Active substances: Isotretinoin
Disease of the sebaceous glands. Dermatology in General Medicine. New York: McGraw-Hill; 1999.
Br J Dermatol. Isotretinoin for acne vulgaris — 10 years later: A safe and successful treatment.
The cost-effectiveness of isotretinoin in the treatment of acne. Part 1. A meta-analysis of effectiveness literature. S Afr Med J. Washington.Most teens experience acne problems during discomfort but also psychological problems. Buy Accutane Online What is Accutane.
C: 1991. Report of the Consensus Conference on Acne Classification; pp.
Clinical evaluation in acne. Treatment of acne with intermittent isotretinoin.
Acne vulgaris in the elderly: The response to low-dose isotretinoin. Chivot M, Midoun H.
Isotretinoin and acne: A study of relapses. Isotretinoin and acne in practice: A prospective analysis of 188 cases over 9 years. Efficacy of fixed low-dose isotretinoin 20 mg, alternate days with topical clindamycin gel in moderately severe acne vulgaris.
Side Effects Isotretinoin has many side effects but most are predictable and rarely interfere with the patient management. Teratogenicity is well recognized and regarded as one of the most serious potential adverse effects.
Discussion about the teratogenicity and recognized side effects should be recorded in the notes at each visit, and patients should be given appropriate written information.
Mood changes including depression are common among adolescents and have been reported in acne patients treated with isotretinoin. Two studies that looked at spontaneous reports of side effects for the FDA in the USA 53, 54 found little or no increase in psychiatric disease including depression and suicide over the background prevalence in the adolescent population.
A further study of general practice databases in Canada and the UK showed similar findings as have subsequent studies. Despite contradictory reports clinicians have been advised of a potential rare idiosyncratic reaction in some young vulnerable patients which could lead to mood changes and clinical depression during treatment with isotretinoin.
It is therefore advisable to specifically enquire about related symptoms at each clinic visit.
Increased aggression has been identified in some male patients and the FDA in the USA has advised clinicians to warn potential patients about this side effect.
If there is any doubt, the drug must be stopped.