The Effect of Isotretinoin (Roaccutane) Therapy on Depression and Quality of Life of Patients with Severe Acne
-
Youssef Fakour
,
Pedram Noormohammadpour
,
Hamed Ameri
,
Amir Houshang Ehsani
,
Leila Mokhtari
,
Najmeh Khosrovanmehr
,
Seyedeh Zahra Hoseini Nezhad
Abstract
Objective: Acne is the most common skin disease and isotretinoin is the most powerful drug among the various drugs used for its treatment, but it has some adverse effects. The aim of this study was to evaluate the effect of isotretinoin on depression and quality of life of a group of patients undergoing isotretinoin therapy before and after the treatment course .
Methods: In this prospective study, 98 patients with severe acne were enrolled consecutively and underwent isotretinoin therapy receiving 0.5 mg/kg/d of isotretinoin for 16 weeks. Isotretinoin effects on quality of life and depression were evaluated using Dermatology Life Quality Index (DLQI) and Beck Depression Inventory (BDI) questionnaires, respectively.
Results: In this study, 98 patients suffering from severe acne (38 males and 60 females) were enrolled. Treatment of acne was associated with improvement of quality of life scores in both male and female patients (p = 0.001). Considering the cutoff value of 13 for mild depressive mood in the BDI score, in total, 48 (49%) of the enrolled patients (21 males and 33 females) had a mild depressive mood before the commencement of the treatment in this study. The analysis of before and after treatment BDI scores showed that the number of patients and also the mean score of BDI were increased in both male and female patients after the treatment (p<0.05).
Conclusion: Isotretinoin therapy improved the quality of life of patients suffering from
Pawin H, Beylot C, Chivot M, Faure M, Poli F, Revuz J, et al. Physiopathology of acne vulgaris: recent data, new understanding of the treatments. Eur J Dermatol 2004; 14: 4-12.
Ng CH, Schweitzer I. The association between depression and isotretinoin use in acne. Aust N Z J Psychiatry 2003; 37: 78-84.
Kellett SC, Gawkrodger DJ. A prospective study of the responsiveness of depression and suicidal ideation in acne patients to different phases of isotretinoin therapy. Eur J Dermatol 2005; 15: 484-488.
King K, Jones DH, Daltrey DC, Cunliffe WJ. A double-blind study of the effect of 13-cis-retinoic acid on acne, sebum excretion rate and microbial population. Br J Dermatol 1982; 107: 583-590.
Beattie PE, Lewis-Jones MS. A comparative study of impairment of quality of life in children with skin disease and children with other chronic childhood diseases. Br J Dermatol 2006; 155: 145–151.
Mallon E, Newton JN, Klassen A, Stewart-Brown SL, Ryan TJ, Finlay AY. The quality of life in acne: a comparison with general medical conditions using generic questionnaires. Br J Dermatol 1999; 140: 672–676.
Cunliffe WJ, Baxter K. The place of oral isotretinoin in the treatment of acne: Benefits and side effects. CME Bulletin Dermatol 2000; 2: 56-62.
Dreno B, Daniel F, Allaert FA, Aube I. Acne; evolution of the clinical practice and therapeutic management of acne between 1996 and 2000. Eur J Dermatol 2003; 13:166-170.
Cordain L, Lindeberg S, Hurtado M, Hill K, Eaton SB, Brand-Miller J. Acne vulgaris: a disease of Western civilization. Arch Dermatol 2002; 138: 1584–1590.
McGrath EJ, Lovell CR, Gillison F, Darvay A, Hickey JR, Skevington SM. A prospective trial of the effects of isotretinoin on quality of life and depressive symptoms. Br J Dermatol 2010; 163: 1323–1329.
Bigby M, Stern RS. Adverse reactions to isotretinoin. J Am Acad Dermatol 1988; 18: 543–552.
Acne, isotretinoin and depression. Drug Ther Bull 2003; 41:76–78.
