{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T15:41:00Z","timestamp":1787586060627,"version":"build-2736575974"},"reference-count":63,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2006,7,4]],"date-time":"2006-07-04T00:00:00Z","timestamp":1151971200000},"content-version":"vor","delay-in-days":3,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int J Dermatology"],"published-print":{"date-parts":[[2006,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Isotretinoin is a synthetic oral retinoid that has great efficacy against severe, recalcitrant, nodulocystic acne. Since its introduction to the market, it has been associated with a variety of adverse psychiatric effects, including depression, psychosis, mood swings, violent behavior, suicide, and suicide attempts. A MEDLINE review was performed to compile all case reports, case series, adverse drug event reportings, and prospective and retrospective studies relating psychiatric adverse events to isotretinoin. In addition, literature linking a biological mechanism for psychiatric adverse events to retinoid signaling pathways was also reviewed. Although a variety of anecdotal and epidemiologic studies are available, the overall lack of concrete scientific data limits any conclusion that can be drawn about a causal relationship between istotretinoin and psychiatric adverse events. Several lines of evidence link retinoid signaling to theorized psychiatric pathogenesis, but are limited in their applicability to adult neurophysiology.<\/jats:p>","DOI":"10.1111\/j.1365-4632.2006.02660.x","type":"journal-article","created":{"date-parts":[[2006,7,6]],"date-time":"2006-07-06T20:24:30Z","timestamp":1152217470000},"page":"789-799","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":73,"title":["Isotretinoin and the controversy of psychiatric adverse effects"],"prefix":"10.1111","volume":"45","author":[{"given":"Jamison E.","family":"Strahan","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sharon","family":"Raimer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2006,7,4]]},"reference":[{"key":"e_1_2_6_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0190-9622(83)80154-6"},{"key":"e_1_2_6_3_2","doi-asserted-by":"publisher","DOI":"10.1097\/00045391-200303000-00012"},{"key":"e_1_2_6_4_2","doi-asserted-by":"publisher","DOI":"10.1067\/mjd.2002.120529"},{"key":"e_1_2_6_5_2","first-page":"49","article-title":"Suicide link: more FDA regulations, designed to protect patients, are coming for acne medication","volume":"145","author":"Conlan MF.","year":"2001","journal-title":"Drug Topics"},{"key":"e_1_2_6_6_2","doi-asserted-by":"publisher","DOI":"10.2165\/00128071-200304070-00005"},{"key":"e_1_2_6_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2004.02.012"},{"key":"e_1_2_6_8_2","first-page":"64","article-title":"Does isotretinoin cause depression and suicide?","volume":"37","author":"Bremner JD.","year":"2003","journal-title":"Psychopharmacol Bull"},{"key":"e_1_2_6_9_2","doi-asserted-by":"publisher","DOI":"10.1067\/mjd.2001.118233"},{"key":"e_1_2_6_10_2","doi-asserted-by":"crossref","first-page":"452","DOI":"10.2340\/0001555566452453","article-title":"Isotretinoin intoxication in attempted suicide","volume":"66","author":"Lindemayr H.","year":"1986","journal-title":"Acta Derm Venereol"},{"key":"e_1_2_6_11_2","doi-asserted-by":"crossref","first-page":"432","DOI":"10.1001\/archderm.1987.01660280032015","article-title":"Nodulocystic infantile acne occurring in a kindred of steatocystoma","volume":"123","author":"Burket JM","year":"1987","journal-title":"Arch Dermatol"},{"key":"e_1_2_6_12_2","first-page":"362","article-title":"Isotretinoin (Accutane)\u2010associated psychosis","volume":"31","author":"Villalobos D","year":"1989","journal-title":"Vet Hum