Functional Brain Imaging Alterations in Acne Patients Treated With Accutane

Am J Psychiatry 162:5, May 2005
983
Article
http://ajp.psychiatryonline.org
Functional Brain Imaging Alterations
in Acne Patients Treated With Isotretinoin
J. Douglas Bremner, M.D.
Negar Fani, M.S.
Ali Ashraf, M.D.
John R. Votaw, Ph.D.
Marijn E. Brummer, Ph.D.
Thomas Cummins, M.D.
Viola Vaccarino, M.D., Ph.D.
Mark M. Goodman, Ph.D.
Lai Reed, M.B.A.
Sajid Siddiq, M.D.
Charles B. Nemeroff, M.D., Ph.D.
Objective:
Although there have been
case reports suggesting a relationship be-
tween treatment with the acne medica-
tion isotretinoin and the development of
depression and suicide, this topic remains
controversial. In order for isotretinoin to
cause depression, it must have an effect
on the brain; however, the effects of
isotretinoin on brain functioning in acne
patients have not been established. The
purpose of this study was to assess the ef-
fects of isotretinoin on brain functioning
in acne patients.
Method:
Brain functioning in adults was
measured with [
18
F]fluorodeoxyglucose
positron emission tomography before and
after 4 months of treatment with isotreti-
noin (N=13) or an antibiotic (N=15).
Results:
Isotretinoin but not antibiotic
treatment was associated with decreased
brain metabolism in the orbitofrontal cor-
tex (–21% change versus 2% change for
antibiotic), a brain area known to medi-
ate symptoms of depression. There were
no differences in the severity of depres-
sive symptoms between the isotretinoin
and antibiotic treatment groups before or
after treatment.
Conclusions:
This study suggests that
isotretinoin treatment is associated with
changes in brain functioning.
(Am J Psychiatry 2005; 162:983–991)