Functional brain imaging alterations in acne patients treated with isotretinoin.
OBJECTIVE
Although there have been case reports suggesting a relationship between treatment with the acne medication 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 effects of isotretinoin on brain functioning in acne patients.


METHODS
Brain functioning in adults was measured with [(18)F]fluorodeoxyglucose positron emission tomography before and after 4 months of treatment with isotretinoin (N=13) or an antibiotic (N=15).


RESULTS
Isotretinoin but not antibiotic treatment was associated with decreased brain metabolism in the orbitofrontal cortex (-21% change versus 2% change for antibiotic), a brain area known to mediate symptoms of depression. There were no differences in the severity of depressive 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.
Bremner
J Douglas
JD
Department of Psychiatry and Behavioral Sciences, Emory Center for Positron Emission Tomography, Emory University School of Medicine, Atlanta, GA, USA. jdbremn@emory.edu
Fani
Negar
N
Ashraf
Ali
A
Votaw
John R
JR
Brummer
Marijn E
ME
Cummins
Thomas
T
Vaccarino
Viola
V
Goodman
Mark M
MM
Reed
Lai
L
Siddiq
Sajid
S
Nemeroff
Charles B
CB
D000152:Acne Vulgaris / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000378:metabolism*; D000293:Adolescent; D000328:Adult; D000900:Anti-Bacterial Agents / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use; D001921:Brain / Q000000981:diagnostic imaging / Q000187:drug effects / Q000378:metabolism*; D003866:Depressive Disorder / Q000139:chemically induced / Q000378:metabolism; D005260:Female; D019788:Fluorodeoxyglucose F18 / Q000378:metabolism; D005625:Frontal Lobe / Q000000981:diagnostic imaging / Q000187:drug effects / Q000378:metabolism; D005947:Glucose / Q000378:metabolism; D006801:Humans; D015474:Isotretinoin / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D049268:Positron-Emission Tomography; D011569:Psychiatric Status Rating Scales; D012720:Severity of Illness Index; D014018:Tissue Distribution
D000900:Anti-Bacterial Agents; D019788:Fluorodeoxyglucose F18; D015474:Isotretinoin; D005947:Glucose