Jury Still out on Accutane

Here is a very interesting article published on a US Law site about Accutane ( known as Roaccutane in Australia ). It follows recent calls in the UK for its banning following a number of suicides by young people taking the drug for acne.

In Australia, prescription of Roaccutane is restricted and it is only supposed to be prescribed for severe cystic acne.

The use of Roaccutane in acne, because of its high side effect profile, has always been contraversial. It is rarely reported that it has a high relapse rate in both males and females, when used at the recommended dose. Relapse rates can be reduced by increasing the dosage, which of course, increases the chance of serious side effects.

I do still recommend Roaccutane for severe cystic acne in young males. I rarely if ever recommend Roaccutane for females as the relapse rate is very high, particularly in females adults with acne. SGA is a far better option for adult women with chronic acne.

. By 

 
London, England: Although Accutane is banned in the US – Roche removed its acne drug from the market in 2009 after settling millions of dollars in damages to Accutane inflammatory bowel claimants – it is still available in many other countries. Prompted by a number of suicides, the UK may also ban the drug after the government reviews its risks and benefits.

Jury Still Out on Accutane?(Isotretinoin, which is a synthetic retinoid and a form of vitamin A, goes by several names including Accutane in the US and Roaccutane [made by Hoffman-La Roche] in the UK. Generic forms of Isotretinoin, however, are still available in the US since Roche’s patents for Isotretinoin expired in 2002. And the generic acne drugs are cheaper.)

Several family members of suicide victims in the UK – at least three suicides in 2012 were blamed on Roaccutane – have recently protested at Roche headquarters (its corporate company is in Switzerland but the global healthcare company has more than two dozen manufacturing sites and many offices worldwide). In the US, however, Accutane has been linked to suicide ideation and psychopathology for a number of years.

One doctor in Ireland (name not given) is defending Roaccutane. In a letter to the editor of Kerryman (April 23, 2014), its author says, “If Roaccutane was banned it would be disastrous for the small group of people who have very severe acne where nothing else will work. The acne support group in the UK reckon far more people suffer from depression and suicidal thoughts as a result of their acne, not their treatments….For the majority of my patients, their biggest regret with ‘Roaccutane’ is that they did not take it earlier.”

At the same time, the writer acknowledges that Isotretinoin is a very powerful drug and Accutane birth defects are “well known.” And it goes on to advise that acne patients need to be screened for signs of depression before starting the drug. If only dermatologists and other prescribing doctors had the time and/or inclination to do so…

One Accutane victim wishes her doctor had time to explain Accutane side effects. “Doctors…should tell their patients about potential side effects; they should take the time to talk to their patients,” Valerie says. “If my doctor only took five minutes to read about Accutane side effects and give me the option, even though I was probably vain in my 20s, I wasn’t naive.”

In the Kerryman letter to the editor, the writer cited a 2008 review that concluded the link between suicides and severe depression has not yet been clearly demonstrated, which was based on clinical studies and case reports. And given the fact that 13 million patients have used “Roaccutane” since it was approved in 1982, the number of suicides linked to the drug is rare.

Interestingly, the doctor doesn’t mention Accutane Ulcerative Colitis and other bowel diseases linked to the drug. The letter goes on to say that all Roaccutane patients get dry lips, dry nose and dry skin, and more serious side effects are rare. Not so, according to the manufacturer, who has paid more than $53 million to settle Accutane lawsuits.