No association found between patients receiving isotretinoin for acne and the development of depression in a Canadian prospective cohort

Can J Clin Pharmacol. Summer 2007;14(2):e227-33. Epub 2007 Jun 6.


Background: There has been concern that the use of isotretinoin to treat acne may lead to depression. To date, research has not conclusively determined if this concern is warranted when contemplating the use of isotretinoin.

Objective: This study investigated the impact of isotretinoin use for patients with acne on mood status. The hypothesis was that an association exists between the use of isotretinoin and the development of depression, aside from acne severity.

Methods: We studied the relationship between isotretinoin and depression using a prospective, controlled, cohort design. The study was conducted in a community dermatology clinic. The exposed cohort consisted of consenting patients who were initiating isotretinoin treatment for acne. Patients were either treated with isotretinoin (Acutaneï) therapy (study group) (N=100) or by oral (N=41) or topical acne therapy (control group) (N=59). The Center for Epidemiologic Studies Depression scale and the Zung Depression Status Inventory were used to assess depression both at baseline and after 2 months of prescribed use of isotretinoin or a control medication (topical or oral antibiotics).

Results: There was no correlation between isotretinoin use and the development of depression, based on either the Centre for Epidemiologic Studies Depression scale (Fisherâs exact test, P=0.497) or Zung Depression Status Inventory (ANOVA; F=1.4, P=0.2).

Conclusion: Isotretinoin does not appear to be associated with the development of depression. Thus, denying patients with significant acne an effective medication for fear of developing depression may not be indicated at this point in time.

Publication types

  • Controlled Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acne Vulgaris / drug therapy*
  • Acne Vulgaris / epidemiology
  • Administration, Oral
  • Administration, Topical
  • Adolescent
  • Adult
  • Affect / drug effects
  • Anti-Bacterial Agents / administration & dosage
  • Anti-Bacterial Agents / therapeutic use*
  • Canada / epidemiology
  • Cohort Studies
  • Community Health Services
  • Depression / chemically induced*
  • Depression / epidemiology
  • Dermatologic Agents / adverse effects*
  • Female
  • Humans
  • Isotretinoin / adverse effects*
  • Male
  • Prospective Studies
  • Psychiatric Status Rating Scales
  • Research Design
  • Risk Assessment
  • Risk Factors
  • Severity of Illness Index
  • Treatment Outcome


  • Anti-Bacterial Agents
  • Dermatologic Agents
  • Isotretinoin