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Does Accutane (isotretinoin) cause mood changes? | Dermatologist explains in 6 minutes

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I'm John Barbieri, MD, a board-certified dermatologist and acne expert at the Brigham and Women’s Hospital and Harvard Medical School. In this video we will discuss the evidence regarding whether isotretinoin causes mood changes (e.g. depression and suicide). The answer is more complicated than you think.
#isotretinoin #accutane #acne #depression #suicide #mood #dermatologist #expert
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Twitter/Instagram: @DrJohnBarbieri
References:
Acne and stigma: pubmed.ncbi.nl...
Acne and mood changes: pubmed.ncbi.nl... pubmed.ncbi.nl...
Isotretinoin and depression: pubmed.ncbi.nl... pubmed.ncbi.nl...
Isotretinoin and suicide: pubmed.ncbi.nl...
Rationale for isotretinoin causing mood changes: pubmed.ncbi.nl... pubmed.ncbi.nl...
Disclaimer: This RU-vid Channel does not provide any diagnosis, treatment or medical advice and does not replace a visit to your doctor. The statements are not intended to treat, diagnose, cure or prevent disease. See your doctor for medical advice and treatment. My statements on this channel are for informational purposes only.

Опубликовано:

27 авг 2024

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Комментарии : 25

@nadashaban908 6 месяцев назад

Thank you doctor for sharing your knowledge and clinical tips with younger doctors , we really appreciate it ❤️

@DrJohnBarbieri 6 месяцев назад

Glad you found it helpful! Please make sure to share the video with your colleagues.

@laurenblack9787 6 месяцев назад

Thank you for sharing your knowledge! I started accutane treatment a week ago and have been nervous about this association, especially with mental health history. I also watched another one of your videos about reducing side effects and have taken your advice in taking an omega 3 supplement daily to reduce dryness. It’s probably too early to tell but so far I haven’t really gotten too dry. Do you have any specific advice on what kind of skincare routine or products I could or should be using to really enhance the process or results of accutane? Especially as someone who is purging a bit?

@DrJohnBarbieri 6 месяцев назад

Glad that you are finding the videos helpful! For patients I am seeing on isotretinoin, I typically recommend only using a gentle cleanser, sunscreen (as isotretinoin makes people more sensitive to the sun), and moisturizer.

@JohnDoe-nq8bo 16 дней назад

So if I understood correctly, the depression symptoms that may come with istretinoin are reversibles ? Like you said people take accutane, they get depressed, they stopped taking accutane, the depressive symptoms go away ? And my research on this side effect shown that it is very rare (like 1 in a 1000) am I right on this point ?

@DrJohnBarbieri 16 дней назад

The strongest evidence to suggest isotretinoin can cause mood changes also supports that these effects are temporary (challenge-challenge case series). Serious mood side effects seem to be extremely rare (though more mild mood effects like irritability might be more common). A key thing to keep in mind is that repeatedly cohort studies support that on average mood is improved with isotretinoin compared to other acne treatments (likely because acne itself can cause serious effects on mental health and isotretinoin is by far the most effective acne treatment).

@JohnDoe-nq8bo 14 дней назад

@@DrJohnBarbieri Thanks for your answer Dr

@emilyparker313 6 месяцев назад

Love accutane, definitely a power house. What do you think about combining low dose accutane + (topical adapalene 3 times per week)?

@DrJohnBarbieri 6 месяцев назад

I think it does not make much sense to combine oral and topical retinoids. The goal of oral isotretinoin is typically to induce a long-term remission. Since we typically try to treat to clinical endpoints (e.g. clear x2-3 months), having other topical treatments makes this more difficult to evaluate and is more work for the patient. The topical retinoid can also increase issues with dryness. However, mild topical retinoids like adapalene can be a good maintenance treatment for those after isotretinoin.

@dennisguilder1 Месяц назад

What are your thoughts on using fabior foam .1% for KPRF (keratosis Pilaris rubra faceii) instead of using Tazarotene gel or cream? Also this condition is tough to treat and seen literature if applying retinoids twice daily for severe acne scars like adapelene and they had better outcomes than once daily. Makes you wonder if applying twice daily could be better

@DrJohnBarbieri Месяц назад

Very hard to treat. When using retinoids, I prefer tazarotene lotion to other formulations as it has the strongest data the vehicle helps reduce irritation.

@dennisguilder1 Месяц назад

@@DrJohnBarbieri what are your thoughts on using Tazarotene twice daily for kprf to exfoliate skin more than once daily in that specific use case? I was using Tazarotene gel and now using fabior foam. Also thank you for reply!

@dennisguilder1 Месяц назад

@@DrJohnBarbieri can you do a video on kprf and your thoughts? Retinoids don’t help it much but I seen a study about topical sirolimus 1% cream applied TWICE daily for it. Also wonder about for bodily KP if just get pulse dye laser when everything else in existence fails.

@Macorelppa 6 месяцев назад

This channel will blowup in next 2 years just start responding to tik tok skin care videos.

@DrJohnBarbieri 6 месяцев назад

Glad you have found the content interesting!

@Levi-bs4oe 6 месяцев назад

Is there anything to can do to prevent an overly dry scalp. I am currently using a leave-in conditioner, hair oil, gentle shampoo, and a prescription ketoconazole shampoo; however, I am still met with dandruff and itchy mess as a result of Isotretinoin.

@DrJohnBarbieri 6 месяцев назад

Omega-3 seem to be a good strategy to prevent any kind of dryness from isotretinoin. However, dry and flaky scalp can have a variety of causes. Some of these, like eczema or contact dermatitis, might be worsened by isotretinoin. Others, like seborrheic dermatitis, sometimes improve with isotretinoin. When it comes to treating any skin problem, it is important to have the right diagnosis and seeing a dermatologist can be a good first step.

@davidsalve9648 4 месяца назад

Can topical retinol help with acne with the same effect as isotretinoin?, is topical retinol a good alternative to isotretinoin?

@DrJohnBarbieri 4 месяца назад

Isotretinoin is substantially more effective than topical treatments such as topical retinoids/retinol. However, for mild-to-moderate acne, a good multimodal topical regimen can often be effective (check out other videos on the channel for more about topical acne treatments).

@alexleee3885 5 месяцев назад

Hello, doctor. I'm currently on a low dose of Accutane, 10mg per day, starting my fifth month. Despite being on Accutane, I still get those annoying whiteheads/pustules. I had some azelaic acid left, so I started using it for its antibacterial effect, and it totally cleared up. However, it is drying, and sometimes it's hard to tolerate both, but without azelaic acid everuting comes back. As an acne expert, what's your opinion on my situation?

@DrJohnBarbieri 5 месяцев назад

Unfortunately, I cannot provide medical advice or speak to your specific situation. Most patients do need at least 120-150mg/kg of isotretinoin to achieve clear skin, so low dose regimens often take longer than higher dose regimens.

@isabelwall1714 3 месяца назад

I struggle with depression, am I guaranteed to experience, worsened, depression, or anxiety?

@DrJohnBarbieri 3 месяца назад

I can't speak to your specific situation, but on average people who are treated with isotretinoin experience improvements in depressive symptoms compared to those treated with other acne treatments. However, isotretinoin can rarely, and unpredictably, cause worsened mood or other mood changes.