{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T14:06:53Z","timestamp":1790777213901,"version":"4.1.0"},"reference-count":38,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T00:00:00Z","timestamp":1784592000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T00:00:00Z","timestamp":1784592000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Dermatology"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Multiple meta\u2010analyzes suggest that acne improvement with isotretinoin leads to improved mental health outcomes in adults, though isotretinoin\u2010related psychiatric data, including for suicidality, are limited for adolescents.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>PubMed, MEDLINE, EmBase, PsychINFO, and the Cochrane Library databases were searched for papers published between 1982 and September 2024 that reported suicidality following isotretinoin treatment for acne vulgaris in adolescents aged 18 or younger.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 24 full text articles were reviewed. Despite numerous case reports describing suicidal ideation, suicide attempts, and completed suicides were rare. Databases suggest that adolescents taking isotretinoin are the group with the most suicide attempts, but epidemiological studies including matched controls suggest this could be a function of the number of prescriptions in this population. Observational, cohort, and case\u2010time\u2010control studies did not consistently report an increased risk of suicidality with isotretinoin. When compared with those prescribed antibiotics, isotretinoin\u2010prescribed adolescents had no increase in suicidality during treatment but had a higher prevalence of suicidal behavior in the year after treatment. If patients prescribed isotretinoin developed suicidal ideation, it was more likely to develop early in or following completion of treatment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>There exists a conventionally held belief in the association between isotretinoin use and suicidal ideation for adolescent patients, but this narrative review does not indicate a consistent relationship.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/pde.70296","type":"journal-article","created":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T00:24:58Z","timestamp":1784679898000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["The Association Between Isotretinoin Use and Suicidality in Adolescents: A Narrative Review"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6647-4159","authenticated-orcid":false,"given":"Ann Marie","family":"Rydberg","sequence":"first","affiliation":[{"name":"Department of Psychiatry and Psychology Mayo Clinic  Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keith A.","family":"Miller","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Psychology Mayo Clinic  Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0528-1134","authenticated-orcid":false,"given":"Alastair J.","family":"McKean","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Psychology Mayo Clinic  Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,21]]},"reference":[{"issue":"1","key":"e_1_2_11_2_1","doi-asserted-by":"crossref","first-page":"54","DOI":"10.1001\/jamadermatol.2023.4579","article-title":"Risk of Suicide and Psychiatric Disorders Among Isotretinoin Users: A Meta\u2010Analysis","volume":"160","author":"Tan N. K. W.","year":"2024","journal-title":"JAMA Dermatology"},{"issue":"1","key":"e_1_2_11_3_1","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2018-021549","article-title":"Use of Isotretinoin and Risk of Depression in Patients With Acne: A Systematic Review and Meta\u2010Analysis","volume":"9","author":"Li C.","year":"2019","journal-title":"BMJ Open"},{"key":"e_1_2_11_4_1","first-page":"49","article-title":"More FDA Regulations, Designed