Accutane, Acne, Suicide Linked in New Study

A new Accutane study out of Sweden has linked the controversial acne drug to an increased risk of suicide. The study’s findings support increased mental health monitoring of patients for up to a year after taking Accutane.

Approved by the Food & Drug Administration (FDA) in 1982, Accutane is a treatment for recalcitrant acne and contains the active ingredient isotretinoin, derived from Vitamin A. Accutane has been the subject of controversy for years, garnering attention in the late 1980s for causing severe birth defects. The drug has also been associated with <"">inflammatory bowel disease, ulcerative colitis, Crohn’s disease, liver problems, and suicidal behavior.

In 2009, Roche decided to stop marketing Accutane for economic reasons. In announcing the decision, Roche cited the high cost of product liability suits involving the drug as one of the factors in the decision.

The Swedish Accutane study was conducted by the Karolinska Institutet over a period of 20 years, an tracked 5,756 men and women — whose mean age upon starting to use isotretinoin, was 22 and 27, respectively — during the years before and after their isotretinoin use and during their treatment. The results show that 128 patients were admitted to hospital following a suicide attempt. The authors also found that between one and three years before starting isotretinoin treatment the number of suicide attempts increased. However the risks were highest within six months after isotretinoin treatment ended.

The researchers said that the data does show that simply having severe acne increases the risk of suicide. However, they also noted that there was an increase in suicide attempts after patients began isotretinoin treatment.

“For certain vulnerable patients, however, (Accutane) may trigger such (suicidal) behavior,” the researchers concluded. “The challenge for future studies is to find out how to identify people who may be vulnerable to (Accutane).”

The researchers suggested close monitoring of the mental status of patients on Accutane, as well as any patients suffering from severe acne. That monitoring should continue for at least a year after treatment has ended.

The Karolinska Institutet study was published in the British Medical Journal.

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