Accutane is a type of medication that treats severe or stubborn acne. However, people may experience mood changes while taking Accutane. For some, depression can be a serious side effect of this medication.

Acne is an inflammatory skin condition that can develop when the hair follicles or sebaceous glands in the skin become clogged. People who experience severe acne may experience frequent breakouts affecting the face, chest, and back that are difficult to treat.

Despite many theories, doctors cannot explain the link between Accutane and depression. Therefore, further research into uncovering the link would be beneficial. People who experience depression may need to stop taking this medication.

Keep reading to learn more about the link between Accutane and depression.

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Accutane is a prescription medication for treating acne. Doctors may prescribe other acne treatments, such as topical medications or antibiotics, before Accutane.

Doctors prescribe Accutane for severe recalcitrant nodular acne, a specific and severe form of the condition.

However, some doctors also prescribe the medication to treat moderate acne that has not responded to other therapy or quickly relapses after stopping antibiotic treatments.

The active ingredient in Accutane is isotretinoin, which blocks the function of the sebaceous gland in the skin. Accutane also blocks keratinization, a process of skin cell maturation. These two processes that occur in the skin can lead to acne.

However, doctors are unsure how blocking these skin cell functions treats acne.

Learn more about acne.

There is conflicting research on the link between Accutane and depression.

Some people may experience depression as a side effect of taking the medication. Others may also develop mood disorders soon after stopping Accutane.

Signs and symptoms of depression may include:

  • a sad mood
  • feelings of hopelessness, guilt, worthlessness, or helplessness
  • a loss of pleasure or interest in activities
  • low energy
  • trouble concentrating
  • changes in sleep patterns
  • changes in weight or appetite

Suicidal thoughts and behaviors are rare symptoms of depression with Accutane, but they can still happen.

Before starting therapy with Accutane, people must sign a consent form stating they understand the risks of taking the drug. By signing the form, they confirm that they are aware of the serious mood changes that may occur. They also agree to stop Accutane and tell their doctor if they experience any symptoms of depression.

Doctors also need to cosign the consent form to confirm that they have explained the risks of taking this medication.

While Accutane can cause depression, acne can also lead to psychological disturbances, including:

  • self-esteem issues
  • depression
  • anxiety

Conversely, by treating acne, Accutane may help improve depressive symptoms. However, the drug itself may cause depression.

Suicide prevention

If you know someone at immediate risk of self-harm, suicide, or hurting another person:

  • Ask the tough question: “Are you considering suicide?”
  • Listen to the person without judgment.
  • Call 911 or the local emergency number, or text TALK to 741741 to communicate with a trained crisis counselor.
  • Stay with the person until professional help arrives.
  • Try to remove any weapons, medications, or other potentially harmful objects if it’s safe to do so.

If you or someone you know is having thoughts of suicide, a prevention hotline can help. The 988 Suicide and Crisis Lifeline is available 24 hours a day at 988. During a crisis, people who are hard of hearing can use their preferred relay service or dial 711 then 988.

Find more links and local resources.

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Doctors cannot explain why depression is a side effect of Accutane. However, some experts suggest that the medication affects the central nervous system and influences pathways that lead to depression.

Some ways that Accutane can affect the nervous system and cause symptoms include the below:

  • Blocking cell division in the hippocampus: This means the cells in this part of the brain may not function adequately.
  • Lower brain metabolism in the orbitofrontal cortex: This means this part of the brain does not receive sufficient essential nutrients. The orbitofrontal cortex has a role in emotion.
  • Changes in serotonin and serotonin receptor levels in the brain: These chemicals have many bodily functions and may affect a person’s mood.

However, these theories require further investigation to fully uncover and decipher the link between Accutane and depression.

Another theory suggests that the risk of depression with Accutane may be due to the person’s history of depression or other nondrug factors.

Data about depression and Accutane from clinical studies show inconclusive results.

Some studies show that Accutane has no effect on mood. The Food and Drug Administration (FDA) reported 40 situations where people had psychiatric symptoms after stopping and subsequently restarting Accutane. Among these situations, 75% had no medical history of mood disorders.

The lifetime prevalence of depressive disorders in the United States and Western Europe, which details the proportion of a population that has ever had depression in their lifetime, is between 13% and 16%. However, the frequency of depression among people using Accutane varies from 1 to 11%.

While depression may not occur in all people taking Accutane, it is an important side effect to report to doctors.

Depression from Accutane may not resolve after stopping the drug. Therefore, doctors recommend stopping the medication if depression occurs.

A referral to a mental health specialist may be necessary for some people.

Avoiding the use of St. John’s Wort

St. John’s wort is a natural remedy that some people use for depression.

The risk of drug interaction exists between St. John’s wort and hormonal contraceptives. While using Accutane, people who can get pregnant must use effective contraception due to the risk of a congenital abnormality in the fetus.

Generally, people taking Accutane alongside hormonal contraceptives should avoid using St. Johns wort, as they may become pregnant.

Before taking any substance for treating depression or improving mood, people taking Accutane need to consult a doctor.

The recommended dosage of Accutane can range from 0.5 milligrams (mg) to 1 mg per kilogram daily. While taking Accutane, doctors may adjust the dose depending on the side effects a person may be experiencing and their body weight.

This is because some side effects may relate to the prescribed dose rather than the drug itself.

Depression is not more likely in people taking a higher dose, according to an older study from 2012. However, other side effects, such as inflammation of the lips and high fat levels in the blood, may worsen with increasing doses.

Another important warning when taking Accutane is the risk of congenital abnormalities in a fetus. These can include:

  • face, eye, skull, ears, and central nervous system abnormalities
  • abnormalities of the heart and blood vessels, thymus, and parathyroid gland
  • low IQ scores

People can also experience spontaneous abortion and premature births if they are pregnant while taking Accutane.

Other side effects include severe inflammation of the lips, which doctors call cheilitis, and high triglyceride levels in the blood.

Learn more about different oral medications for acne.

Before prescribing Accutane, doctors will gather a complete medical history, including a person’s history of depression, mood disorders, psychosis, and aggression.

During follow-up visits, doctors will check for any signs of mood changes. If a person suspects they are experiencing depression, their doctor may tell them to stop taking Accutane.

People experiencing depressive thoughts while taking the medication can speak with a doctor.

Sometimes a family member or caretaker may alert a doctor to a person’s change in mood. Doctors will help guide people to receive the help they need. However, stopping Accutane may not resolve mood changes such as depression.

Depression can be a severe side effect of Accutane. Doctors usually tell people to stop taking the drug if they experience depression.

Awareness of depression and mood changes with Accutane helps detect psychological side effects early. In some situations, depression may persist despite stopping this medication.