Rather than admit that one of their silver bullets, Accutane (isotretinoin), which was a “goose laying the golden egg” for F. Hoffman-La Roche Pharmaceuticals (and their various “Roche” associates world-wide) to the tune of a billion dollars a year, could make kids depressed or kill themselves or cause grotesque birth defects in the kids of over half of women exposed when pregnant, dermatologists have sung themselves a lullaby that their magic pills don’t make kids depressed, they actually make them better, by clearing up pimples that drive them to despair. In what can only be described as a tragic collusion of conflicts of interest (COI) amongst their Key Opinion Leaders (KOLs) and willful denial amongst the lowly rank and file, they have decided to say “What? Me Worry?”

When the heat got turned up on Roche Pharmaceuticals after the son of Congressman Bart Stupak’s (D-Mich) son Bart Jr. died of suicide while on Accutane in 2000, they got busy and called a “Scientific Advisory Board” meeting at the Ritz Carlton in Alexandria, Virginia, to opine on the topic of the relationship between Accutane treatment and depression. This meeting included figures from psychiatry like Kathleen Merikangas, PhD, Stuart Montgomery, PhD, and David Nutt, MD, Chair of Dermatology David Bickers MD, and psychiatrist Douglas Jacobs, MD. Between the lot of them I think they have written about one paper total in the literature on the subject. But they did get paid a nice consulting fee for their efforts.

Accutane and depression

Their conclusion? No relationship, of course.

Fact is Accutane’s efficacy for acne was discovered a decade before Roche put a patent on it, in a paper in the New England Journal of Medicine.

I have communicated with two of the authors, both dermatologists, Frank Yoder MD and Gary Peck, MD.

Both of them agreed with my opinion that Accutane can cause depression in some individuals.

What is really sad about this whole sordid tale is how degenerated the so-called dermatology “literature” has become on the topic.

For example, the most commonly cited study to support the statement that acne is associated with depression, a study that has been cited several hundred times by dermatologists writing in the literature, involved only ten patients with acne and no comparison subjects (Gupta et al., 1990). No statistics were performed (obviously since there was no comparison group). Scores on the questionnaires for anxiety and depression were not related to severity of acne.

And the fact is that the rest of the literature isn’t any better. Objective measures of acne do not correlate with severity of anxiety or depression. Acne does not cause major depression. It is simple as that.

Sure, kids worry about their zits and feel better when they go away, but the studies do not support the conclusion that acne causes major depression, and that treatment of acne cures depression.

In spite of this the manufacturer of Accutane, Hoffman-LaRoche, has consistently downplayed the risks of suicide and depression and has denied a causal association (McCoy, 2004). The dermatology community has joined with the manufacturer in praising the merits of this medication for the treatment of acne which they describe as the “penicillin of dermatology”. It took only 10 months for the FDA to approve Accutane for the treatment of cystic and nodular acne in May of 1982, however controversy has followed it from the time of its initial launch. In January of 1983 one of the authors of the first paper to describe the use of isotretinoin for the treatment of acne in 1977, Dr. Frank Yoder, wrote about the potential dangers of Accutane (Yoder, 1983). In 1990 Dr. David Graham of the FDA highlighted the inability of the Dermatological Medications Advisory Committee to the FDA to be impartial since it was made up entirely of dermatologists (Green & Hutt, 2002). At that time he stated that Accutane should be taken off of the market, mainly because of the risk of birth defects. Indeed its use has always been curtailed or highly restricted in European countries, unlike the US where it is often prescribed for minor blemishes. Strong feelings about the utility of isotretinoin for the treatment of acne in the dermatology community, and forceful marketing by the manufacturer in the US, have caused a delay in awareness of the potential risks in the US. In 1998, the year that the FDA first approached Hoffmann-LaRoche about adding a warning related to suicide with Accutane to its label, the manufacturer ran an ad that stated, “Effective treatment of severe recalcitrant nodular acne minimizes progressive physical scarring, as well as negative psychosocial effects such as depression and poor self image” (Green & Hutt, 2002). This was in spite of the fact that less than half of patients prescribed the medication actually had nodular acne. The FDA required that Hoffman-LaRoche pull the ad.