to Protect Patients, Are Coming for Acne Drug","volume":"1","author":"Conlan M.","year":"2001","journal-title":"Drug Topics"},{"key":"e_1_2_11_5_1","volume-title":"Suicide Pilot's Mom Blames Accutane","author":"Cosgrove\u2010Mather B.","year":"2002"},{"key":"e_1_2_11_6_1","doi-asserted-by":"crossref","first-page":"90","DOI":"10.1016\/j.jdin.2023.10.008","article-title":"Portrayal of Mental Health Effects of Isotretinoin on TikTok","volume":"14","author":"Hackley M.","year":"2024","journal-title":"JAAD International"},{"issue":"10","key":"e_1_2_11_7_1","doi-asserted-by":"crossref","first-page":"1162","DOI":"10.1001\/jamadermatol.2019.1416","article-title":"Psychiatric Adverse Events in Patients Taking Isotretinoin as Reported in a Food and Drug Administration Database From 1997 to 2017","volume":"155","author":"Singer S.","year":"2019","journal-title":"JAMA Dermatology"},{"issue":"7","key":"e_1_2_11_8_1","doi-asserted-by":"crossref","first-page":"1124","DOI":"10.1345\/aph.1C415","article-title":"Isotretinoin and Psychiatric Illness in Adolescents and Young Adults","volume":"37","author":"Enders S. 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C.","year":"1990","journal-title":"British Journal of Dermatology"},{"issue":"1","key":"e_1_2_11_12_1","doi-asserted-by":"crossref","first-page":"132","DOI":"10.1016\/S0190-9622(08)80509-9","article-title":"Acute Depression From Isotretinoin","volume":"25","author":"Gatti S.","year":"1991","journal-title":"Journal of the American Academy of Dermatology"},{"issue":"3","key":"e_1_2_11_13_1","doi-asserted-by":"crossref","first-page":"159","DOI":"10.3109\/15622970109026803","article-title":"Acne, Isotretinoin Treatment and Acute Depression","volume":"2","author":"Ng C. H.","year":"2001","journal-title":"World Journal of Biological Psychiatry"},{"issue":"3","key":"e_1_2_11_14_1","doi-asserted-by":"crossref","first-page":"128","DOI":"10.1055\/s-2007-972575","article-title":"Isotretinoin, Depression and Suicide Ideation in an Adolescent Boy","volume":"40","author":"Bachmann C.","year":"2007","journal-title":"Pharmacopsychiatry"},{"issue":"3","key":"e_1_2_11_15_1","first-page":"269","article-title":"Isotretinoin Intoxication in Attempted Suicide: A Case Report","volume":"21","author":"Deniz T.","year":"2008","journal-title":"Marmara Medical Journal"},{"issue":"3","key":"e_1_2_11_16_1","doi-asserted-by":"crossref","first-page":"283","DOI":"10.1111\/ced.12746","article-title":"Recognizing Off\u2010Target Drug Effects in the Gut and Brain: Revisiting Isotretinoin and Depression","volume":"41","author":"Kollipara R.","year":"2016","journal-title":"Clinical and Experimental Dermatology"},{"key":"e_1_2_11_17_1","first-page":"9942327","article-title":"Isotretinoin in Acne Vulgaris Complicated by Underlying Major Depression: A Case Report and Review of Literature","volume":"2021","author":"DeLuca M.","year":"2021","journal-title":"Case Rep Psychiatry"},{"issue":"9","key":"e_1_2_11_18_1","doi-asserted-by":"crossref","first-page":"567","DOI":"10.1177\/070674379504000915","article-title":"Depression Associated With Isotretinoin Therapy","volume":"40","author":"Byrne A.","year":"1995","journal-title":"Canadian Journal of Psychiatry"},{"issue":"2","key":"e_1_2_11_19_1","doi-asserted-by":"crossref","first-page":"58","DOI":"10.1017\/S0790966700003530","article-title":"Isotretinoin Therapy and Depression \u2010 Evidence for an Association","volume":"15","author":"Byrne A.","year":"1998","journal-title":"Irish Journal of Psychological Medicine"},{"issue":"3","key":"e_1_2_11_20_1","doi-asserted-by":"crossref","first-page":"306","DOI":"10.1016\/j.jad.2009.09.005","article-title":"Psychiatric Reactions to Isotretinoin in Patients With Bipolar Disorder","volume":"122","author":"Schaffer L. C.","year":"2010","journal-title":"Journal of Affective