Toxicol"},{"key":"e_1_2_6_13_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2133.1990.tb06279.x"},{"key":"e_1_2_6_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0190-9622(08)80509-9"},{"key":"e_1_2_6_15_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2230.1995.tb01341.x"},{"key":"e_1_2_6_16_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2133.1997.18131897.x"},{"key":"e_1_2_6_17_2","doi-asserted-by":"publisher","DOI":"10.4088\/JCP.v60n0611a"},{"key":"e_1_2_6_18_2","doi-asserted-by":"publisher","DOI":"10.1177\/089719009901200502"},{"key":"e_1_2_6_19_2","doi-asserted-by":"publisher","DOI":"10.3109\/15622970109026803"},{"key":"e_1_2_6_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0190-9622(82)80054-6"},{"key":"e_1_2_6_21_2","first-page":"484","article-title":"Adverse effects of isotretinoin therapy","volume":"33","author":"Bruno NP","year":"1984","journal-title":"Cutis"},{"key":"e_1_2_6_22_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0190-9622(88)70078-X"},{"key":"e_1_2_6_23_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0190-9622(08)81018-3"},{"key":"e_1_2_6_24_2","first-page":"467","article-title":"Psychiatric reactions to the retinoids","volume":"5","author":"Duke EE","year":"1993","journal-title":"Can J Dermatol"},{"key":"e_1_2_6_25_2","first-page":"215","article-title":"Isotretinoin and depression: care is needed [letter]","volume":"12","author":"Bravard P","year":"1993","journal-title":"Nouv Dermatol"},{"key":"e_1_2_6_26_2","doi-asserted-by":"publisher","DOI":"10.1017\/S0790966700003530"},{"key":"e_1_2_6_27_2","article-title":"Depression with isotretinoin","volume":"17","author":"Adverse Drug Reactions Advisory Committee.","year":"1998","journal-title":"Aust Adverse Drug Reaction Bull"},{"key":"e_1_2_6_28_2","unstructured":"Irish Medicines Board.RoAccutane. Drug Safety Newsletter 7th edn.1998. Available online at URL:http:\/\/www.imb.ie\/uploads\/publications\/7077996_Issue%208pdf. Accessed on September 15 2004."},{"key":"e_1_2_6_29_2","unstructured":"Accutane\/RoAccutane Action Group.Accutane\/RoAccutane Action Group homepage [online]. Available from URL:http:\/\/www.roAccutaneaction.com\/index.htm. Accessed on September 15 2004."},{"key":"e_1_2_6_30_2","doi-asserted-by":"publisher","DOI":"10.1067\/mjd.2001.117730"},{"key":"e_1_2_6_31_2","first-page":"66","article-title":"Accutane (isotretinoin) and psychiatric adverse effects","volume":"168","author":"Wooltorton E.","year":"2003","journal-title":"CMAJ"},{"key":"e_1_2_6_32_2","doi-asserted-by":"publisher","DOI":"10.1177\/120347540000400205"},{"key":"e_1_2_6_33_2","doi-asserted-by":"publisher","DOI":"10.1001\/archderm.136.10.1231"},{"key":"e_1_2_6_34_2","doi-asserted-by":"crossref","first-page":"160","DOI":"10.1001\/archderm.1981.01650030038018","article-title":"Retinoids, cancer, and the skin","volume":"117","author":"Elias PM","year":"1981","journal-title":"Arch Dermatol"},{"key":"e_1_2_6_35_2","doi-asserted-by":"crossref","first-page":"5216","DOI":"10.1016\/S0021-9258(19)63334-X","article-title":"Uptake of retinol and retinoic acid from serum retinol\u2010binding protein by retinal pigment epithelial cells","volume":"252","author":"Chen CC","year":"1977","journal-title":"J Biol Chem"},{"key":"e_1_2_6_36_2","doi-asserted-by":"publisher","DOI":"10.1038\/255074a0"},{"key":"e_1_2_6_37_2","first-page":"2510","article-title":"Cellular retinol and retinoic acid\u2010binding proteins in vitamin A action","volume":"38","author":"Chytil F","year":"1979","journal-title":"Fed Proc"},{"key":"e_1_2_6_38_2","doi-asserted-by":"crossref","first-page":"1048","DOI":"10.1093\/ajcn\/22.8.1048","article-title":"Vitamin A and nuclear RNA synthesis","volume":"22","author":"Johnson BC","year":"1969","journal-title":"Am J Clin Nutr"},{"key":"e_1_2_6_39_2","doi-asserted-by":"publisher","DOI":"10.1016\/B978-0-12-571148-7.50008-7"},{"key":"e_1_2_6_40_2","doi-asserted-by":"publisher","DOI":"10.1038\/263110a0"},{"key":"e_1_2_6_41_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0190-9622(80)80074-0"},{"key":"e_1_2_6_42_2","doi-asserted-by":"publisher","DOI":"10.1111\/1523-1747.ep12511753"},{"key":"e_1_2_6_43_2","first-page":"228","article-title":"Sebum