In 2000 Congressman Bart Stupak’s son, Bart Jr., committed suicide while on Accutane. Congressman Stupak called for congressional hearings on the safety of the drug and in September of that year the FDA called a Dermatologic Advisory Committee meeting on the topic. In November of 2001 an educational grant from Roche funded a supplement of the Journal of the American Academy of Dermatology on isotretinoin which followed the Scientific Advisory Board Meeting in Alexandria VA they held on the topic. The basic science-related articles focused on retinoids and the skin, essentially ignoring the large extant literature on retinoids and the central nervous system. Psychiatric side effects merited literally two sentences, and one article, written by one of Roche’s hired guns, stated that there was no evidence for any association (Jacobs et al., 2001), ignoring the reported challenge-rechallenge cases which have been cited in the pharmacoepidemiology literature as adequate in and of themselves to establish causality (Strom, 2005). This led members of the FDA to write a letter of response, “in the interest of public health,” admonishing the authors of these articles for the short shrift they paid to the issue of Accutane and psychiatric side effects (O’Connell, Wilkin, Pitts, 2002).

The degree to which dermatologists have thrown science and logic out of the window in order to protect their magic bullet is simply remarkable. For instance in a 2004 article entitled “Myths of Isotretinoin Therapy” (Alcalay, 2004) “isotretinoin causes depression and suicide attempts” was listed as a “myth”. The article went on to state that any risk needed to be “weighed against the increasing prevalence of depression among adolescents and young adults and the psychological impact of acne.” [In fact, depression is not increasing amongst teenagers and acne has not been associated with clinical depression, rather only changes in self esteem].

Aktan, S., Ozmen, E., Sanli, B. (2000). Anxiety, depression, and nature of acne vulgaris in adolescents. International Journal of Dermatology, 39, 354-357.

Alcalay, J. (2004). Myths of isotretinoin therapy in patients with acne: A personal opinion. Journal of Drugs in Dermatology, 3(2), 179-182.

Green, J., Hutt, P. (2002). Babies, blemishes, and FDA: A history of Accutane regulation in the United States., Leda. Cambridge, MA.

Gupta, M. A., Gupta, A. K., Schork, N. J., Ellis, C. N., Voorhees, J. J. (1990). Psychiatric aspects of the treatment of mild to moderate facial acne: Some preliminary observations. International Journal of Dermatology, 29(10), 719-721.

Jacobs, D. G., Deutsch, N., Brewer, M. (2001). Suicide, depression, and isotretinoin: Is there a causal link? Journal of the American Academy of Dermatology, 45, S168.

Kellett, S. C., Gawkrodger, D. J. (1999). The psychological and emotional impact of acne and the effect of treatment with isotretinoin. British Journal of Dermatology, 273-282.

McCoy, K. (2004, December 7, 2004). Drug Maker rebuffed call to monitor users. USA Today, pp. 1-2.

O’Connell, K. A., Wilkin, J. K., Pitts, M. (2002). Isotretinoin (Accutane) and serious psychiatric adverse events. Journal of the American Academy of Dermatology, 48(2), 306-307.

Shuster, S., Fisher, G. H., Harris, E., Binnel, D. (1978). The effect of skin disease on self-image. British Journal of Dermatology, 99(Suppl 16), 18-19.

Smithard, A., Glazebrook, C., Williams, H. C. (2001). Acne prevalence, knowledge about acne and psychological morbidity in mid-adolescence: a community-based study. British Journal of Dermatology, 145, 274-279.

Strom, B. L. (Ed.). (2005). Pharmacoepidemiology (4 ed.). New York: Wiley.

Van der Meeren, H. L. M., van der Schaar, W. W., van den Hurk, C. M. A. M. (1985). The psychological impact of severe acne. Cutis, 36(1), 84-86.

