Isotretinoin treatment improves depression symptoms in acne patients
Depression symptoms in acne patients may improve following treatment with isotretinoin, according to a systematic review and meta-analysis.
Researchers searched multiple electronic databases for intervention studies comparing the outcomes before and after the use of isotretinoin or evaluating the drug against other treatment regimens in acne patients. Outcomes were change in depressive symptoms measured using a continuous depression scale and the number of patients with depression before and after the use of isotretinoin.
The meta-analysis included 20 studies, with the number of participants using isotretinoin ranging from 16 to 7,195. Most studies prescribed isotretinoin for moderate-to-severe acne, with the dose varying from 0.5–1.0 mg/(kg⋅d) and treatment duration from around 1–6 months.
Pooled data, obtained using the random-effects model, revealed that the use of isotretinoin was significantly associated with improved depressive symptoms (standardized mean difference [SMD], −0.33; 95 percent CI, −0.51 to −0.15; p<0.05; I2, 76.6 percent; p<0.05).
The beneficial effect of isotretinoin on depressive symptoms in patients with acne remained significant for studies using the Hospital Anxiety and Depression Scale-Depression scale or the Centre for Epidemiologic Studies Depression scale.
On the other hand, there was no evidence of a relationship between the use of isotretinoin with the risk of depressive disorders (relative risk [RR], 1.15; 0.60–2.21; p=0.14). Specifically, the result was statistically significant on pooling retrospective studies (RR, 1.39; 1.05–1.84; p=0.02) but not evident on pooling prospective studies (RR, 0.85; 0.60–2.21; p=0.86).
Researchers pointed out the need for prospective controlled trials to verify the present data, as well as to explore whether the use of isotretinoin in patients with acne might increase the risk of depression.