Isotretinoin poses no risk to mental health

Isotretinoin has been a recent topic of intense discussion due to its perceived risks to mental health, including its association with psychiatric disorders and suicide.

A new JAMA Dermatology journal analysis of the outcomes of 25 previous studies offers a fresh perspective.

The findings from more than 1.6 million patients on isotretinoin show that the risk of developing psychiatric disorders or attempting suicide is much lower than previously thought. The review revealed that instances of depression were at 3.83%, mood disorders at 2.32%, and anxiety at 0.57%, indicating a lower overall psychiatric risk than previously thought.

Interestingly, patients on isotretinoin for 2-4 years were less likely to attempt suicide than those on other medications, challenging long-held concerns. Moreover, the risk of depression decreased over time, while increased risks were noted among male patients within the first year of treatment.

A notable observation was that individuals with a history of psychiatric issues were more prone to suicide attempts while on isotretinoin.

The review concludes that while the risk is limited, vigilance is still crucial.

Dr JoAnn See said this study highlighted the complex relationship between acne, isotretinoin, and mental health, reinforcing the importance of a personalised approach in dermatological treatment. She recommends dermatologists to consider mental health history when prescribing isotretinoin, and to monitor patients closely, tailoring treatment to individual needs.

Reference: JAMA Dermatol 2024;160(1):54-62. doi: 10.1001/ jamadermatol.2023.4579