Wu, S. F., Kinder, B. N., Trunnell, T. N., Fulton, J. E. (1988). Role of anxiety and anger in acne patients: Relationship with the severity of the disorder. Journal of the American Academy of Dermatology, 18, 325-333.

Yoder, F. W. (1983). Isotretinoin: A word of caution. Journal of the American Medical Association, 249(3), 350-351.

 

Originally posted Jan 5 2008

EDT: My book The Goose that Laid the Golden Egg: Accutane, the truth that had to be told is now out and available on Amazon in the US and UK.

42 Responses to Accutane and Depression: A Depressing Tale

  1. [...] down into lower levels of spiritual and mental functioning. On top of this Dr. Nutt was part of the shameful Advisory Board to Hoffmann-La Roche Pharmaceuticals at the Ritz Carlton in Alexandria, VA, in about 2002, where [...]

  2. Catherine Cocciolone says:

    Our highly intelligent and capable son, with obvious and abundant potential, who at only 19 years of had a range of humanitarian and intellectual interests committed suicide after 8 months of continuous treatment with Isotretinoin (marketed in Australia as Roaccutane). His dermatologist did not acknowldege that his depression was caused by Roaccutaene and did not treat it. This is a crime. Why is this drug still on the market? How many more young people have to die? How many more families have to suffer watching their teenagers decline and then suffer the hopelessness that leads to suicide? The manufacturers of this drug are without humanity.

  3. Doug Bremner says:

    The Australian Drug Regulatory Agency had commented on the risk of Accutane and suicide several years ago, as well.

  4. Doug Bremner says:

    You are citing a single abstract you picked up trolling the internet while I have spent hours reviewing the literature and the so called link between acne and depression does not exist. Your numbers on suicide related to Accutane are way off and the FDA says that reported adverse events correspond to as little as 1% of true cases. Roche has pulled Accutane off the market, so they must not think the risk-benefit ratio is that great either.

  5. Stephany says:

    As an FYI, Supremacy Claus was banned from my blog as well as 2 other well-known blogs you are familiar with Doug.

  6. Stephany says:

    Yeah, SC and you used to write that I believed 911 was a conspiracy on another mental health blog.

  7. Doug Bremner says:

    I deleted some comments by a drug rep from Tap Pharmaceuticals who has made a career as a troll writing gratuitous comments insulting myself and other commenters and who has been banned from several other web sites. I am all for the free exchange of ideas but those who insult others are not welcome here.

  8. C says:

    I find your post to be ridiculous and unprofessional. My face was completely deformed from cystic acne three years ago. I was fortunate that there was a drug that could help me – while I acknowledge that accutane may cause medical problems, you seem to ignore all the good effects people have seen from it. Perhaps next time you decide to write a post, you will be more professional and include the arguments for and against. There are a lot of people out there who have experienced many benefits from accutane – I am one of them.

  9. Morgan says:

    The time for this toxin on the market is approaching it’s end, even if it has helped many, the long-term risks are just too great. Retinoids are casual to schizo, depression, psychosis, etc. isotretinion needs to go

  10. Morgan says:

    My list of side effects :

    Started months after treatment and slowly got worse

    Psychological effects -

    depression : I do not enjoy life like I did, actually I enjoy absolutely nothing, I’m restless, I can’t find peace, accutane partly killed my soul. Suicidal impulses come throughout the day.

    problems concentrating : I’m not as sharp as I used to be, I can’t think as clearly, I’m just not mentally on top of my game.

    fatigue : major apathy, tired, no energy, don’t respond to feelings like I used to.

    memory loss : I forget where I put things and so on, I forget what I talk about

    physical effects -

    Joint pains : All my joints click and crack especially my neck, they are sore as well.

    Hairloss : I had a thick full head of hair, now I’m balding

    sexual dysfunction/lowered libido : I’ve lost all interest in sex, and it is no longer pleasurable.

