Isotretinoin and the controversy of psychiatric adverse effects

Jamison E. Strahan, Sharon Raimer

Research output: Contribution to journalReview articlepeer-review

72 Scopus citations


Isotretinoin is a synthetic oral retinoid that has great efficacy against severe, recalcitrant, nodulocystic acne. Since its introduction to the market, it has been associated with a variety of adverse psychiatric effects, including depression, psychosis, mood swings, violent behavior, suicide, and suicide attempts. A MEDLINE review was performed to compile all case reports, case series, adverse drug event reportings, and prospective and retrospective studies relating psychiatric adverse events to isotretinoin. In addition, literature linking a biological mechanism for psychiatric adverse events to retinoid signaling pathways was also reviewed. Although a variety of anecdotal and epidemiologic studies are available, the overall lack of concrete scientific data limits any conclusion that can be drawn about a causal relationship between istotretinoin and psychiatric adverse events. Several lines of evidence link retinoid signaling to theorized psychiatric pathogenesis, but are limited in their applicability to adult neurophysiology.

Original languageEnglish (US)
Pages (from-to)789-799
Number of pages11
JournalInternational Journal of Dermatology
Issue number7
StatePublished - Jul 1 2006

ASJC Scopus subject areas

  • Dermatology


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