Accutane - Recognizing Psychiatric Disorders
Although no conclusive studies have established a definite link, some health
providers and consumers believe that Accutane may cause depression, psychosis
and, in rare cases, suicide attempts. Discontinuation of Accutane therapy may
be insufficient to combat such psychiatric disorders, so it is important to
recognize and understand their symptoms and warning signs.
Depression
Depression is the most commonly reported psychiatric problem in patients taking
Accutane, and is also a well-established risk factor for suicidal behavior.
Depression is characterized by symptoms including intense, persistent sadness;
anxiety; loss of pleasure from usual activities; loss of energy; and others
identified below. Some of these feelings can be normal responses to a negative
life event, but clinical depression is either not triggered by such an event,
or is disproportional to the trigger.
Symptoms Of Depression:
- Persistent sadness, anxiety or feeling of emptiness
- Feelings of guilt, worthlessness or helplessness
- Loss of pleasure from activities that were once enjoyable
- Loss of energy
- Difficulty concentrating or making decisions
- Change in sleep pattern
- Change in appetite
- Physical problems that do not respond to treatment
- Restlessness
- Irritability
Causes Of Depression:
- Genetic predisposition
- Stress at home, work or school
- Loss of a parent or loved one
- Alcohol or substance abuse
- Breakup of a romantic relationship
- Medications
Mania
Often associated with depression is a condition known as manic-depression,
where the patient alternated between exhibiting symptoms of mania, and symptoms
of depression. Symptoms of mania include:
- Excessive elation
- Increased energy and sexual desire
- Decreased need for sleep
- Racing thoughts and impaired judgment
- Increased talking
- Inappropriate behavior
Suicide
Suicide accounts for more than 30,000 American deaths each year. It is the
third leading cause of death (after accidents and homicide) among people aged
15 to 24, which makes it responsible for more deaths in this age group than
any physical illness. Healthcare providers often miss the warning
signs because patients may hide suicidal intent very successfully. In fact,
60% of people who commit suicide had seen a physician within 1 month of their
deaths. Suicidal tendencies rarely arise spontaneously; 93% of people
who commit suicide suffer from depression, schizophrenia and/or substance abuse.
Despite a patient's attempt to hide suicidal thoughts, he or she may send deliberate warning signals, some of which can be explicit. Every mention or discussion of "killing myself" should be treated with utmost seriousness.
It is important to note that depression itself is a major risk factor for suicidal
behavior. Thus, special attention is needed when prescribing drugs that may
cause depression. An association with Accutane should be considered in patients
with signs and symptoms of depression, even in the presence of other life stressors.
Discontinuation of Accutane may be insufficient intervention, and formal psychiatric
evaluation should be conducted. It is also important to note that signs and
symptoms of depression are not included in all reported cases of suicidal behavior.
It is not known if this means the signs were masked by the patient, unrecognized
by observers, or if the suicidal tendency arose impulsively. It is important
that patients taking Accutane be made aware of this so that they might recognize
any such signs and symptoms. Patients (and parents, if the patient is a minor)
should be instructed to stop Accutane and seek immediate medical help.
