Patients Treated for Severe Acne Have Higher Suicide Risk

Those treated with isotretinoin have increased risk up to six months after treatment

FRIDAY, Nov. 12 (HealthDay News) -- Individuals treated with isotretinoin for severe acne are at an increased risk of attempted suicide up to six months after the end of treatment, though there is already an increased risk in acne patients before treatment, so an additional risk due to treatment cannot be established, according to a study published online Nov. 11 in BMJ.

In a retrospective cohort study, Anders Sundström, of the Karolinska University Hospital in Stockholm, Sweden, and colleagues evaluated 5,756 patients aged 15 to 49 years prescribed isotretinoin for severe acne. The patients were observed before, during, and after treatment.

The researchers found that the standardized incidence ratio for attempted suicide was 1.57 for all attempts and 1.36 for first attempts during the year prior to treatment. During and up to six months after treatment, the standardized incidence ratio was 1.78 for all attempts and 1.93 for first attempts. Three years after treatment was completed, the observed number of suicide attempts was in line with the expected number, and remained so during 15 years of follow-up. The investigators also found that 38 percent of patients who made their first suicide attempt prior to treatment and 71 percent who made their first suicide attempt within six months after treatment stopped made a new attempt or committed suicide during follow-up.

"An increased risk of attempted suicide was apparent up to six months after the end of treatment with isotretinoin, which motivates a close monitoring of patients for suicidal behavior for up to a year after treatment has ended. However, the risk of attempted suicide was already rising before treatment, so an additional risk due to the isotretinoin treatment cannot be established," the authors conclude.

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