Yu-Chen Huang1, Ying-Chih Cheng2. 1. Department of Dermatology, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan; Department of Dermatology, School of Medicine and College of Medicine, Taipei Medical University, Taipei, Taiwan. Electronic address: dhist2002@yahoo.com.tw. 2. Department of Psychiatry, Cardinal Tien Hospital, New Taipei City, Taiwan; Department of Public Health and Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan.
Abstract
BACKGROUND: The relationship between isotretinoin treatment for acne and depression is controversial. Quantitative analysis has not yet been conducted. OBJECTIVE: To conduct a meta-analysis, evidence-based examination of the relationship between isotretinoin and depression. METHOD: A systematic review and meta-analysis of the literature published from inception to September 30, 2016, was conducted. Controlled or prospective non-controlled trials on ≥15 acne patients receiving isotretinoin treatment were included. The prevalence of depression and change in depression scores were calculated. RESULT: Thirty-one studies met the inclusion criteria. In the controlled studies, the change in depression scores from baseline was not significantly different between patients receiving isotretinoin treatment and those receiving an alternative treatment (standardized mean difference [SMD] -0.334, 95% confidence interval [CI] -0.680 to 0.011). The prevalence of depression after isotretinoin treatment significantly declined (relative risk [RR] 0.588, 95% CI 0.382-0.904). The mean depression scores significantly decreased from baseline (SMD -0.335, 95% CI -0.498 to -0.172). LIMITATIONS: No randomized controlled trials were reviewed; a large inter-study variation was observed. CONCLUSIONS: Isotretinoin treatment for acne does not appear to be associated with an increased risk for depression. Moreover, the treatment of acne appears to ameliorate depressive symptoms.
BACKGROUND: The relationship between isotretinoin treatment for acne and depression is controversial. Quantitative analysis has not yet been conducted. OBJECTIVE: To conduct a meta-analysis, evidence-based examination of the relationship between isotretinoin and depression. METHOD: A systematic review and meta-analysis of the literature published from inception to September 30, 2016, was conducted. Controlled or prospective non-controlled trials on ≥15 acnepatients receiving isotretinoin treatment were included. The prevalence of depression and change in depression scores were calculated. RESULT: Thirty-one studies met the inclusion criteria. In the controlled studies, the change in depression scores from baseline was not significantly different between patients receiving isotretinoin treatment and those receiving an alternative treatment (standardized mean difference [SMD] -0.334, 95% confidence interval [CI] -0.680 to 0.011). The prevalence of depression after isotretinoin treatment significantly declined (relative risk [RR] 0.588, 95% CI 0.382-0.904). The mean depression scores significantly decreased from baseline (SMD -0.335, 95% CI -0.498 to -0.172). LIMITATIONS: No randomized controlled trials were reviewed; a large inter-study variation was observed. CONCLUSIONS:Isotretinoin treatment for acne does not appear to be associated with an increased risk for depression. Moreover, the treatment of acne appears to ameliorate depressive symptoms.
Authors: Maria Cecilia Rivitti Machado; Edileia Bagatin; Thais Helena Proença de Freitas; Maria Cecília Rivitti-Machado; Beatriz Medeiros Ribeiro; Samanta Nunes; Marco Alexandre Dias da Rocha Journal: An Bras Dermatol Date: 2019 Jan-Feb Impact factor: 1.896