Isotretinoin is an effective treatment for severe acne, but its use has been associated with depression and suicide. Researchers in Sweden carried out a retrospective cohort study to assess the risk of attempted suicide in 5,756 patients with severe acne, before, during and up to 15 years after they received treatment with isotretinoin.
During the study period, 128 patients attempted suicide. The incidence ratio for suicide was 1.57 during the year before treatment, increasing to 1.78 6 months after treatment (1.93 for first attempts). During the 15 years of follow-up, the ratio decreased to 1.04 and this was consistent from 3 years after discontinuation of treatment.
These results suggest that patients should be closely monitored for up to a year after isotretinoin treatment has stopped.
Sundstrom A, Alfredsson L, Sjolin-Forsberg G et al. BMJ 2010; 341: c5812