Isotretinoin is not an independent risk factor for depression in adult acne patients, finds new research presented at the 2019 American Academy of Dermatology (AAD) Annual Meeting in Washington.

“There has been mixed evidence and much debate around the impact of isotretinoin on mood change,” says Bethanee Schlosser, MD, PhD, FAAD, an associate professor in the department of dermatology at the Northwestern University Feinberg School of Medicine in Chicago. “There’s also a lot of misinformation out there, particularly on social media, so we hope this large-scale study can shed some light on the issue.”

Dr. Schlosser and her colleagues evaluated medical records for more than 38,000 patients age 18-65 who were diagnosed with acne between January 2001 and December 2017. Forty-one of the 1,087 patients exposed to isotretinoin (3.77 percent) developed depression, compared to 1,775 of the 36,929 who were not exposed to isotretinoin (4.81 percent).

“These results showed no significant difference in frequency of depression between acne patients treated with isotretinoin and those who receive other types of therapy,” Dr. Schlosser says. “Further, we know the mere presence of acne can be associated with mood disorders, including depression, and isotretinoin can provide significant relief for patients whose acne is not responding to other treatments and causing severe psychosocial distress.”

No studies to date have established a causal relationship between isotretinoin and depression, Dr. Schlosser says, and her research indicates that the drug’s effect on mood is limited. She says more research in this area is necessary, however, and she encourages those with acne to see a board-certified dermatologist to discuss their treatment options and let their doctors know if they experience symptoms of depression.