Changes in mood during isotretinoin treatment for acne vulgaris ‘may be multifactorial’
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Key takeaways:
- 10.5% of patients treated with isotretinoin experienced mood changes.
- 88% of patients experienced symptom improvement, regardless of treatment management.
While some adolescents treated with isotretinoin for moderate to severe acne vulgaris reported mood-changes, a majority experienced improvement in symptoms and completed treatment, according to a study.
It has long been ascertained that isotretinoin, an effective treatment option for moderate to severe acne vulgaris, may be linked to psychiatric disturbances. While this linkage has not been deemed causal, particularly with suicide and depression, subtle mood changes and idiosyncratic mood symptoms continue to be reported in this treatment population.
As a result, researchers Adena E. Rosenblatt, MD, PhD, of the section of dermatology in the department of medicine at the University of Chicago, Michelle Verghese, BA, of Pritzker School of Medicine at the University of Chicago, and Kelsey Gradwohl, MD, of the transitional year program at Ascension Resurrection Medical Center, conducted a retrospective chart review to evaluate the correlation between the drug and subtle mood changes. The study included 247 patients aged 10 to 25 years being treated with isotretinoin for acne vulgaris.
“The majority of mood changes we observed in adolescent patients during isotretinoin treatment were short-lasting and improved to baseline regardless of treatment management,” the authors told Healio in a statement. “This suggests that these mood changes may be multifactorial.”
According to the study, results showed that 10.5% (n = 26) of patients treated with isotretinoin experienced mood changes, with depressive symptoms (29.7%), anxiety (24.3%), aggression (10.8%) and emotional lability (10.8%) being the most prevalent.
Those who experienced vs. did not experience these symptoms tended to be younger (16.6 years ± 2.8 vs. 18.5 years ± 3.1; P = .004) and were more likely to have pre-existing mood disorders (38.5% vs. 14.5%; P = .002).
When these symptoms began, 10 of the 26 patients decided to continue with their original dosage, whereas eight patients chose to reduce the dosage by half. Also, another eight patients stopped isotretinoin altogether.
Nevertheless, 88% of patients experienced an improvement to mood symptom baseline, regardless of treatment management. The same number of patients were also able to complete their treatment course without a repeated change in mood symptoms.
While there remains no causal relationship between isotretinoin and suicide or depression, the authors encourage dermatologists to continue exercising judgement when prescribing this medication.
“Our findings suggest that it is important for clinicians to screen acne patients on isotretinoin for pre-existing mood disorders and to regularly monitor patients for a broad range of mood changes at monthly visits,” the authors told Healio.