Wysowski DK, Pitts M, Beitz J. An analysis of reports of depression and suicide in patients treated with isotretinoin. J Am Acad Dermatol 2001; 45: 515–519.
Uhlenhake E, Yentzer BA, Feldman SR. Acne vulgaris and depression: a retrospective examination. J Cosmetic Dermatol 2009; 9: 59–63.
Ng CH, Tam MM, Celi E, Tate B, Schweitzer I. Prospective study of depressive symptoms and quality of life in acne vulgaris patients treated with isotretinoin compared to antibiotic and topical therapy. Australas J Dermatol 2002; 43: 262–268.
Doshi A, Zaheer A, Stiller MJ. A comparison of current acne grading systems and proposal of a novel system. Int J Dermatol 1997; 36:416–418.
Kaymak Y, Taner E, Taner Y. Comparison of depression, anxiety and life quality in acne vulgaris patients who were treated with either isotretinoin or topical agents. Int J Dermatol 2009; 48: 41–46.
18-Hahm BJ, Min SU, Yoon MY, Shin YW, Kim JS, Jung JY, et al. Changes of psychiatric parameters and their relationships by oral isotretinoin in acne patients. J Dermatol 2009; 36: 255-261.
Dunn LK, O'Neill JL, Feldman SR. Acne in adolescents: quality of life, self-esteem, mood, and psychological disorders. Dermatol Online J 2011; 17: 1.
Grahame V, Dick DC, Morton CM, Watkins O, Power KG. The psychological correlates of treatment efficacy in acne. Dermatol Psychosom 2002; 3:119–125.
Yazici K, Baz K, Yazici AE, Köktürk A, Tot S, Demirseren D, et al. Disease -specific Quality of life is associated with anxiety and depression in patients with acne. J Eur Acad Dermatol Venereol 2004; 18: 435–439.
Byrne A, Costello M, Greene E, Zibin T. Isotretinoin therapy and depression-evidence for an association. Irish J Psychosom Med 1998; 15: 58–60.
Byrne A , Hnatko G. Depression associated with isotretinoin therapy. Can J Psychiatry 1995; 40: 567.
Cott AD, Wisner KL. Isotretinoin treatment of a woman with bipolar disorder. J Clin Psychiatry 1999; 60: 407–408.
Van Broekhoven F, Verkes RJ, Janzing JG. Psychiatric symptoms during isotretinoin therapy. Ned Tijdschr Geneeskd 2003; 147: 2341–2343.
Barak Y, Wohl Y, Greenberg Y, Bar Dayan Y, Friedman T, Shoval G, et al. Affective psychosis following Accutane (isotretinoin) treatment. Int Clin Psychopharmacol 2005; 20: 39–41.
Golchai J, Khani SH, Heidarzadeh A, Eshkevari SS, Alizade N, Eftekhari H. Comparison of anxiety and depression in patients with acne vulgaris and healthy individuals. Indian J Dermatol 2010; 55: 352-354.
O’Reilly KC, Shumaker J, Gonzalez-Lima F, Lane MA, Bailey SJ. Chronic administration of 13-cisretinoic acid increases depression-related behavior in mice. Neuropsychopharmacology 2006; 31: 1919–1927.
Goodfield MJD, Cox NH, Bowser A, McMillan JC, Millard LG, Simpson NB, et al. Advice on the safe introduction and continued use of isotretinoin in acne in the U.K. 2010. Br J Dermatol 2010; 162: 1172–1179.
Misery L. Consequences of psychological distress in adolescents with acne. J Invest Dermatol 2011; 131: 290–292.
Bremner JD, McCaffery P. The neurobiology of retinoic acid in affective disorders. Prog Neuropsychopharmacol Biol Psychiatry 2008; 32:315–331.
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| Issue | Vol 9 No 4 (2014) | |
| Section | Articles | |
| Keywords | ||
| Depression Isotretinoin Quality of Life | ||
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