    Painful intercourse : skin on urethra has been thinned out to the point I have troubles wearing underwear because of the pain

    IBS : I have no craving for food or any appetite at all, severe abdominal pains come and go.

    sjogrens syndrome : my eyes, hair, skin, mouth, lips, nasal passage are all extremely dry.

    Intolerance to alcohol : 1 beer gives me body cramps and severe head aches, never did before accutane.

    I can cope with most of these symptoms, it’s the psych effects and the sexual problems that really bother me. I guess there is not much to do anymore, various treatments have failed, the problem with ssri’s is the effect doesn’t last, and they don’t solve the problem, Dr. Bremner do you know the best anti depressants to treat accutane-induced depressions?

  11. Amy Philo says:

    Um… Morgan was your last sentence a joke? I have a hard time knowing. If you were on SSRIs while on Accutane, you barely stand a chance at not being depressed. You’re lucky you’re alive.

  12. Morgan says:

    I was never depressed before accutane, nor on ssri’s, didnt even know what they were

  13. Morgan says:

    sorry for the miscommunication

  14. Amy Philo says:

    No my point is that SSRIs cause depression and suicide etc. So if you were on both Accutane and SSRIs at the same time, or if you are off Accutane (obviously) but still depressed, SSRIs may be the cause too. Both of them cause depression is my point. Other antidepressants are similar. All of them can cause depression. Look for alternatives or allow yourself to heal from the Accutane.

  15. Morgan says:

    Accutane’s effects are permanent. The healing of the brain, even if it exists is minimal. Accutane differs from many other medicines. It is one of the only on the market, for non deadly conditions that influence gene-expression in such a severe way, that it is permanently harmful to the brain.

    The brain changes it´s structure all through life, and being negative is not the same as being depressed. I can think with a positive mind lots, but I still don´t have the feelings that I should have. Not because of a mental block, but because I am physically unable to feel them.

    Roche pharmaceuticals are the ones to blame for this. They knew from the very beginning that some people were to kill themselves on the drug, or after ingesting the drug. They knew that some were going to suffer from it, life long, with the knowledge that it was the drug that ruined it all for them.

    The patient is of no whatsoever concern in the Hoffman La-Roche culture. They do not have feelings, what counts is how much they can profit, nothing else.

    That is the way it is. They would easily kill 50% of their patients if they just earned from it. They will never admit do anything, or donate money for cures. One can count on nothing from Hoffman La-Roche, there is people in this world that are such.

  16. Doug Bremner says:

    A psychiatrist went from being deeply involved with the psychotropic drug industry to someone who eventually took on a multibillion dollar drug company over their acne drug Accutane. This drug, which made a billion dollars a year for the company at one point, was causing teenagers to commit suicide. The drug company tried to discredit him which led to a crisis in his career and family life. He then went back and re-visited the trauma of the death of his mother in early childhood and eventually was able to come back and fight against the drug company. The drug was taken off the
    market two weeks ago.

    The story is true, and it is based on my life.

    I am writing a screenplay about this story which is almost finished.

    If anyone is interested in this story, let me know.

  17. Amy Philo says:

    Good for you Dr. Bremner. Morgan can you email me at amy@uniteforlife.org so I can send you a private message?

  18. bosox88 says:

    Hello

    I’m a 21 year old male who took accutane for six months in 2005(I believe I was on a generic and I definately had my dosage increased over the 6 month course). I have experienced anxiety,depression,possibly psychosis,hair loss, insomnia and jaundice(especially around inner eye) Currently I’m trying to learn all I can about the long term side effects of the drug/effects of drug when combined with alcohol while taking it/any information that might helpe with these side effects.

    Morgan, do you have any articles that explain what you are talking about with accutane and gene expression.

  19. [...] there here. Why I am Not Getting a Flu Shot This Year. DSM-5 Internet Addiction Disorder? Armag Are Dermatologists Dippy? The Depressing  Motherhood is Not a Medical Disorder  What Ever Happened to Pharmagiles?  Taking Ecstasy Not [...]

