Accutane and Depression

Accutane is a drug that is commonly prescribed for severe acne and other skin problems. It is normally reserved for patients whose acne has not responded to other forms of treatment, such as antibiotics. Accutane, also known as isotretinoin, is a form of vitamin A. It helps those who have acne by decreasing the amount of oil produced by the sebaceous glands and increasing the skin renewal rate. Considered the biggest breakthrough in acne drug treatment over the last 20 years, Accutane is the only drug that has the potential to clear severe acne permanently after one course of treatment. One course, which is typically five months, results in prolonged remission of acne in up to 85 percent of patients. A member of a class of drugs known as retinoids, Accutane is highly effective. But it doesn't work for everyone, and some patients need more than one course of treatment. FDA approved Accutane in 1982, and since then, about 5 million people in the United States and 12 million worldwide have been treated with it, according to its manufacturer, Hoffmann-La Roche of Nutley, N.J. The number of patients taking the drug has increased, and half are females, most of who are in their childbearing years (age 15-44). Because of concern about the drug's risks, FDA continues to evaluate Accutane and work with the manufacturer to maximize safe use of the drug.

Accutane has been shown to have several serious side effects. Among these is the drug's apparent connection to depression and suicidal behavior in some patients who are taking or have recently taken Accutane. Patients are warned at the onset of their treatment that "Accutane may cause depression, psychosis and, rarely, suicidal ideation, suicide attempts, and suicide. Discontinuation of Accutane may be insufficient." While it is unclear exactly why Accutane causes some patients to develop mental problems, the fact that it can have severe side effects is unavoidable.

Accutane and Suicide

There are possible legal actions against Hoffman-La Roche, Inc., manufacturer of the prescription acne drug Accutane, to recover for psychological damage--sometimes leading to suicide--suffered by Accutane users. As of late 2000, the federal Food and Drug Administration (FDA) had received reports of 66 suicides and 1,373 other psychiatric adverse events in Accutane users. Accutane was approved in 1982 to treat only a very special type of acne--severe nodular acne that had not responded to other therapies. Critics estimate that most of the 500,000 people in the United States who try it each year have acne too mild for the drug.

The possible connection between Accutane and suicide became national news in October, 2000, after U.S. Rep. Bart Stupak from Michigan said that his 17-year-old son's suicide earlier that year might be linked to Accutane. Bart Stupak Jr., known as 'B.J.,' shot himself in the head with his father's gun in the early hours of May 14. Stupak, a football player who was popular in school, killed himself after a prom-night party.

'Within days of taking Accutane, my mood began to change. Within weeks, I was crying,' testified Amanda Callais of Denham Springs, Louisiana, who at age 14 attempted suicide, two months after beginning Accutane therapy. Before taking Accutane, she was an outgoing, happy, straight-A student. According to her mother, within days after throwing out the pills, Amanda made 'a miraculous recovery.'

Stacy and Michael Baumann of Mundelein, Ill., whose son, Daniel, a high school sophomore, killed himself in December, 1999 while taking Accutane, have described how their dermatologist handed out outdated brochures and their pharmacist provided no counseling.