Accutane, a controversial drug used to treat severe acne, has long been associated with higher rates of depression among users. Now, researchers in Britain and the United States believe they have discovered the cause for this Accutane side effect. It seems that Accutane decreases serotonin levels in the brain, which in turn can lead to depression and even aggressive behavior.
Introduced in 1982, Accutane has been the subject of controversy for years. It has been associated with psychiatric problems, and has been linked to 266 cases of suicide in the United States. In addition to its connection with depression, the drug has been associated with myriad other serious side effects. It first garnered attention in the late eighties for causing severe birth defects. Accutane has also been linked to problems of the liver, kidneys, digestive tract, central nervous system, and pancreas, as well as the cardiovascular, musculoskeletal and auto-immune systems.
Earlier this year, scientists from Bath University in conjunction with the University of Texas in Austin conducted experiments on mice that showed that Accutane made the mice behave in ways comparable to depression in humans. Now, in an article published in the journal Experimental Biology and Medicine, those same scientists have revealed a potential mechanism that might link Accutane to reported cases of depression in some patients taking the medication. Using cells cultured in a laboratory, the researchers monitored the effect of Accutane on the chemistry of the cells that produce serotonin. The researchers now say that Accutane could be disrupting the process by which serotonin relays signals between neurons in the brain.
Serotonin is a hormone found in the pineal gland, blood platelets, the digestive tract, and the brain. Serotonin acts both as a chemical messenger that transmits nerve signals between nerve cells and that causes blood vessels to narrow. Changes in the serotonin levels in the brain can alter the mood, and low levels of serotonin have been linked to depression, as well as bipolar disorder and anxiety disorders.
The link between low serotonin levels and Accutane use is further confirmation that this drug causes psychiatric problems – something that has been known for quite a long time. In fact, the manufacture of Accutane, Roche AG, knew about these problems long before they were made public. A 2004 USA Today article reported that, in the mid-1990s, contrary to advice from its own doctors, Roche executives chose not to issue stronger warnings about Accutane’s depression risks. According to the article, Roche decided against the warnings after its marketing department expressed concern that doing so would hurt sales. At the time, Accutane was one of Roche’s top-selling medications, bringing in more than $1.2 million every year. In 1999, in the face of mounting evidence, the Food & Drug Administration finally required Roche to include a suicide warning on the Accutane package insert.
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