Department of Biomedicine - Pharmacology and Therapeutics Unit, Faculty of Medicine, University of Oporto, Porto, Portugal.
Department of Dermatology and Venereology, CHSJoão, Porto, Portugal.
Cutan Ocul Toxicol. 2023 Sep;42(3):83-90. doi: 10.1080/15569527.2023.2227889. Epub 2023 Jul 5.
Acne vulgaris is a very prevalent dermatological condition, especially among adolescents and young adults up to 25 years old, classifying it as juvenile acne. One of the most effective treatments for severe acne is isotretinoin, a derivative of retinoic acid. Despite its high efficacy, this drug has been linked to several side effects including psychiatric adverse alterations, such as anxiety, depression and even suicide. With this systematic review we aim to determine if it is possible to establish a causal relation between oral isotretinoin in the treatment of juvenile acne and the appearance of psychiatric adverse effects.
We searched two distinct databases, PubMed and Web of Science, and considered the work published between January 2000 and November 2021.
Out of the 599 identified articles, we included 19 studies in this systematic review. Globally, the results we found do not support an association between the use of isotretinoin for acne treatment and mental side effects and the safety of this drug appears to be assured. However, the individual characteristics of each adolescent and their environment should be considered; the personal and family history of mental disorders are pointed out as red flags we should look out for when treating these patients.
Despite this being a highly debated topic, especially among the dermatology community, more studies with larger populations and randomised controlled trials are necessary to increase the strength of the evidence presented.
寻常痤疮是一种非常普遍的皮肤科疾病，尤其是在青少年和 25 岁以下的年轻人中，可将其归类为青少年痤疮。治疗重度痤疮最有效的方法之一是异维 A 酸，它是维 A 酸的衍生物。尽管这种药物疗效很高，但它与几种副作用有关，包括精神方面的不良反应，如焦虑、抑郁，甚至自杀。通过这项系统评价，我们旨在确定口服异维 A 酸治疗青少年痤疮与出现精神不良反应之间是否存在因果关系。
我们在两个不同的数据库 PubMed 和 Web of Science 中进行了搜索，并考虑了 2000 年 1 月至 2021 年 11 月期间发表的工作。
在确定的 599 篇文章中，我们在这项系统评价中纳入了 19 项研究。总体而言，我们发现的结果并不支持将异维 A 酸用于痤疮治疗与精神副作用之间存在关联，而且这种药物的安全性似乎得到了保证。然而，每个青少年的个体特征及其所处的环境都应该被考虑在内；个人和家族精神疾病史被指出是我们在治疗这些患者时需要注意的危险信号。
尽管这是一个备受争议的话题，尤其是在皮肤科领域，但需要更多具有更大人群和随机对照试验的研究来增加所提出证据的强度。
