Psychiatric and Developmental Effects of Isotretinoin (Retinoid) Treatment for Acne Vulgaris

Suuberg, Alessandra

doi:10.1016/j.curtheres.2019.01.008

Cited by 33 publications

(28 citation statements)

References 91 publications

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“…Isotretinoin is a teratogen; there is about a 20–35% risk for congenital defects in infants exposed to the drug in the uterus, and about 30–60% of children exposed to isotretinoin prenatally have been reported to show neurocognitive impairment ( Choi et al, 2013 ). Studies showed that the teratogenic effect of isotretinoin was associated with a wide spectrum of birth defects including craniofacial, heart, and nervous system malformation as well as psychomotor retardation, mental retardation, learning disabilities, and premature birth ( Suuberg, 2019 ).…”

Section: Introductionmentioning

confidence: 99%

Awareness of isotretinoin use and Saudi FDA pregnancy prevention program in Riyadh, Saudi Arabia: A cross-sectional study among female patients

Ibrahim

Alshatri

Alsuwaidan

et al. 2021

Saudi Pharmaceutical Journal

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Introduction Oral isotretinoin is an effective agent for the treatment of severe cystic acne. Isotretinoin is a teratogen; there is an increased risk of congenital defects in infants exposed to the drug in the uterus. The Saudi Food and Drug Authority (SFDA) has implemented a pregnancy prevention program (PPP) to protect females from those teratogenic effects. Objectives To investigate the awareness of women, of reproductive age who were using Isotretinoin or used it previously, about isotretinoin use and the SFDA-approved PPP in Riyadh, Saudi Arabia. Methods This cross-sectional study was conducted during the period from June to October 2019. A questionnaire was developed based on the published literature and the PPP recommendations. The study was carried out online among female patients who were on Isotretinoin therapy or have used it previously in Riyadh city. The Statistical Package for Social Sciences (SPSS for Windows, version 24) was used to analyze the study data. Results During the study period, 483 patients participated in the study. Among them, 97.3% reported that they used the drug based on a doctor’s prescription, 94.6% were aware of Isotretinoin’s teratogenic effect, and 30.6% confirmed their awareness of the PPP. Amongst the participants, 9.1% (n = 44) used Isotretinoin while being married or planning to get married within a one-month period after using it. Concerning the use of two contraceptive methods according to the PPP guidelines, of the participants, 43.2% reported that they have been informed by their healthcare providers to use two contraceptive methods before starting the medication. Also 43.2% reported that they have been informed to use two contraceptive methods while using the medication, and 50% reported that they have been informed to use two contraceptive methods for one month after stopping the medication. Regardless of the information they had, participants’ actual practice, was as follow: 15.9% used two contraceptive methods before starting the medication, 15.9% used two contraceptive methods during the treatment, and 13.6% used two contraceptive methods for one month after stopping the medication. Conclusions Although this study revealed that the vast majority of participants were aware of isotretinoin’s teratogenic effect, still a considerable number of them had no idea about the PPP. This issue needs to greatly be addressed to minimize the risk of teratogenicity.

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Section: Introductionmentioning

confidence: 99%

Awareness of isotretinoin use and Saudi FDA pregnancy prevention program in Riyadh, Saudi Arabia: A cross-sectional study among female patients

Ibrahim

Alshatri

Alsuwaidan

et al. 2021

Saudi Pharmaceutical Journal

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“…Thus, our findings indicated DGCs as a potential cellular target for the direct alleviation of RA-induced depression. A significant body of evidence indicates that chronic 13-cis-RA administration is involved in both clinical depression and animal models of depression [5,[10][11][12][13]37]. Clinically, 13-cis-RA is a highly effective drug for severe acne but is associated with depression and suicide, which has attracted major attention for a long time.…”

Section: Discussionmentioning

confidence: 99%

“…In contrast to primary depression, secondary depression can be caused by specific reasons, including organic diseases, psychotic disorders, medications, and so on [5][6][7][8][9]. It has been reported that treatment with the anti-acne drug Accutane (isotretinoin, 13-cis-retinoic acid [13-cis-RA]) has been associated with severe depression and even suicide [5,[10][11][12][13]. For all drugs, Accutane ranks fourth in the top five medications with the most frequent reports of depression [7].…”

Section: Introductionmentioning

confidence: 99%

Chronic Administration of 13-cis-retinoic Acid Induces Depression-Like Behavior by Altering the Activity of Dentate Granule Cells

Wang

et al. 2022

Neurotherapeutics

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Depression is a common but serious mental disorder and can be caused by the side effects of medications. Evidence from abundant clinical case reports and experimental animal models has revealed the association between the classic anti-acne drug 13-cis-retinoic acid (13-cis-RA) and depressive symptoms. However, direct experimental evidence of this mechanism and information on appropriate therapeutic rescue strategies are lacking. Herein, our data revealed that chronic administration of 13-cis-RA to adolescent mice induced depression-like behavior but not anxiety-like behavior. We next demonstrated that chronic 13-cis-RA application increased neural activity in the dentate gyrus (DG) using c-Fos immunostaining, which may be critically involved in some aspects of depression-like behavior. Therefore, we assessed electrophysiological functions by obtaining whole-cell patch-clamp recordings of dentate granule cells (DGCs), which revealed that chronic 13-cis-RA treatment shifted the excitatory-inhibitory balance toward excitation and increased intrinsic excitability. Furthermore, a pharmacogenetic approach was performed to repeatedly silence DGCs, and this manipulation could rescue depression-like behavior in chronically 13-cis-RA-treated mice, suggesting DGCs as a potential cellular target for the direct alleviation of 13-cis-RA-induced depression.

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“…However, the evidence base for severe neuropsychiatric outcomes is mixed and inconclusive. [9][10][11][12][13][14][15][16][17][18][19][20][21][22] For example, isotretinoin has been associated with both increased 14 and reduced 16 risk of depression.…”

mentioning

confidence: 99%

“…In addition, severe neuropsychiatric outcomes, such as anxiety, depression, suicidal ideation, self‐harm and completed suicide, have been reported. However, the evidence base for severe neuropsychiatric outcomes is mixed and inconclusive 9–22 . For example, isotretinoin has been associated with both increased 14 and reduced 16 risk of depression.…”

mentioning

confidence: 99%

Isotretinoin and adverse neuropsychiatric outcomes: retrospective cohort study using routine data*

et al. 2022

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Psychiatric and Developmental Effects of Isotretinoin (Retinoid) Treatment for Acne Vulgaris

Cited by 33 publications

References 91 publications

Awareness of isotretinoin use and Saudi FDA pregnancy prevention program in Riyadh, Saudi Arabia: A cross-sectional study among female patients

Awareness of isotretinoin use and Saudi FDA pregnancy prevention program in Riyadh, Saudi Arabia: A cross-sectional study among female patients

Chronic Administration of 13-cis-retinoic Acid Induces Depression-Like Behavior by Altering the Activity of Dentate Granule Cells

Isotretinoin and adverse neuropsychiatric outcomes: retrospective cohort study using routine data*

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