The Royal College of Psychiatrists has published guidance on the possible mental health side-effects associated with taking a popular drug for treating acne.
The resource outlines the links between the drug isotretinoin (also known by the brand names Roaccutane or Accutane) and mental health.
An estimated 48,000 people in the UK currently take isotretinoin for severe acne that is resistant to other treatments, or acne that might cause permanent scarring, the college has pointed out.
First approved for acne in the 1980s, millions of people around the world have taken the drug without experiencing any problems. However, over the years, some people have reported changes in their mood while taking the medication.
Mental health
The guidance therefore focuses on isotretinoin and its possible association with mood changes and mental illness, as well as the benefits of the medication.
The aim is to help patients make an informed decision when considering if the medication is right for them, the college has said.
The resource explains some of the mental health problems that people have reported while taking and after stopping isotretinoin. It also outlines how frequently these problems have been reported, and what people should do if they experience them.
It is estimated that between one in 1,000 and one in 10,000 people taking isotretinoin might experience small changes in their mental wellbeing, such as tearfulness, low mood, anxiety and agitation. More serious mood and behaviour changes affect less than one in 10,000 people, the college said.
Those affected might experience depression, behave unusually, show signs of psychosis such as losing contact with reality or hearing voices, have suicidal thoughts, harm themselves, or even attempt or die by suicide.
These feelings and behavioural changes have been reported in people who have had mental health problems in the past, and in people who haven’t. They have happened while people are taking isotretinoin, and after they have stopped taking it.
The college’s guidance urges anyone taking isotretinoin to pay close attention to their mood throughout and after treatment and to inform their doctor if they experience any changes in mood or behaviour.
Consultant psychiatrist Dr Jim Bolton, expert contributor to the College’s isotretinoin and mental health resource, said: “We encourage people to discuss any mental health concerns with their clinician prior to taking this medication, including any history of mental illness.
“Isotretinoin’s effects are a burgeoning area of scientific research; the exact frequency of mental health problems experienced by patients taking it is still unknown, and emerging evidence should be routinely reviewed,” he added.
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