Acne drug associated with depression

Animal studies have suggested that a drug commonly used to treat acne may cause depression.

Roaccutane is a highly effective drug used to treat serious acne, but in recent years the drug has been implicated in serious side effects, including suicidal behavior. The labeling cites such risks, but it remains unclear as to why it causes these adverse effects. As well, it has not been proven that the drug is responsible, since teenagers with severe acne may already be depressed.

Researchers at England’s University of Bath and at the University of Texas at Austin investigated the effect of Roaccutane on mice. University of Bath researcher Sarah Bailey said, “You can’t ask a mouse if it is depressed. So we used two tests to model behavior.” Both of the tests involved exposing the mice to stress. In one, they were put in water and forced to swim; in the other, they were suspended by their tails.

Mice will typically try to swim, climb or thrash around in order to escape under these conditions. This will come with periods of immobility when they appear to be resigned to their situation.

A mouse that is depressed will spend longer in the immobile state than one that is healthy. So the team gave Roaccutane to adolescent mice in doses equivalent to those given to human adolescents, and found that periods of immobility significantly increased. The researchers concluded that Roaccutane tended to increase depression-related behavior in adolescent mice.

The drug is in the class of chemicals called retinoids, which have an effect on the way genes are “read” by the body, and reduce the rate at which new brain cells are generated. Roaccutane has been shown to damage fetuses in the womb, and precautions are taken to ensure it is not used by women likely to become pregnant. However, more recent findings suggest that brain cell generation may be important not only in fetuses but also in adolescents and even adults, according to Dr. Bailey. The suspicion is that the drug may lower levels of the mood hormone serotonin.

The evidence on the patients who received the drug suggests that perhaps only 5 to 10% were vulnerable to the effect. There have been suggestions however that retinoids may be linked to Alzheimer’s disease and schizophrenia, so understanding more about how they work could lead to new treatments.

Roche, the makers of Roaccutane, said, “While no causal link has been established between Roaccutane and either depression or suicide, we are constantly monitoring all available safety databases on Roaccutane worldwide.”

© Copyright 2007 Insight Journal Online Magazine.

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