S. Rea, R. Gunnarsson, S. Tucker, V. Frittelli
Background: Isotretinoin is the most efﬁcacious treatment for acne vulgaris. It has been controversially associated with depression, suicidal ideation and suicide1. Current lit- erature on this issue remains conﬂicted and lacks well designed blinded randomized controlled trials2.
Aim: To assess Australian Dermatologists’ experiences and perceptions with acne vulgaris patients treated with Isotretinoin and the development of depression, suicidal ideation and suicide. To conduct a feasibility study for a triple blind randomized controlled trial investigating the effects of Isotretinoin on depression and quality of life.
Methods: This project consisted of two complimentary original studies. A questionnaire was conducted at the 48th Australasian Dermatologists’ Annual Scientiﬁc Meeting. The feasibility study randomized all acne vulgaris patients meeting inclusion criteria who were willing to participate to Isotretinoin or Doxycycline for 2 weeks. Questionnaires screening for depression and quality of life were com- pleted at baseline and at 2 weeks.
Results: The questionnaire surveyed 120 Dermatologists with 73 responses included. Many Dermatologists had observed acne vulgaris patients on Isotretinoin develop depressive symptoms (77%). Most (66%) believe Isotretinoin could cause depression. The feasibility study screened 200 acne vulgaris patients and found despite the superior efﬁ- cacy of Isotretinoin, patients would accept randomization.
Conclusion: Many Australian Dermatologists are seeing acne vulgaris patients treated with Isotretinoin develop depressive symptoms and believe Isotretinoin is the cause. There is a distinct difference between clinical opinion and that in the literature. The feasibility study demonstrates a triple blind randomized controlled trial investigating the effects of Isotretinoin on depression and quality of life is possible.