Isotretinoin and the risk of psychiatric disturbances: A global study shedding new light on a debatable story

Abstract

Introduction: Isotretinoin-related risk of depression and suicidal behavior is a topic of inconclusiveness. A crucial knowledge gap exists in defining the association of isotretinoin with other psychiatric comorbidities. Objective: To evaluate the risk of psychiatric outcomes among patients with acne treated with isotretinoin versus oral antibiotics. Methods: A global population-based retrospective cohort study enrolled 2 groups of patients with acne managed by isotretinoin (n = 75,708) and oral antibiotics (n = 75,708). Patients were compared regarding the risk of 9 psychiatric outcomes. Results: Relative to those treated with oral antibiotics, patients prescribed isotretinoin experienced lower risk of depression (hazard ratio [HR], 0.90; 95% confidence interval [CI], 0.87-0.93; P