Adverse Effects

Isotretinoin is an extremely effective anti-acne preparation, but in a small number of patients (less than 1 percent) it may be associated with symptoms of a major depressive episode. In these cases, symptoms resolve rapidly (within two to seven days) after stopping the medicine. After a period off medication, treatment can begin again at a lower dose.

In a "Dear Doctor" letter to 210,000 dermatologists, family doctors, and psychiatrists, the maker of the drug (Roche) wrote that the strengthened depression warning on its boxes was tied to uncommon adverse reactions. But the "potential consequences" led to label changes, warning physicians that isotretinoin may cause "depression, psychosis, and rarely, suicidal ideation, suicide attempts, and suicide." Stopping the drug may not be enough to ease the depression, the label warns.

Although the link between depression and isotretinoin has not been scientifically proven (the manufacturer insists there is no link), several people who have taken it claim they experienced depression, mood swings, and even suicidal thoughts. Both the FDA and the drug company

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