Dr. Anders Sundstrom and colleagues at the Karolinska Institute in Sweden investigated suicide attempts before, during and after the acne drug isotretinoin was prescribed for severe acne.
The researchers assessed the data of 5,756 people first prescribed isotretinoin at the average age of 22 for men and at age 27 for women. Sixty-three percent of the test subjects were male.
The study, published in the British Medical Journal, shows that 128 patients were admitted to hospitals following a suicide attempt, and the number of suicide attempts increased between one and three years before starting isotretinoin treatment. Risks were highest within six months after treatment ended.
Sundstrom says it is impossible to say whether the continued suicide risk "is due to the natural course of severe acne, or to negative effects of the treatment."
The increased suicide risk could be "a consequence of exposure to the drug" but "a more probable interpretation is that the underlying severe acne may best explain the raised risk," the researchers say.
"The most important proactive measure to be taken would be to closely monitor all patients' psychiatric status, not only during treatment, but also for at least one year after treatment with isotretinoin," the researchers conclude.