Publication: The effect of Isotretinoin on mood in patients with acne vulgaris - a feasibility study and Dermatologists' perception

The effect of Isotretinoin on mood in patients with acne vulgaris - a feasibility study and Dermatologists' perception.
Rea S, Gunnarsson R, Tucker S, Frittelli V.
The Townsville Hospital: 1st prize & $2500 - The Northern Clinical Training Network/James Cook University/ The Townsville Hospital - Research Symposium; 2015.

Abstract

Background Isotretinoin is the most efficacious medication in the treatment of acne vulgaris. It has controversially been associated with depression and suicide. Research lacks well designed blinded randomized controlled trials. Aim This project consists of three parts. A systematic literature review to assess the evidence for Isotretinoin induced depression and suicide. A questionnaire to assess Australian Dermatologists’ experiences and perceptions with acne vulgaris patients treated with Isotretinoin and the development of depression, suicidal ideation and suicide. A feasibility study for a triple blind randomized controlled trial investigating the effects of Isotretinoin on depression, suicidal ideation and suicide. Methods A systematic review of the literature was performed including quality assessment. Our questionnaire was conducted at the 48th Australasian Dermatologists’ Annual Scientific Meeting. Our feasibility study randomized all acne vulgaris patients meeting inclusion criteria who were willing to participate to Isotretinoin or Doxycycline for two weeks. Questionnaires screening for depression and quality of life were completed at baseline and at two weeks. Results Eighteen observational studies were included in the review and their findings synthesized. Many studies were poorly designed and outcomes conflicting. There were no blinded randomized controlled trials. Our questionnaire surveyed 120 Dermatologists with 73 included. Many Dermatologists had experienced acne vulgaris patients on Isotretinoin who have developed depressive symptoms (77%). Many believed Isotretinoin can cause depression (66%). The feasibility study screened 194 acne vulgaris patients and found despite the superior efficacy of Isotretinoin, acne vulgaris patients would accept randomization. Conclusion The literature review identified a clear gap in research which lacks randomized controlled trials on the effect of Isotretinoin induced depression and suicide. Our questionnaire found many Australian Dermatologists see acne patients with depressive symptoms who have been prescribed Isotretinoin and, believe Isotretinoin could be the cause. Our feasibility study found a triple blind randomized controlled trial is possible.


, from FoU-centrum för primärvård och folktandvård Södra Älvsborg
http://au.researchweb.org/is/en/foualvsborg/user/publication?ref=2279061