Does Isotretinoin Cause Depression and Suicide?

Isotretinoin is a retinoid approved for the treatment of cystic acne. There has been growing interest in the possible relationship between isotretinoin use and increased risk of depression and suicide. The issue, however, remains controversial. This review examines the available evidence on this association, including published case reports, challenge-rechallenge studies, reports to government agencies of isotretinoin-related adverse events involving suicide and depression, and possible biological mechanisms of action. Given the evidence to date, clinicians are advised to counsel their patients about the risk of depression and suicide as possible side effects of isotretinoin use and to administer self-report questionnaires during treatment to screen for the development of depression. Further epidemiological and neurobiological studies are needed to assess the possible relationship between isotretinoin administration and depression and suicide. Psychopharmacology Bulletin. 2003;37(1):64-78.