Isotretinoin use for acne may ameliorate depressive symptoms
It appears that using isotretinoin for acne does not increase the risk for depression, and the treatment of acne seems to improve depressive symptoms, according to a recent study.
To assess the relationship between isotretinoin and depression, researchers conducted a systematic review and meta-analysis of literature published from inception to 30 September 2016. Included were controlled or prospective noncontrolled trials on ≥15 acne patients receiving isotretinoin treatment. The prevalence of depression and change in depression scores were calculated.
There were 31 studies that met the inclusion criteria. In the controlled studies, no significant difference was seen in the change in depression scores from baseline between patients receiving isotretinoin treatment and those receiving an alternative treatment (standardized mean difference [SMD], ‒0.334; 95 percent CI, ‒0.680 to 0.011).
After treatment with isotretinoin, the prevalence of depression declined (relative risk, 0.588; 0.382 to 0.904). The mean depression scores significantly decreased from baseline (SMD, ‒0.335; ‒0.498 to ‒0.172).
A previous systematic review found that studies comparing depression before and after isotretinoin treatment did not show a statistically significant increase in depression diagnoses or depressive symptoms. Moreover, some studies showed a trend toward fewer or less severe depressive symptoms after isotretinoin therapy. There was also no association between isotretinoin use and suicidal behaviour, although only one retrospective study presented data on this topic. [Semin Cutan Med Surg 2005;24:92-102]
The current study had some limitations. Researchers did not review randomized controlled trials, and a large interstudy variation was observed.