Accutane, known generically as isotretinoin, is a retinoid that is taken in capsule form to treat severe nodular acne that has not improved from other treatments, according to the drug's manufacturer, Hoffman LaRoche, Inc. Accutane works by decreasing the production of skin oil, called sebum. A course of Accutane therapy typically lasts 15 to 20 weeks. Although Accutane can be beneficial, it also has potentially serious side effects.
Birth Defects
Accutane must never be taken by patients who are pregnant or who may become pregnant, warns the National Institutes of Health. Accutane causes a high risk of serious birth defects, stillbirth, premature birth and miscarriage. Because of these risks, patients must participate in a program called iPLEDGE, which includes receiving instruction about potential adverse reactions, signing an informed consent form, providing negative pregnancy tests before treatment and regularly during treatment and using two forms of birth control. According to Hoffman LaRoche, possible birth defects include mental retardation, cleft palate and abnormalities of the skull, ears, eyes and face.
Psychiatric Symptoms
Accutane can cause depression, psychosis or suicidal thoughts and actions, explains Hoffman LaRoche. Risks may outweigh benefits in patients with a personal or family history of mental illness. Patients and family members should be alert to signs of possible psychiatric disturbance and seek medical attention. Signs include sadness, crying spells, feelings of hopelessness or worthlessness, nervousness, difficulty sleeping, lack of energy, withdrawal from friends and family, irritability, aggression, anger, violent behavior and hallucinations.
Pseudotumor Cerebri
Accutane can cause pseudotumor cerebri, a dangerous elevation of pressure inside the skull. Symptoms include headaches that may be severe and worsen during eye movement, nausea, vomiting, dizziness, brief periods of blindness, blurred or double vision and ringing in the ears, notes MayoClinic.com. Pseudotumor cerebri can result in blindness. Surgery may be required to reduce the pressure. According to Hoffman LaRoche, pseudotumor cerebri happens more often in patients taking tetracycline along with Accutane. Patients with these symptoms require urgent medical treatment.
Serious Skin Reactions
Accutane can cause two life-threatening skin reactions called Stevens-Johnson syndrome, or SJS, and toxic epidermal necrolysis, or TEN. According to the Merck Manual Online Medical Library, SJS and TEN are two forms of the same disease, and are caused by certain medications or bacteria. Symptoms for both include fever, headache, body aches, blisters on the skin and mucous membranes and a flat red rash. SJS produces small patches of peeling skin, while TENS produces peeling of larger areas. Victims receive care on a hospital burn unit because the skin loss is similar to that from burns, and is equally as life-threatening.
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