  20. Anne says:

    Generic Accutane had our 15 year old son commit himself to a psychiatric hospital, because he started having thoughts that he wanted to hurt himself and/or others.
    My husband took brand name Accutane over 10 years ago. He told me that it caused him great anxiety and a lot of muscle aches, but it did work for him.
    An age limit should most definitely be put on prescriptions for this medicine. A grown man was much better able to handle the side effects than a young teenage boy.

  21. fale says:

    I was on this at 13-14, about 20 years ago. What surprises me is that no one studied these kids BEFORE the drug for suicide. I remember seeing myself in a mirror brought thoughts of suicide before I even took Accutane. The thoughts continued until my skin cleared (during the second round). The round ended about a month or two after I cleared…and I was totally happy…still on the drug. People with severe acne are depressed way before they start accutane, because of the way they look and the way they are treated because of it. This was a miracle, without this drug, I would have killed myself, because of it, I am alive and happy with my appearance.

  22. Jan says:

    I have 5 children. 4 used Accutane in the 90′s. All 4 of them have moderate to severe depression. Talks of suicide. They are in their late 20′s and early 30′s now. Does this ever leave their systems? What do we do now?

  23. Jen C says:

    I like to know who is going to take on the gerincs companies of Accutane???? Does anyone even care anymore??? Beware they are in phase III of a new form of Accutane. More will be damaged or dead.
    Good work Dr. Bremner, I hope you keep us updated on the appeal won in the suicide case.

  24. [...] have written about the effects of Accutane on depression (see “Accutane and Depression: A Depressing Tale“) and have gotten a lot of heat about it in the past. Nevertheless, the evidence continues to [...]

  25. markbosox88 says:

    Hey Jan a gluten free diet has helped my symptoms although not cured all of them. Some others with post accutane sides have had some success with this as well; but it doesn’t seem to help everyone.

  26. Rebecca says:

    I have experienced horrible psychiatric side effects – mostly severe depression and loss of mental functioning. Wellbutrin has helped a bit, but I am afraid of how long I can take this and what I will be like without it. I know the depression is still there in all its severity and I know Accutane significantly changed the person I was- from happy all the time and (probably too) confident to shaky, anti-social, and without Wellbutrin completely lifeless and sad.

    We’re going on two years since I stopped taking it. Can ANYONE tell me if this will ever go away, if there is any way to improve chances of my brain recovering, or if Wellbutrin is OK to take long term or will continue working? Anyone have successes with other non-prescription remedies?

    Please help. I am only 23 and the thought that this could have ruined my incredibly happy life and bright future is beyond terrifying.

  27. Ron says:

    MY daughter took a 4 month treatment of accutane 5 years ago. An Carefree A student before the treatment turned into a life of poor grades, memory loss, and very bad depression with thoughts of sucide on a daily basis. Now her life is filled with sorrow and no intrest in anything. As a Dad I cry inside over my decision to go to the dermatoligist and to allow using the drug on her.

  28. Rebecca Disbrow says:

    Ron,
    I feel like I may be a similar case to your daughter (see post above). Get her to seek continuous medical treatment, even when she may be too depressed or hopeless to want to.
    Wellbutrin has worked for me. SAM-E has also been decent. I take contant vitamins, b especially, ginko biloba (increases circulation to the brain) and have come to terms that I may be on anti-depressants forever. But I am 85% of who I used to be, and that is far, far better than where I was a year ago.

    You might get some solace from talking to my mom (Debi – dndisbrow@aol.com) who I don’t think has stopped crying over this for two years.

    Best to you and your family.

    -Rebecca

  29. [...] have written about the effects of Accutane on depression (see “Accutane and Depression: A Depressing Tale“) and have gotten a lot of heat about it in the past. Nevertheless, the evidence continues to [...]

  30. mona says:

    i have just started taking this roaccutane and i have seen some new things happinging to me such as lossing my concentartion and forgeting plus im un happy most of the time and having insomnia the thing is the only drug im taking at the moment is this so it made me look for answers. dont really know if its the cuz my treatment should be for the up coming 6 months and im worried no idea wt to do shall i stop it ?

