Effect of oral isotretinoin on anxiety and depression in patients with acne

Objective: To study the side effect profile of systemic isotretinoin (ITT) and its association with anxiety and depression in the Indian population. Materials and Methods: In this prospective observational study, 300 patients of either gender, aged >12 years, taking oral ITT were evaluated for severity of acne by the visual analog scale (VAS) and psychiatric side effects with the Hamilton anxiety rating scale (HAM-A) and Montgomery Asberg Depression Rating scale (MADRS) at baseline up till the fourth visit. Software R version 3.6.0. was employed to analyze the data. Results: A significant improvement in VAS score was observed at baseline to final visit (P = 0.001). Significant increase in MADRS score was observed at baseline to final visit (P < 0.05) with mild and moderate depression in four (1.3%) and two patients (0.6%), respectively. On the contrary, a significant decrease in HAM-A score was observed over the visits (P < 0.05). Xerosis-Pruritus (79.7%) and cheilitis (82.7%) were the most common side effects observed. A trend from regular menstrual cycles to irregular menstrual cycles was found with ITT. With respect to lipid profile, a significant difference was observed at baseline values to the final visit (P < 0.05). Conclusion: ITT has proven its efficacy in reducing the severity of acne. Although it showed an improvement in anxiety, a negligible association was found with depression. Hence, ITT can be used safely as its benefits outweigh its side effects.