Isotretinoin and the Risk of Depression in Patients With Acne Vulgaris

Azoulay, Laurent; Blais, Lucie; Koren, Gideon; LeLorier, Jacques; Berard, Aurélie

doi:10.4088/jcp.v69n0403

Cited by 129 publications

(86 citation statements)

References 52 publications

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“…Isotretinoin resulted in a statistically significant three fold increased adjusted risk for depression. Minocycline, an antibiotic used to treat acne, was not found to increase the risk of depression (Azoulay et al 2006).…”

Section: Retrospective Analyses Of Databasesmentioning

confidence: 98%

The neurobiology of retinoic acid in affective disorders

Bremner

McCaffery

2008

Progress in Neuro-Psychopharmacology and Biological Psychiatry

145

154

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Current models of affective disorders implicate alterations in norepinephrine, serotonin, dopamine, and CRF/cortisol; however treatments targeted at these neurotransmitters or hormones have led to imperfect resolution of symptoms, suggesting that the neurobiology of affective disorders is incompletely understood. Until now retinoids have not been considered as possible contributors to affective disorders. Retinoids represent a family of compounds derived from Vitamin A that perform a large number of functions, many via the vitamin A product, retinoic acid. This signaling molecule binds to specific retinoic acid receptors in the brain which, like the glucocorticoid and thyroid hormone receptors, are part of the nuclear receptor superfamily and regulate gene transcription. Research in the field of retinoic acid in the CNS has focused on the developing brain, in part stimulated by the observation that isotretinoin (13-cis retinoic acid), an isomer of retinoic acid used in the treatment of acne, is highly teratogenic for the CNS. More recent work has suggested that retinoic acid may influence the adult brain; animal studies indicated that the administration of isotretinoin is associated with alterations in behavior as well as inhibition of neurogenesis in the hippocampus. Clinical evidence for an association between retinoids and depression includes case reports in the literature, studies of health care databases, and other sources. A preliminary PET study in human subjects showed that isotretinoin was associated with a decrease in orbitofrontal metabolism. Several studies have shown that the molecular components required for retinoic acid signaling are expressed in the adult brain ; the overlap of brain areas implicated in retinoic acid function and stress and depression suggest that retinoids could play a role in affective disorders. This report reviews the evidence in this area and describes several systems that may be targets of retinoic acid and which contribute to the pathophysiology of depression.

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Section: Retrospective Analyses Of Databasesmentioning

confidence: 98%

The neurobiology of retinoic acid in affective disorders

Bremner

McCaffery

2008

Progress in Neuro-Psychopharmacology and Biological Psychiatry

145

154

View full text Add to dashboard Cite

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“…Bu olgu çaprazlama (case cross-over) çalışmada farklı zamanlarda ilaca maruz kalma durumu değerlendirildiğinden olgu grubu aynı zamanda kontrol grubu olarak alınmıştır. Çalışmada hiç depresyon geçmişi olmayan hastalarda izotretioninin kullanımından sonra depresyon riskinin üç kat arttığı vurgulanmış ve bu sebeple izotretinoin kullanan bireylerin depresyon bulguları açısından sıkı takibi önerilmiştir 20 . Biz yaptığımız çalışmada klinik olarak şiddetli (Allen-Smith Skalası'na göre grade 4 ve grade 8 arasında) akne vulgarisi olan ve daha önce topikal akne preparatlarına veya sistemik antibiyotik tedavilerine cevap vermemiş, izotretinoin tedavisi planlanan 89 hastaya, tedavi öncesinde ve sonrasında HAD ölçeği uyguladık.…”

Section: Discussionunclassified

Akne Vulgarisli Hastalarda İzotretinoin Kullanımının Anksiyete ve Depresyon Skorlarına Etkisi

Azaklı¹,

Derviş²,

Altunay³

et al. 2012

Turkderm

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ÖzetAmaç: Bu çalışmada akne vulgaris tedavisinde kullanılan izotretinoinin depresyon ve anksiyete ölçeği skorları üzerine etkisine bakarak depresyon ve anksiyete semptomlarına neden olup olmadığının saptanması amaçlandı. Gi riflİzotretinoin akne patogenezinde rol oynayan bütün faktörlere etkili tek ilaçtır 1 . Şiddetli nodülokistik akne dışında, topikal ve diğer geleneksel tedavilere yanıt vermeyen, skar oluşumuna neden olan, psikolojik olarak problem yaratan akne formlarında ve şiddetli seborede yaygın olarak kullanılmaktadır 2,3 . İzotretinoin ve depresyon arasındaki ilişki halen tartışmalı bir konudur. Toplumdaki depresyon insidansının yüksek olması, izotretinoin gibi başka nedenlerle tetiklenen depresyonların ayırt Ori ji nal Arafl t›r ma Ori gi nal In ves ti ga ti on

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“…In addition, given the time span of our study (1983)(1984)(1985)(1986)(1987)(1988)(1989)(1990)(1991)(1992)(1993)(1994)(1995)(1996)(1997)(1998)(1999)(2000)(2001)(2002), the case-crossover design was best suited to inherently adjust for trends in acne management over the years and guideline changes, as is discussed in length in our article. 1 Thakrar and Robinson claimed that our criterion of requiring at least 1 acne diagnosis in the year prior to the index date might have introduced a bias. That is, patients with a first diagnosis with acne in the risk period had no opportunity of being exposed to isotretinoin in the control period (since they did not have acne), thereby biasing the point estimates away from unity under the null hypothesis.…”

Section: Drs Azouley and Bérard Replymentioning

confidence: 99%