  31. Doug Bremner says:

    @Mona Sounds like your problems are related to Accutane. Your dose may be too high and you may not need to take it for a full six months.

    By book about Accutane is now out and available in paperback or on kindle for $0.99
    http://www.amazon.com/Goose-That-Laid-Golden-Egg/dp/1463648812/ref=tmm_pap_title_0

  32. Doug Bremner says:

    My latest book ‘The Goose That Laid the Golden Egg: Accutane, the truth that had to be told’ has been released. It has 39/42 five star reviews on Amazon.
    http://www.amazon.com/Goose-That-Laid-Golden-Egg/dp/1463648812/ref=tmm_pap_title_0

  33. Jen says:

    Mona – I really hoped you stopped taking Accutane! Please do it is not worth your health.

  34. Rebecca Disbrow says:

    To everyone who still reads this blog – I posted here almost a year ago, terrified and seeking answers and help. I found help, a real solution that I think has cured all of the mental side effects from Accutane. It is called neurofeedback and is a brain-frequency-training treatment that helps you to retrain your brain to operate at the right frequencies in the right area. I had a quantitative EEG done in May, and it showed considerable damage – perfectly in line with what Dr. Bremner predicted in his research. In the last 6 months I have been able to completely correct all the excess slow brain waves (typical of depression) and have not felt “depressed” a single day in several months.

    My normal energy returned, my desire to do nice things for others, my motivation and excitement about my future, my relationship with my mom – the person I used to be came back, and I noticed the change within a couple of weeks.

    It is a long and expensive treatment that requires dedication and a lot of time / effort – but it works, and it works on the “permanent” damage done by accutane. (It also is more commonly used to treat people with epileptic seizures and ADD, as well as depression, stutter, migranes, and a long list of other mental disorders)

    I hope anyone out there who is still suffering the side effects of this drug will google neurofeedback and schedule a consultation with a provider nearby. If anyone wants copies of my EEGs (current, previous, or both) to look at or show to a neurofeedback specialist, I’d be happy to share them. The differences are remarkable, and they’re shown through quantitative tests.

  35. mary says:

    Dr. Bremner, we are so appreciation of your ongoing work to uncover the neuropsychiatric effects of accutane. Your recent comprehensive publication in the Journal of Clinical Psychology (e-publication, printed August 23, 2011)is very insightful, offering clear evidence that Accutane can adversely affect vulnerable patients, albeit, in different ways. There is no question that there is a great deal of under-reporting going on especially since depressive episodes can often begin after treatment is completed, and that accutane (or the generic of) can have lasting effects after being discontinued. Also, many clinicians have difficulty believing that depressive episodes can begin after treatment is completed. Our family has been deeply affected since our daughter has been one of those vulnerable patients, who has had severe ongoing depression. She continues to experience unrelenting symptoms of depression and anxiety, seven years after accutane use. We were informed that Accutane likely triggered a severe bipolar disorder. She had 2 rounds of accutane for 3 month periods each about 7 years ago. Accutane was discontinued and dermatologist immediately notified after she showed dramatic behavioral changes (uncharacteristic bouts of anger) a couple weeks after her dose was increased. She developed a long lasting major depression 5 weeks later. FDA, and Roche Hoffman were notified immediately and psychiatric care initiated. Her ongoing cognitive deficits, and fragile mental health status has been minimally responsive to multiple mood stabilizers and other appropriate psychopharmacologic treatments. During the first few years, we faced tremendous judgement and irresponsible care from clinicians who failed to listen to clinically relevant information from family and recognize that our daughter’s condition was indeed related to accutane. Over the past couple years we have been grateful to have top-notch psychiatrists involved in her care. Although it is felt that accutane likely propelled her depression and treatment resistance, the major focus is to vigilantly treat her ongoing symptoms, which include high anxiety, deep depression, cognitive decline, and mixed states. Our entire focus was in helping our daughter during these very difficult years. We have had no time, energy nor financial ability to pursue any legal consultation. The statute of limitations passed. Our efforts have focused on our daughter’s care. We will do anything possible to help her. However, she remains treatment resistant, now at 24 years of age.

