ArticleThe British journal of dermatology2022
Isotretinoin and adverse neuropsychiatric outcomes: retrospective cohort study using routine data.
Article in The British journal of dermatology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis that pooled it.
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Who cites it
11 citing papers in PubMed, 1 synthesis or guideline pooled it.
- The Burden of Acne Vulgaris on Health-Related Quality of Life and Psychosocial Well-Being Domains: A Systematic Review.American journal of clinical dermatology · 2026Pooled it
- Real-World Evidence of Neuropsychiatric Adverse Reactions to Isotretinoin: Insights from EudraVigilance (2005-2025).Pharmaceuticals (Basel, Switzerland) · 2025Article
- Toxic Effects of Excess Vitamins A, B6, and Folic Acid on the Nervous System.Behavioural neurology · 2025Review
- Isotretinoin-Induced Dyslipidemia: a Single-Center Study in Saudi Arabia.Patient preference and adherence · 2024Article
- Article
- High Levels of Anxiety, Depression, Risk of Suicide, and Implications for Treatment in Patients with Lamellar Ichthyosis.Healthcare (Basel, Switzerland) · 2023Article
- Isotretinoin use for acne is not associated with an increased risk of migraine, fibromyalgia, multiple sclerosis, or neuropathy: A matched, retrospective cohort study.Journal of the American Academy of Dermatology · 2023Article
- Truncal Acne and Scarring: A Comprehensive Review of Current Medical and Cosmetic Approaches to Treatment and Patient Management.American journal of clinical dermatology · 2023Review
- Antibiotic exposure is associated with decreased risk of psychiatric disorders.Frontiers in pharmacology · 2023Article
- Physiological and Psychological Effects of Isotretinoin in the Treatment of Patients with Acne: A Narrative Review.Clinical, cosmetic and investigational dermatology · 2023Review
- Acne treatment challenges - Recommendations of Latin American expert consensus.Anais brasileiros de dermatologiaReview
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5 authors.
Funding
Abstract
backgroundSevere neuropsychiatric outcomes have been reported in individuals exposed to isotretinoin, but the evidence is inconclusive and complicated by several methodological limitations.
objectivesTo establish and quantify the association between isotretinoin use for acne and 1-year incident neuropsychiatric adverse outcomes.
methodsA propensity score-matched cohort study of electronic medical records between the years 2013 and 2019 with patients followed up for 1 year after their index dispensed prescription was conducted. The database included over 12 million patients aged 12-27 years. We analysed data for individuals with acne in this age range with a dispensed prescription for isotretinoin or a control prescription. Outcomes included diagnoses of any incident sleep or mental health disorder, or nonfatal self-harm within 1 year of the index prescription.
resultsWe included 30 866 patients prescribed isotretinoin for their acne, 44 748 prescribed oral antibiotics, 108 367 prescribed topical anti-acne agents and 78 666 patients with acne but without an anti-acne prescription. After propensity score matching for baseline confounders, the odds ratio (OR) for any incident neuropsychiatric outcomes in patients with acne exposed to isotretinoin was 0·80 [95% confidence interval (CI) 0·74-0·87] compared with those on oral antibiotics; 0·94 (95% CI 0·87-1·02) compared with those using topical anti-acne medicines; and 1·06 (95% CI 0·97-1·16) compared with those without a prescription for anti-acne medicines. Patients exposed to isotretinoin experienced significantly more incident physical symptoms than patients in any of the three comparison cohorts.
conclusionsIsotretinoin was not independently associated with excess adverse neuropsychiatric outcomes at the population level. When monitoring potential adverse outcomes during isotretinoin treatment, clinicians should also consider the high mental health burden associated with treatment-resistant acne and the potential contribution of physical side-effects of prescribed medication on mental health.
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