The following is a summary of “Isotretinoin and the risk of psychiatric disturbances: A global study shedding new light on a debatable story,” published in the FEBRUARY 2023 issue of Dermatology by Kridin, et al.

The risk of depression and suicidal ideation associated with isotretinoin is controversial. The relationship between isotretinoin and other mental comorbidities was poorly understood, a critical knowledge gap. For a study, researchers examined whether acne patients receiving isotretinoin treatment versus oral antibiotics faced a higher risk of developing psychiatric conditions.

A global population-based retrospective cohort analysis included isotretinoin-treated acne patients (n = 75,708) and oral antibiotic-treated acne patients (n = 75,708). Nine mental outcomes were compared between patients in terms of risk.

Patients using isotretinoin had a lower risk of depression (hazard ratio [HR], 0.90; 95% CI, 0.87-0.93; P< .001) but a similar risk of major depressive disorder (HR, 0.97; 95% CI, 0.92-1.03; P =.318), compared to those receiving oral antibiotics. Despite the higher prevalence of suicidal thoughts in those on isotretinoin (HR, 1.41; 95% CI, 1.32-1.50; P < .001), the risk of suicide attempts was equal between groups (HR, 0.97; 95% CI, 0.85-1.11; P =.663). Bipolar disorder (HR, 0.65; 95% CI, 0.59-0.72; P< .001), schizophrenia (HR, 0.60; 95% CI, 0.48-0.76; P< .001), anxiety (HR, 0.84; 95% CI, 0.82-0.87; P < .001), adjustment disorder (HR, 0.82; 95% CI, 0.77-0.87; P< .001), and post-traumatic stress disorder (HR, 0.75; 95% CI, 0.68-0.82; P < .001) were all reduced in patients

Six psychiatric comorbidities had a lower risk with isotretinoin, and the risk of suicide attempts was equivalent.