Derm Venerol

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Isotretinoin (13-cis retinoic acid) is the most effective sebum-suppressive drug for the treatment of severe acne. Its effect depends on sebocyte apoptosis, which results from isotretinoin-induced expression of the apoptotic protein tumour necrosis factor-related apoptosis-inducing ligand, insulin-like growth factor-binding protein-3 and neutrophil gelatinase-associated lipocalin. This review proposes that the pharmacological mode of action of isotretinoin in the treatment of severe acne, acute promyelocytic leukaemia, and neuroblastoma results from apoptosis. Furthermore, apoptosis may be the underlying and unifying mechanism of the adverse effects of isotretinoin on neural crest cells (teratogenicity), hippocampal neurones (depression), epidermal keratinocytes and mucosa cells (mucocutaneous side-effects), hair follicle cells (telogen effluvium), intestinal epithelial cells (inflammatory bowel disease), skeletal muscle cells (myalgia and release of creatine kinase), and hepatocytes (release of transaminases and very low-density lipoproteins). Genetic variants of components of the apoptotic signalling cascade, such as RARA polymorphisms, might explain variations in the magnitude of isotretinoin-induced apoptotic signalling and apparently identify subgroups of patients who experience either stronger adverse effects with isotretinoin therapy or resistance to treatment.

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Depression screening using health questionnaires in patients receiving oral isotretinoin for acne vulgaris

Cited by 19 publications

References 24 publications

Prospects of Phage Application in the Treatment of Acne Caused by Propionibacterium acnes

Prospects of Phage Application in the Treatment of Acne Caused by Propionibacterium acnes

Association of Isotretinoin With Depression and Suicide: A Review of Current Literature

Apoptosis May Explain the Pharmacological Mode of Action and Adverse Effects of Isotretinoin, Including Teratogenicity

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