Acutane

[Lisa761]

My son is 17 years old and has struggled with acne for 5 years.  He has tried different oral medicines and topical creams and nothing seems to work.  A dermatologist recently prescribed Acutane for him.  I am very skeptical about him taking it because of the bad side effects I have read about.  I read that people have had suicidal tendencies after taking this medicine.  My son has ADHD and struggled with depression in the past.  Is this a medicine that you think would work for him or possibly do more harm than good?

[loiloi]

Hi Lisa, this is a really good question and a situation i can empathize with.
No causal link has been established between accutane and depression. However, the makers of accutane Roche have included depression as a possible rare side effect as some patients have experience this. Some people think the cases of depression are linked to the features of the patient group taking accutane rather than the drug itself. People with severe acne are often adolescent males who have a higher suicide rate than the general population. It can also be argued that acne itself causes depression.
Accutane has a high success rate with most patients achieving long term remission from their acne after one course of treatment lasting 16-24 weeks. Occassionally a second or third course is necessary, I have taken accutane twice. Anti-biotics and topical preparations are useful in treating acne but repeat prescriptions will be necessary for as long as the patient is prone to acne. The most useful topical acne gel is Differin, has your son tried this? Have you also looked into laser treatment which would avoid the need for oral treatment?
My son is nine and has had acne all his life. He also has cerebral palsy and Aspergers syndrome so I do worry about what acne treatment would help him in the future. The most common side effects of accutane are very dry skin and lips. Some people also experience muscle and joint ache. The acne can also get worse in the first two weeks before starting to get better. Would your son be able to cope with these side effects?
The dermatologist should have taken a full medical history before prescribing accutane. Was he aware of your son's previous depressive states when he decided the expected benefits of accutane outweighed any potential side effects?
If your son experiences any distressing thoughts or actions whilst on accutane he should take no further tablets and go to the nearest doctor or hospital.
Loiloi xx