    Dr. Bremner, she has not had any imaging to date.

    We wonder if imaging, ie, pet scan or MRI could show some reason that accutane may have contributed to her treatment resistance, with respect to permanent damage or whether she is expereinceing a kindling effect from ongoing depressive episodes over the past 7 years.
    Many thanks for what you have done. I’m a seasoned health care practitioner and totally feel the FDA has missed the boat in not taking the generic as well off the market. The dermatology community and big pharma clearly have their stakes in keeping this deleterious drug around. There is no question that this medication must be discontinued, until patients can be adequately screened (either by labs or imaging) to prevent long term and possible permanent damage to vulnerable patients

  36. rebecca disbrow says:

    Mary,
    I’m so sorry to hear of your daughters condition. I too am 24 and experienced similar intense mood disorder and cognitive deficiencies. Read my post above, i think it may be very helpful. this last resort treatment I found truly gave me my life back. Feel free to contact me dirextly at Rebecca.disbrow@gmail.com

    Sincerely,
    Rebecca

  37. Doug Bremner says:

    I wouldn’t recommend getting brain scans. It has already been established that accutane can cause depression and cognitive problems and a brain scan is not required to prove that in individuals cases and in any case doesn’t affect treatment. If you are having problems finding a doctor that doesn’t believe it could cause these changes I would suggest getting another opinion. I have heard about a lot of these cases and recovery can be slow but it seems like there can be recovery even over the course of years. I have heard some positive feedback on neurofeedback therapies.

  38. Rebecca Disbrow says:

    Dr Bremner – In the case of neurofeedback, the two qEEG’s I’ve had done were very very helpful in my treatment. I was able to target specific deficiencies and the treatment actually drastically changed the areas we targeted exactly the way we hoped. It did, however, lead to some other deficiencies (much, much better though), so the continued testing-treating regimen, although expensive, has allowed for tailored treatment that has been effective.

    Just my two cents. I know how much this can suck, and also how absolutely unresponsive 90% of practitioners can be to Accutane-related issues, including psychiatrists, dermatologists, general physicians, psychologists, etc. In my experience neurologists and neuro-psychologists have been the most open minded, responsive, and helpful.

  39. mary says:

    Dr. Bremner,
    Thank you for your helpful feedback about imaging. Also, Rebecca, many thanks for your recommendation to pursue neurofeedback; my daughter will begin this coming week.

    Dr. Bremner: In addressing psychopharm agents which could be helpful in treating ongoing accutane induced depression, mood lability, cognitive decline and anxiety, have you heard of any specific medications which have helped other patients with the above issues? I realize each patient has their own story and care must be individualized. However, my daughter’s psychiatrist advised that I blog you again to ask if you know of any psychopharm agent/s which have been particularly helpful in treating patients with similar bipolar manifestations, with respect to treatment of depression, mixed states and cognitive/ADHD symptoms associated with accutane use.

  40. Doug Bremner says:

    There aren’t any specific medications that are useful for Accutane related neuropsychiatric effects other than what you would normally use for depression, bipolar, etc.

  41. Chris Silva says:

    Dr. Bremner – you are amazing, simply put. Thank you for all the time and energy you have dedicated to these discoveries. There are many people, including myself, that suffer because of this drug, in where certain people have peddled, or helped peddle in one way or another. To everyone out there – please sign my petition – together we can achieve success against this industry giant. With support, we can clearly identify the problems, and work towards a healthy, wholesome solution, vs taking more drugs and damaging ourselves further, and feeding the machine further..the industry will change when the consumer changes their decisions. Together we can find not just a drug to cover symptoms, but a natural,healthy cure.

  42. Sergio says:

    Mary,

    How is your daughter doing now after the neurofeedback? I hope she got better !!

    all the best

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