Accutane And Depression: What To Know Before Starting The Medication

Acne affects nearly 50 million Americans each year, making it the most common skin condition in the United States (per American Academy of Dermatology Association). And while the extent of acne's prevalence may make it seem like no big deal, people with severe acne may find that it takes a notable toll on their mental health. For that reason, many people try prescription medication to get their acne under wraps, and few medications are as successful at giving acne the boot as isotretinoin.

Isotretinoin is commonly referred to as Accutane — a brand name for the drug that is no longer on the market. Released in 1982, the controversial acne "wonder drug" boasts an impressive success rate, completely eliminating acne in 90% of users (per Science Daily). How does it pull that off? Acne occurs when hair follicles become clogged with excess oil and dead skin cells. Accutane works by shrinking the oil glands and slowing oil production, making it more difficult for acne-causing bacteria to take up residence in the pores.

And while Accutane has the potential to give you the skin you've always dreamed of, it doesn't come without its side effects. Dry skin, chapped lips, thinning hair, headaches, muscle, bone pain, joint pain, skin irritation, and digestive issues are among the milder side effects of isotretinoin (per Healthline). On the more serious side, some people have experienced increased pressure in the brain, gastrointestinal disorders, liver damage, and depression upon taking the medication.

Why is Accutane linked to depression?

Experts don't fully understand the link between Isotretinoin and depression, but there's no denying that a correlation has been made. In 1998, the Food and Drug Administration went so far as to warn doctors that depression, psychosis, and suicide should be listed as side effects of the drug (per Science Daily). Just two years later, Accutane made national headlines after Congressman Bart Stupak's 17-year-old son committed suicide after 5 months of taking the medication — a tragedy he blamed on the "dangerous and powerful drug."

While it's estimated that between 1% to 11% of people taking Accutane do experience depressive symptoms like sadness, withdrawal, mood swings, low energy, and changes in appetite or sleep patterns, the occurrence of suicidal thoughts and behaviors is considered a low risk — but a risk all the same (per Medical News Today). As a result, people who intend to take isotretinoin as a treatment for acne are required to sign a consent form indicating that they understand the risks of taking the drug. Doctors are also required to cosign the document as confirmation that they explained all of the associated risks. The consent form explicitly states that if any such symptoms are experienced, users will inform the doctors immediately.

What the research says

Research regarding the link between Accutane usage and depression has produced varying results. A 2005 study published in the British Journal of General Practice reports that between 1982 and 2000, 394 cases of depression and 37 suicides occurred in people who were actively taking the medication. However, the study concluded that while there was some risk involved, the occurrence was rare enough that keeping people from a treatment option that could put an end to their struggle with acne wasn't justified.

To that effect, a 2020 study published in the Journal of American Academy of Dermatology examined how severe acne, in and of itself, can lead to depression. Misaki Natsuaki, one of the study's authors, said, "Given the psychiatric risk of acne itself, it is important for clinicians to optimize acne management which may include utilization of isotretinoin," (per Science Daily).

More recent research, like a 2019 study published in BMJ Open, reported that the incidence of depression was not increased by the use of isotretinoin. One 2017 study published in the Journal of the American Academy of Dermatology even went so far as to suggest that the drug improved depressive symptoms.