Other studies also have discounted a link between Accutane and depression and suicide. But the reports are likely to continue because 'there's always somebody who could get depressed whether they're on Accutane or not. ... The fears are out there.'

Several high-profile court cases have blamed Accutane for suicides, including that of a Florida boy who stole an airplane and crashed into an office building. Tests later showed that although the 15-year-old had previously taken Accutane, he did not have any of the drug in his blood at the time of his suicide.

Now an independent study conducted by Dr. Elaine Siegfried and her colleagues at St. Louis University shows that youngsters who take the acne drug are no more likely to attempt suicide than teenagers treated with other acne remedies.

"I think the results reflect the clinical experience of most dermatologists," Siegfried said.

The study results appear in the Archives of Dermatology, a journal published by the American Medical Association.

Accutane, also known as isotretinoin, is a derivative of vitamin A. The Food and Drug Administration approved the drug for acne treatment in 1982. Since then, Accutane has been a "miracle drug" for people suffering from severe acne, Siegfried said.

The drug can cause birth defects when taken by pregnant women, so female patients must use birth control while on the drug. The drug affects the development of the fetus in the womb and does not affect offspring of men who take the drug, Siegfried said. The FDA set up a hotline to monitor side effects and pregnancies in people taking Accutane.

Increasing reports of suicide and depression in patients using Accutane led to new labeling standards, and patients are informed that the drug may have psychiatric side effects.

The SLU study followed 132 patients ages 12 to 19 for four months. The researchers tested the patients for depression at the beginning of the study using a screening tool called the Center for Epidemiologic Studies Depression Scale. Scores of 17 or higher indicate depression.

The patients were divided into two groups. A group of 59 patients received Accutane. The researchers prescribed a treatment of topical and oral antibiotics plus topical retinoid to 73 patients. At the end of four months, doctors tested the patients again for depression.

Patients normally take Accutane for five months to 10 months. The researchers chose to follow the patients for four months because most complaints about depression come about four months after treatment starts, Siegfried said.

At the beginning of the study, 14.3 percent of the Accutane users scored 17 or above on the depression scale, while 19.2 percent of the control group showed signs of depression. After treatment, just 8.2 percent of the Accutane group and 15.4 percent of the group taking antibiotics had scores suggestive of depression.

The greater improvement in the depression scores of the Accutane group was not statistically significant from the group using antibiotics and retinoid, Siegfried said.

New cases of depression showed up at a rate of 4.1 percent in the Accutane group and 3.8 percent in the antibiotic group.

The study was small because the researchers did not have outside funding from pharmaceutical companies or from the government, Siegfried said.

She doesn't discount the possibility that in very rare instances the drug could have some psychiatric side effects, noting that none of the patients in the study showed a rare side effect in which triglyceride blood fats are elevated when taking Accutane.

Siegfried said she has seen the rare triglyceride side effect in her patients before, but "I haven't personally seen anyone who's had dramatic mood changes (while on Accutane)."

Other studies have also discounted a link between Accutane and depression and suicide, said Dr. Susan Mallory, a professor of dermatology and pediatrics at Washington University. But the reports of such a link are likely to continue because "There's always somebody who could get depressed whether they're on Accutane or not. ... The fears are out there."

Accutane shuts down the sebaceous glands, glands in the skin that produce a greasy substance, Mallory said.

"It's more curative than any other medication out there" for acne, she said.

Antibiotics and anti-inflammatory drugs must be taken for years to calm acne down, but they don't usually get rid of the skin condition, she said.

Efforts to remove Accutane from the market due to fears of suicide are "a real disservice to those who could benefit from this" drug, Mallory said.

© 2005 St. Louis Post-Dispatch. All rights reserved.
© 2005 Daily News Central. All rights reserved.