Those familiar with isotretinoin, the drug formerly known under the brand name Accutane — a heavy-duty prescription acne medication — are probably also familiar with the drug’s potential side effects, which include some serious warnings. Now, lawyers for a teen accused of murder are suggesting that the drug may have contributed to his violent behavior.
Isotretinoin has developed a reputation for delivering viral skin transformations, but doctors stress “it is a serious drug that requires close monitoring,” Joshua Zeichner, director of cosmetic and clinical research in dermatology at Mount Sinai Hospital in New York City, previously told Allure.
The issue with the drug is that its side effects can be grave. In addition to severe skin irritation and birth defects, some studies cite a possible association between isotretinoin use and serious mental health issues. Studies of the drug performed over the last decade have suggested links between isotretinoin and anxiety, depression, bipolar disorder, and even psychosis.
A 2015 review of that research published in the World Journal of Psychiatry concluded: “There is strong evidence from the psychiatric literature that demonstrates an association of isotretinoin to depression, probable clinical exacerbation of bipolar mood disorder and possible links to psychosis.” However, while there have been suggested relationships between isotretinoin use and depression and anxiety, the American Academy of Dermatology’s official position is that, based on current evidence, isotretinoin is still appropriate to use if patients are aware of the risks.
But mental health effects from isotretinoin are now being cited in the trial of a 15-year-old charged with first-degree murder and 10 other counts in the alleged stabbing of a 20-year-old woman in Colorado last year. In a report by the Longmont Times-Call, lawyers for the teen suggested in court last week that they may cite isotretinoin in their defense (though it was never explicitly stated that the defendant was using the acne treatment at the time of the murder).
According to the Times-Call, the defense attorneys in the case hope to have Doug Bremner, a psychiatrist known for his research on the effects of the drug, testify how isotretinoin might be linked to violent behaviors. They argue that he may also be able to testify how patients who experience mental health effects from isotretinoin may be rehabilitated after they stop using the drug.
In the American Academy of Dermatology‘s official position on isotretinoin (last amended in 2010), they noted that some “studies give evidence that treatment of acne with isotretinoin was accompanied by improvement of both depressive and anxiety symptoms, as well as improved quality of life of patients with acne.” They concluded, “the prescription of isotretinoin for severe nodular acne continues to be appropriate as long as prescribing physicians are aware of the issues related to isotretinoin use, including IBD or psychiatric disturbance, and educate their patients about these and other potential risks,” the statement reads. “Physicians also should monitor their patients for any indication of IBD and depressive symptoms.”
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