Response to ‘Isotretinoin and adverse neuropsychiatric outcomes: retrospective cohort study using routine data’: reply from authors

Fazel, Seena; Paljärvi, Tapio

doi:10.1111/bjd.21626

Cited by 2 publications

(1 citation statement)

References 6 publications

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“…32 The effect of isotretinoin on mood remains controversial; new population based studies have not shown an increased risk of suicide, however, there are reports of individual distressing cases. 35 The MHRA has recommended better provision of information to patients regarding possible risk of mental health and sexual function adverse effects; standardised assessment of mental health prior to starting and improved monitoring for adverse effects while on treatment. 32 Patients under the age of 18 years require two health professionals to agree their acne is severe and that isotretinoin is the most appropriate treatment before initiation of isotretinoin therapy.…”

Section: Treatment Options and Guidelinesmentioning

confidence: 99%

Managing acne vulgaris: an update

Santer,

Burden-Teh,

Ravenscroft

2023

DTB

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Acne vulgaris is very common and can have significant negative impact on people. While sometimes a transient problem, acne may persist for many years and often leads to permanent scars or pigment changes. Guidelines unanimously advise topical treatments as first-line, although differ in recommending either topical benzoyl peroxide or topical retinoid (mainly adapalene) alone or in combination. Guidance published by the National Institute for Health and Care Excellence advises counselling patients regarding avoidance of skin irritation when starting topical treatments and promoting adherence (treatments take 6–8 weeks to work). Oral antibiotics are currently overprescribed for acne but have a role when coprescribed with a non-antibiotic topical treatment. Hormonal treatments, such as the combined contraceptive pill, are also effective and there is growing evidence for the use of spironolactone for women with persistent acne. Recent guidance from the Medicines and Healthcare products Regulatory Agency regarding isotretinoin has implications for specialist prescribing and monitoring, and increasing public awareness of potential risks of mental health problems and sexual dysfunction. Although acne is associated with psychiatric disorder, the mental health effects of isotretinoin remain controversial.

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Section: Treatment Options and Guidelinesmentioning

confidence: 99%