Acne is a very distressing disorder and can cause loss of self-esteem and lead to lack of confidence. Acne is a very common complaint and affects four-fifths of all teenagers and adults. While most mild cases of acne usually resolve, at least 20 percent of individuals develop severe acne. The treatment of acne is abysmal. So far, there is no ideal product and almost every week a new product is available on cyberspace.
One of the more effective treatments for acne has been the use of retinoids like Accutane. However, during the earlier clinical trials it was obvious that Accutane not only improved acne but it also affected behavior in some individuals. These behaviors changes included suicidal ideation, depression and severe anxiety. These emotional warnings have been on the Accutane packaging since it was first introduced into the North American market. Every now and then, there are isolated reports about individuals who have committed suicide while taking Accutane.
Now, some European researchers claim that the these reports of depression and suicidal ideation are overblown, because it is the acne which is responsible, not the drugs. The latest study from Norway revealed that levels of depression and suicidal ideation were two to three times higher in individuals with severe acne compared to those who had no skin problems. The researchers claimed that the depression previously associated with Accutane was in fact from the acne itself.
"There is a pretty strong and consistent association between acne and symptoms of depression or mental health problems," said Dr. Jon Anders Halvorsen of Oslo University Hospital, whose study was published in the Journal of Investigative Dermatology.
Accutane, manufactured by the Swiss pharmaceutical company Roche, has always been a controversial medication since it was first introduced in 1992. Roche said that it intends to stop selling this highly effective drug because of the availability of generic Accutane, known as Isotretinoin.
There is no question that Accutane is probably the most effective medication for clearing acne, but it has also been associated with teratogenic effects if taken by pregnant women. The drug also has been suspected of causing a variety of mental side effects, although Roche has never admitted to these claims. To make matters worse for Roche, a study from Canada several years ago did indicate that Isotretinoin increased the risk of depression.
Halvorsen said, "There has been a lot of controversy regarding these drugs and that has made many dermatologists cautious about prescribing Isotretinoin. Our study is important because it provides an argument for not being so cautious."
However, psychiatrist Dr. Ian Goodyer from Cambridge University said it is perhaps too early to jump to conclusions about Accutane. "From this research I do not think we can say negative impacts on mental health were nothing to do with the drugs taken for severe acne. There may be additive effects in an already vulnerable group."
To date, the evidence we have on Accutane is not adequate. So far, no direct link between Accutane and suicide or depression has ever been shown. We do know that acne can cause a certain mental morbidity and perhaps Accutane may augment these symptoms. Even if Accutane did cause an idiosyncratic reaction like depression or suicidal thoughts, the case reports are minuscule and appear to be very rare.
Final point: So far, it is not clear how this Norwegian study was funded. In the last decade, almost every study supported by drug companies has shown extremely favorable results for the drugs. Does anyone believe that doctors who get paid lots of money by pharmaceutical companies will ever come up with negative results?