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Isotretinoin treatment for acne and risk of depression: A systematic review and meta-analysis

  • Yu-Chen Huang
    Correspondence
    Correspondence to: Yu-Chen Huang, MD, Department of Dermatology, Wan Fang Hospital, Taipei Medical University, 111, Hsing-Long Road Sec 3, Wenshan District, Taipei City 116, Taiwan.
    Affiliations
    Department of Dermatology, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan

    Department of Dermatology, School of Medicine and College of Medicine, Taipei Medical University, Taipei, Taiwan
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  • Ying-Chih Cheng
    Affiliations
    Department of Psychiatry, Cardinal Tien Hospital, New Taipei City, Taiwan

    Department of Public Health and Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
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Published:March 10, 2017DOI:https://doi.org/10.1016/j.jaad.2016.12.028

      Background

      The relationship between isotretinoin treatment for acne and depression is controversial. Quantitative analysis has not yet been conducted.

      Objective

      To conduct a meta-analysis, evidence-based examination of the relationship between isotretinoin and depression.

      Method

      A systematic review and meta-analysis of the literature published from inception to September 30, 2016, was conducted. Controlled or prospective non-controlled trials on ≥15 acne patients receiving isotretinoin treatment were included. The prevalence of depression and change in depression scores were calculated.

      Result

      Thirty-one studies met the inclusion criteria. In the controlled studies, the change in depression scores from baseline was not significantly different between patients receiving isotretinoin treatment and those receiving an alternative treatment (standardized mean difference [SMD] −0.334, 95% confidence interval [CI] −0.680 to 0.011). The prevalence of depression after isotretinoin treatment significantly declined (relative risk [RR] 0.588, 95% CI 0.382–0.904). The mean depression scores significantly decreased from baseline (SMD −0.335, 95% CI −0.498 to −0.172).

      Limitations

      No randomized controlled trials were reviewed; a large inter-study variation was observed.

      Conclusions

      Isotretinoin treatment for acne does not appear to be associated with an increased risk for depression. Moreover, the treatment of acne appears to ameliorate depressive symptoms.

      Key words

      Abbreviations used:

      CI (confidence interval), RCT (randomized controlled trial), RR (risk ratio), SD (standard deviation), SMD (standardized mean difference)
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        Journal of the American Academy of DermatologyVol. 78Issue 2
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          Huang Y-C, Cheng Y-C. Isotretinoin treatment for acne and risk of depression: A systematic review and meta-analysis. J Am Acad Dermatol. 2017;76(6):1068-1076.e9.
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