A prospective trial of the effects of isotretinoin on quality of life and depressive symptoms

McGrath, Elly; Lovell, C. R.; Gillison, Fiona; Darvay, A.; Hickey, Janis; Skevington, Suzanne M.

doi:10.1111/j.1365-2133.2010.10060.x

Cited by 63 publications

(30 citation statements)

References 45 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Four subsequent additional studies (2 prospective, 1 case-control, and 1 cohort study) evaluated isotretinoin use and depressive symptoms. 135,136 Although none of these additional studies identified a positive association between isotretinoin use and depression, 2 of them indicated that as acne improved, quality of life improved 137 and depressive symptoms and suicidal ideation actually decreased. 138 In summary, case reports and case series have identified patients who developed depressive symptoms while receiving or after isotretinoin therapy, and 1 study utilizing positron emission tomography has documented changes in cerebral metabolism in patients receiving isotretinoin therapy.…”

Section: Mood Disordersmentioning

confidence: 99%

Evidence-Based Recommendations for the Diagnosis and Treatment of Pediatric Acne

et al. 2013

View full text Add to dashboard Cite

INTRODUCTION: Acne vulgaris is one of the most common skin conditions in children and adolescents. The presentation, differential diagnosis, and association of acne with systemic pathology differs by age of presentation. Current acknowledged guidelines for the diagnosis and management of pediatric acne are lacking, and there are variations in management across the spectrum of primary and specialty care. The American Acne and Rosacea Society convened a panel of pediatric dermatologists, pediatricians, and dermatologists with expertise in acne to develop recommendations for the management of pediatric acne and evidence-based treatment algorithms. METHODS: Ten major topic areas in the diagnosis and treatment of pediatric acne were identified. A thorough literature search was performed and articles identified, reviewed, and assessed for evidence grading. Each topic area was assigned to 2 expert reviewers who developed and presented summaries and recommendations for critique and editing. Furthermore, the Strength of Recommendation Taxonomy, including ratings for the strength of recommendation for a body of evidence, was used throughout for the consensus recommendations for the evaluation and management of pediatric acne. Practical evidence-based treatment algorithms also were developed. RESULTS: Recommendations were put forth regarding the classification, diagnosis, evaluation, and management of pediatric acne, based on age and pubertal status. Treatment considerations include the use of over-the-counter products, topical benzoyl peroxide, topical retinoids, topical antibiotics, oral antibiotics, hormonal therapy, and isotretinoin. Simplified treatment algorithms and recommendations are presented in detail for adolescent, preadolescent, infantile, and neonatal acne. Other considerations, including psychosocial effects of acne, adherence to treatment regimens, and the role of diet and acne, also are discussed. CONCLUSIONS: These expert recommendations by the American Acne and Rosacea Society as reviewed and endorsed by the American Academy of Pediatrics constitute the first detailed, evidence-based clinical guidelines for the management of pediatric acne including issues of special concern when treating pediatric patients.

show abstract

Section: Mood Disordersmentioning

confidence: 99%

Evidence-Based Recommendations for the Diagnosis and Treatment of Pediatric Acne

et al. 2013

View full text Add to dashboard Cite

show abstract

“…However, as other authors have pointed out (25), more research is needed on the relationship between acne, isotretinoin, QoL and psychosocial impact. Before starting oral isotretinoin treatment, acne patients should be tested for symptoms of depression and suicidal tendencies and undergo a detailed psychometric examination.…”

Section: Discussionmentioning

confidence: 96%

“…Whilst the issues have been dealt with in previously published works (24)(25)(26)(27), this study was prospective and based on a relative large number of subjects (« = 346). Furthermore, an intention-to-treat (ITT) analysis was undertaken and this aided decisions on prescription or modification of isotretinoin use and its dosage with groups of patients with moderate acne.…”

Section: Discussionmentioning

confidence: 99%

Retinoids Reduce Formation of Keratin Aggregates in Heat-stressed Immortalized Keratinocytes from an Epidermolytic Ichthyosis Patient with a KRT10 Mutation*

Li¹,

Törmä²

2013

Acta Derm Venerol

View full text Add to dashboard Cite

Epidermolytic ichthyosis (EI) is an autosomal dominant epidermal skin fragility disorder caused by mutations in keratin 1 and 10 (K1 and K10) genes. Mutated keratins form characteristic aggregates in vivo and in vitro. Some patients benefit from retinoid therapy, although the mechanism is not fully understood. Our aim was to demonstrate whether retinoids affect the formation of keratin aggregates in immortalized EI cells in vitro. EI keratinocytes were seeded on cover slips, pre-treated or not with retinoids, heat-stressed, and keratin aggregate formation monitored. K10 aggregates were detected in 5% of cells in the resting state, whereas heat stress increased this proportion to 25%. When cells were pre-incubated with all-trans-retinoic acid (ATRA) or retinoic acid receptor (RAR)-α agonists the aggregates decreased in a dose-dependent manner. Furthermore, ATRA decreased the KRT10 transcripts 200-fold as well as diminished the ratio of mutant to wild-type transcripts from 0.41 to 0.35, thus providing a plausible rational for retinoid therapy of EI due to K10 mutations.

show abstract

“…Although it is clear that there are a number of adverse effects in the CNS, the most common being headache (Bremner and McCaffery 2008), many studies have linked the onset of depression with such treatment (Hazen et al 1983; Gatti and Serri 1991; Jick et al 2000; Bremner et al 2005; Azoulay et al 2008) while other studies have found the contrary (Rubinow et al 1987; Ng et al 2002; Cohen et al 2007; Bozdag et al 2009; McGrath et al 2010). One profound problem in resolving this quandary is the difficulty in untangling the psychosocial influence of severe acne with the potential effects of the drug.…”

Section: Discussionmentioning

confidence: 99%

High expression of retinoic acid receptors and synthetic enzymes in the human hippocampus

et al. 2011

View full text Add to dashboard Cite

Retinoic acid, the active form of the nutrient vitamin A, regulates several facets of neuronal plasticity in the hippocampus, including neurogenesis and synaptic strength, acting via specific retinoic acid receptors (RARs). Essential for conversion of vitamin A to retinoic acid is the enzyme retinaldehyde dehydrogenase (RALDH) and in the rodent hippocampus this is only present in the adjacent meninges where it must act as a locally released paracrine hormone. Little is known though about the expression of RALDHs and RARs in the human hippocampus. This study confirms that RALDH levels are very low in mouse neurons but, surprisingly, strong expression of RALDH protein is detected by immunohistochemistry in hippocampal neurons. The receptors RARα, β and γ were also detected, each receptor exhibiting differing subcellular locations implying their potential regulation of both transcription and non-genomic actions. These results imply an essential function of retinoic acid in the human hippocampus likely to include regulation of neuronal plasticity.

show abstract

A prospective trial of the effects of isotretinoin on quality of life and depressive symptoms

Abstract: Treatment of acne improves QoL, particularly in those with more depressive symptoms at the outset. Mood deterioration was not detected, but the possibility of subtle or rare mood effects of isotretinoin cannot be ruled out.

Cited by 63 publications

References 45 publications

Evidence-Based Recommendations for the Diagnosis and Treatment of Pediatric Acne

Evidence-Based Recommendations for the Diagnosis and Treatment of Pediatric Acne

Retinoids Reduce Formation of Keratin Aggregates in Heat-stressed Immortalized Keratinocytes from an Epidermolytic Ichthyosis Patient with a KRT10 Mutation*

High expression of retinoic acid receptors and synthetic enzymes in the human hippocampus

Contact Info

Product

Resources

About