If you have severe acne, you're probably pretty unhappy about the way your skin looks. But you may not realize that two of the medications commonly prescribed for moderate to severe acne actually can cause clinical depression in users: isotretinoin and oral contraceptives. Depression can be far more severe in isotretinoin users. Although the vast majority of people don't experience depression as a side effect of either of these medications, if you're taking one of them and have experienced mood changes, you should discuss them with your physician.
Function
Isotretinoin, known by the brand name Accutane, works the best out of all acne medications to treat every cause of acne: excess oil, clogged pores and infection, according to the American Academy of Dermatology. You usually take it one or two times a day for up to five months, and it potentially can drive your acne into long-term remission in that time frame. However, dermatologists reserve it to treat only the most severe cases because it also can cause some severe side effects, including depression.
Research
Several medical studies have indicated a link between isotretinoin use, depression and suicidal thoughts, although other researchers have failed to back up this link. Clinicians reporting in the Journal of the American Academy of Dermatology in 2001 analyzed reports to the U.S. Food and Drug Administration of adverse events, including depression and suicide, associated with isotretinoin use. They found that isotretinoin ranks within the top 10 medications for reports of depression and suicide attempts.
Effects
In the AAD journal analysis, the researchers noted that more research is needed before determining conclusively that isotretinoin can cause depression and suicidal thoughts. However, they recommended that physicians advise patients and--in the case of teen patients--their parents about the possibility that isotretinoin users might develop depression or have it worsen while taking isotretinoin.
Warning
If you're taking isotretinoin for severe acne and you experience depressive symptoms such as extreme sadness, bouts of crying, loss of normal appetite, extreme or unusual fatigue, withdrawal from social activities or problems concentrating, you should contact your doctor immediately. You might need to discontinue your medication and seek help from mental health professionals.
Considerations
Oral contraceptives, which can help curb acne in women, also carry a slight risk of depression, although not as severe as the risk potentially associated with isotretinoin. Researchers at the Massachusetts General Hospital looked at 658 women taking oral contraceptives and found about 16 percent said their mood got worse on the pill, 12 percent said their mood got better, and more than 70 percent experienced no change. Women with a prior history of depression were more likely to experience mood changes on oral contraceptives than women with no such medical history. However, the researchers concluded that even women who have had depression before can take the pill safely.
