The use of isotretinoin to treat acne was not associated with an increase in adverse neuropsychiatric outcomes, compared with the use of oral antibiotics, in a large retrospective cohort study published in the British Journal of Dermatology.
Although severe neuropsychiatric effects associated with isotretinoin therapy in patients with acne have been reported, "the evidence base…is mixed and inconclusive," and many studies are small, Seena Fazel, MBChB, MD, of the department of psychiatry, Oxford University, Oxford, UK, and co-authors write in the study.
The study results suggest that isotretinoin is conferring protection against adverse neuropsychiatric outcomes, particularly when compared with using oral antibiotics to treat acne, Fazel, professor of forensic psychiatry, at Oxford University, the study's senior author said in an interview.
In the study, the investigators reviewed electronic health records (2013-2019) from a primarily US-based dataset (TriNetX) of patients with acne aged 12-27 who had been followed for up to 1 year after their prescriptions had been dispensed.
There were four arms: those prescribed isotretinoin (30,866), oral antibiotics (44,748), topical anti-acne treatments (108,367), and those who had not been prescribed any acne treatment (78,666). The primary outcomes were diagnoses of a neuropsychiatric disorder (psychotic, mood, anxiety, personality, behavioral, and sleep disorders; and non-fatal self-harm) within one year of being prescribed treatment.