composition during oral 13\u2010cis\u2010retinoic acid administration","volume":"70","author":"Strauss JS","year":"1978","journal-title":"J Invest Dermatol"},{"key":"e_1_2_6_44_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1523-1747.2000.00066.x"},{"key":"e_1_2_6_45_2","first-page":"36","volume-title":"AHFS Drug Information","author":"McEvoy GK.","year":"2004"},{"key":"e_1_2_6_46_2","volume-title":"Essential Psychopharmacology: Neuroscientific Basis and Practical Application","author":"Stahl SM.","year":"2002"},{"key":"e_1_2_6_47_2","volume-title":"The Human Brain: An Introduction to its Functional Anatomy","author":"Nolte J.","year":"1999"},{"key":"e_1_2_6_48_2","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.231475998"},{"key":"e_1_2_6_49_2","volume-title":"Essential Psychopharmacology: Neuroscientific Basis and Practical Application","author":"Stahl SM.","year":"2002"},{"key":"e_1_2_6_50_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.brainres.2004.05.019"},{"key":"e_1_2_6_51_2","doi-asserted-by":"publisher","DOI":"10.1196\/annals.1308.059"},{"key":"e_1_2_6_52_2","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.0306336101"},{"key":"e_1_2_6_53_2","doi-asserted-by":"publisher","DOI":"10.1038\/35066584"},{"key":"e_1_2_6_54_2","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.94.26.14349"},{"key":"e_1_2_6_55_2","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.95.13.7240"},{"key":"e_1_2_6_56_2","doi-asserted-by":"publisher","DOI":"10.1126\/science.276.5310.248"},{"key":"e_1_2_6_57_2","doi-asserted-by":"crossref","first-page":"945","DOI":"10.1242\/dev.112.4.945","article-title":"Retinoic acid modifies the pattern of cell differentiation in the central nervous system of neurula stage Xenopus embryos","volume":"112","author":"Ruiz I","year":"1991","journal-title":"Development"},{"key":"e_1_2_6_58_2","doi-asserted-by":"publisher","DOI":"10.1002\/aja.1002040212"},{"key":"e_1_2_6_59_2","unstructured":"PittsMR.Positive rechallenge cases of Accutane\u2010associated depressive symptoms: Dermatologic and Ophthalmic Drugs Advisory Committee to the Food and Drug Administration Gaithersburg (MD) 2000[online]. Available from URL:http:\/\/www.fda.gov\/ohrms\/dockets\/ac\/00\/slides\/3639s2i.pdf. Accessed on September 15 2004."},{"key":"e_1_2_6_60_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1525-1470.1996.tb01255.x"},{"key":"e_1_2_6_61_2","doi-asserted-by":"publisher","DOI":"10.1097\/00004583-199912000-00010"},{"key":"e_1_2_6_62_2","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ajp.160.6.1093"},{"key":"e_1_2_6_63_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1468-3083.1999.tb00839.x"},{"key":"e_1_2_6_64_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0190-9622(82)80054-6"}],"container-title":["International Journal of Dermatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fj.1365-4632.2006.02660.x","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/j.1365-4632.2006.02660.x","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,10]],"date-time":"2023-10-10T03:20:00Z","timestamp":1696908000000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/j.1365-4632.2006.02660.x"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2006,7]]},"references-count":63,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2006,7]]}},"alternative-id":["10.1111\/j.1365-4632.2006.02660.x"],"URL":"https:\/\/doi.org\/10.1111\/j.1365-4632.2006.02660.x","archive":["Portico"],"relation":{},"ISSN":["0011-9059","1365-4632"],"issn-type":[{"value":"0011-9059","type":"print"},{"value":"1365-4632","type":"electronic"}],"subject":[],"published":{"date-parts":[[2006,7]]},"assertion":[{"value":"2006-07-04","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}