Prospective Study
Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Psychiatr. Mar 22, 2016; 6(1): 136-142
Published online Mar 22, 2016. doi: 10.5498/wjp.v6.i1.136
Isotretinoin was not associated with depression or anxiety: A twelve-week study
Bella Suarez, Ana Serrano, Yves Cova, Trino Baptista
Bella Suarez, Ana Serrano, Department of Psychiatry, Los Andes University Medical School, Mérida 5101, Venezuela
Yves Cova, Department of Dermatology, Los Andes University Medical School, Mérida 5101, Venezuela
Trino Baptista, Department of Physiology, Los Andes University Medical School, Mérida 5101, Venezuela
Author contributions: Suarez B and Cova Y conducted the study; Serrano A and Baptista T did the data processing and analysis; Baptista T designed the study and wrote the manuscript.
Institutional review board statement: The study was reviewed and approved by the institutional review boards of the Department of Psychiatry, Los Andes University Medical School, Mérida 5101, Venezuela.
Clinical trial registration statement: There is not a system for trial registration in Venezuela. We only count on the Institutional Review Board Statement.
Informed consent statement: All involved persons in this study (subjects or legally authorized representative) gave their informed consent (written or verbal, as appropriate) prior to study inclusion.
Conflict-of-interest statement: None of the authors declare any conflict of interest in this study.
Data sharing statement: There is no additional data available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/bync/4.0/
Correspondence to: Trino Baptista, MD, PhD, Professor, Department of Physiology, Los Andes University Medical School, Tulio Febres Cordero Avenue, Merida 5101, Venezuela. trinbap@yahoo.com
Telephone: +58-274-2636395 Fax: +58-274-2639011
Received: September 16, 2015
Peer-review started: September 21, 2015
First decision: October 30, 2015
Revised: December 9, 2015
Accepted: December 29, 2015
Article in press: January 4, 2016
Published online: March 22, 2016
Processing time: 181 Days and 19.7 Hours
Abstract

AIM: To investigate the frequency and severity of depression and/or anxiety in isotretinoin (ITT)-treated subjects and in a non-ITT control group.

METHODS: Sixty consecutively-admitted non-psychiatric outpatients with acne were assigned to either ITT at a fixed dose of 30 mg/d (n = 36) or “other treatment” group (OT; n = 24). The Zung depression or anxiety scales (with cut-off points), two locally developed scales for depression (GeDepr) and anxiety (Ansilet) (without cut-off points) and clinical global impression scales of acne severity were administered at baseline and at weeks 6 and 12 of treatment. Data was analyzed with the chi-squared test and covariance analysis.

RESULTS: Gender distribution, age, marital status and education level did not differ between both treatment groups. The frequency of depression, as defined by the Zung scale cut-off points was similar in the ITT and in the non-ITT groups: Weeks 6 and 12: 8.3% in both groups, P = 0.9. The frequency of anxiety was similar in the groups as well: Week 6: ITT = 8.3%; OT = 0.0%, P > 0.05; week 12: ITT = 11.1%, OT = 4.2%, P > 0.05. The scores in both scales’ sets did not differ between the treatment groups at any evaluation time point (P > 0.05). Five ITT-treated subjects (13.8%) and two from the OT-treated group (8.3%) developed clinically significant anxiety and/or depression during treatment (P > 0.05).

CONCLUSION: Our study confirms the safety of ITT regarding psychological side effects in regular dermatological patients. Susceptible subjects may exist but their identification requires additional strategies.

Keywords: Isotretinoin; Short-term; Psychopathology; Depression; Anxiety; Other treatments

Core tip: Isotretinoin (ITT) is frequently used for acne therapy, particularly in young people, but concerns exist regarding the risk of depression and suicide attempts. We conducted a 12-wk prospective study administering a fixed ITT dose in non-psychiatric acne patients an in a non-ITT control group. We used categorical and continuous scales for the assessment of depression and anxiety. The frequency and severity of psychopathology was similar in both treatment groups, stressing the safety of ITT in typical dermatological patients. However, 13.8% ITT subjects and 8.3% of the non-ITT developed clinically significant anxiety and/or depression. Hence, susceptible subjects exist, who deserve further investigation and assistance.