What about depression and suicide with isotretinoin?

A number of case reports and case series appear in the literature that link depression, suicide, and suicidal ideation to isotretinoin use. In several of these cases, cessation of the drug resulted in improvement of the depressive symptoms and rechallenge caused recurrence of depression. Between 1982 and 2000, the FDA received reports of 394 cases of depression and 37 suicides occurring in patients exposed to isotretinoin. However, depression is more common in the age group affected by acne than in the general population. To complicate matters further, there is evidence that acne itself has significant psychological effects, and there are case reports of improvement in depression scores of acne patients during and after treatment with isotretinoin. Epidemiologic studies to date have not shown a causal relationship between isotretinoin and depression and suicide. Because depression and suicide are serious matters, careful monitoring of patients undergoing therapy with isotretinoin for signs/symptoms of depression and suicidal ideation is advisable.

Magin P, Pond D, Smith W: Isotretinoin, depression, and suicide: a review of the evidence, Br J Gen Pract 55:134–138, 2005.