The acne medicine Accutane has often been linked anecdotally to suicide. But research hasn't proved that the drug, also known by the generic name isotretinoin, actually has that effect. Researchers in St. Louis tested the drug's effects on adolescents with moderate to severe acne.

What the researchers wanted to know: Are adolescents who take isotretinoin (Accutane) more or less likely to have depressive symptoms than those who were treated with antibiotics and topical antiacne solutions?

What they did: The researchers recruited 132 12-to-19-year-olds with moderate to severe acne. Patients weren't allowed to join the study if they had been previously diagnosed with major depression. The patients used either isotretinoin or a combination of a topical antibiotic, a topical retinoid, and an oral antibiotic. The patients were not randomly assigned to these two treatments; instead, the doctor, patient, and parents chose a treatment based on what the patient had tried before, what they and their parents preferred, out-of-pocket cost, and other factors. The patients were assessed for depressive symptoms at the beginning of the study and three to four months after they'd started treatment, using the Center for Epidemiologic Studies Depression Scale (CES-D), a questionnaire developed by the National Institute of Mental Health. A score of 17 or higher suggests possible depression.

What they found: The patients who took isotretinoin weren't any more likely than the patients on conservative therapy to be depressed three to four months after treatment started. Also, none of the adolescents on isotretinoin who scored 17 or higher on the depression scale reported thinking about suicide.

What the study means to you: Despite anecdotal reports of children on Accutane committing suicide, the drug doesn't seem to cause depressive symptoms. In fact, in this study, treating acne (whether with Accutane or conservative treatment) seemed to make adolescents less depressed. The researchers say dermatologists—not the first doctors you think of when you think about depression—should be keeping an eye out for signs of depression in their adolescent patients with acne, whether or not they're on Accutane.

Caveats: If Accutane increases suicide risk, but only very occasionally, it would take a much larger study to detect that effect.

Find out more: Read information about depression from the National Institute of Mental Health.

Check out the Food and Drug Administration's alert on Accutane.

Read the article: Chia, C. Y., et al. "Isotretinoin Therapy and Mood Changes in Adolescents With Moderate to Severe Acne." Archives of Dermatology. May 2005, Vol. 141, pp. 557–560.

Abstract online: http://archderm.ama-assn.org