A statement published earlier this month by the FDA notes that the agency continues to assess reports of suicide or suicidal attempts associated with the use of Accutane. The statement also calls on physicians to be vigilant about following their patients taking the drug closely for signs of depression.
The latest study was conducted by Siegfried and colleagues from St. Louis University Health Sciences Center without financial backing from Roche Pharmaceuticals.
The researchers used standardized tests to evaluate depression levels among teens with moderate to severe acne -- before beginning Accutane and while on the drug. Another group of teens who took antibiotics instead of Accutane for their acne were also evaluated.
Roughly 14% of the teens in the Accutane group and 19% of those in the antibiotic group had scores suggestive of depression before beginning treatment. Three to four months later about 8% of the teens taking Accutane and 15% of those taking antibiotics had similar scores.
Siegfried says it just makes sense that teens who feel better about the way they look will be less depressed.
"I have seen it over and over in my practice," she says.
Brain Imaging Studies
But Emory University psychiatrist J. Douglas Bremner, MD, who also studies Accutane, says the latest study was too small to answer many questions about whether Accutane causes depression. Of the 132 patients enrolled, 59 were treated with Accutane and 73 were prescribed antibiotics and topical creams.
Bremner says a study of at least 1,000 patients is needed to either prove or disprove the link between Accutane and depression.
The psychiatrist says his own recent imaging research shows that Accutane causes changes in the frontal lobe of the brain, which is associated with emotion. The research was published last month in the American Journal of Psychiatry.
Bremner found significant changes in the area of the brain known as the orbitofrontal cortex in 13 adults taking Accutane. No such changes were seen in a similar number of adults taking antibiotics.
But a Roche spokeswoman tells WebMD there is no consensus in the scientific community that the orbitofrontal cortex of the brain controls depression and mood. She added that there was no difference in depression symptoms between the people in Bremner's study taking Accutane and those taking antibiotics.