Disorders"},{"issue":"2","key":"e_1_2_11_21_1","doi-asserted-by":"crossref","first-page":"158","DOI":"10.3109\/15622970903449853","article-title":"Genetic Vulnerability and Isotretinoin\u2010Induced Psychiatric Adverse Events","volume":"11","author":"Kontaxakis V. P.","year":"2010","journal-title":"World Journal of Biological Psychiatry"},{"key":"e_1_2_11_22_1","doi-asserted-by":"crossref","first-page":"154","DOI":"10.1016\/j.jad.2016.06.048","article-title":"Affective Disorders as Potential Complication of Anti\u2010Acne Treatment With Isotretinoin: A Case Series","volume":"204","author":"Hanna K. J.","year":"2016","journal-title":"Journal of Affective Disorders"},{"issue":"4","key":"e_1_2_11_23_1","doi-asserted-by":"crossref","first-page":"515","DOI":"10.1067\/mjd.2001.117730","article-title":"An Analysis of Reports of Depression and Suicide in Patients Treated With Isotretinoin","volume":"45","author":"Wysowski D. K.","year":"2001","journal-title":"Journal of the American Academy of Dermatology"},{"issue":"8","key":"e_1_2_11_24_1","doi-asserted-by":"crossref","first-page":"749","DOI":"10.1136\/archdischild-2019-317933","article-title":"Psychiatric Adverse Drug Reactions in the Paediatric Population","volume":"105","author":"Ekhart C.","year":"2020","journal-title":"Archives of Disease in Childhood"},{"issue":"3","key":"e_1_2_11_25_1","doi-asserted-by":"crossref","first-page":"517","DOI":"10.1016\/j.jaad.2010.06.040","article-title":"Effective Monitoring of Isotretinoin Safety in a Pediatric Dermatology Population: A Novel \u201cPatient Symptom Survey\u201d Approach","volume":"65","author":"Hodgkiss\u2010Harlow C. J.","year":"2011","journal-title":"Journal of the American Academy of Dermatology"},{"issue":"4","key":"e_1_2_11_26_1","doi-asserted-by":"crossref","first-page":"709","DOI":"10.1111\/ced.15039","article-title":"First Use of the Adolescent Depression Rating Scale (ADRS) in the Management of Young People With Severe Acne Treated With Isotretinoin: A Pilot Study of an Active Monitoring of Depressive Disorders by Dermatologists","volume":"47","author":"Hefez L.","year":"2022","journal-title":"Clinical and Experimental Dermatology"},{"issue":"4","key":"e_1_2_11_27_1","doi-asserted-by":"crossref","first-page":"635","DOI":"10.1111\/pde.15595","article-title":"The Occurrence of Mental Health Symptoms in Isotretinoin\u2010Treated Adolescents","volume":"41","author":"Miller K.","year":"2024","journal-title":"Pediatric Dermatology"},{"issue":"5","key":"e_1_2_11_28_1","doi-asserted-by":"crossref","first-page":"1623","DOI":"10.1093\/ije\/dyz093","article-title":"Risk of Suicide Attempt Associated With Isotretinoin: A Nationwide Cohort and Nested Case\u2010Time\u2010Control Study","volume":"48","author":"Droitcourt C.","year":"2019","journal-title":"International Journal of Epidemiology"},{"issue":"6","key":"e_1_2_11_29_1","doi-asserted-by":"crossref","first-page":"1293","DOI":"10.1111\/jdv.16005","article-title":"Isotretinoin and Risk Factors for Suicide Attempt: A Population\u2010Based Comprehensive Case Series and Nested Case\u2010Control Study Using 2010\u20132014 French Health Insurance Data","volume":"34","author":"Droitcourt C.","year":"2020","journal-title":"Journal of the European Academy of Dermatology and Venereology"},{"issue":"4","key":"e_1_2_11_30_1","doi-asserted-by":"crossref","first-page":"878","DOI":"10.1016\/j.jaad.2021.01.107","article-title":"Psychiatric Disorders and Suicidal Behavior in Patients With Acne Prescribed Oral Antibiotics Versus Isotretinoin: Analysis of a Large Commercial Insurance Claims Database","volume":"85","author":"Ugonabo N.","year":"2021","journal-title":"Journal of the American Academy of Dermatology"},{"issue":"3","key":"e_1_2_11_31_1","doi-asserted-by":"crossref","first-page":"571","DOI":"10.1016\/j.jaad.2024.05.042","article-title":"Neuropsychiatric Diagnoses After Isotretinoin Initiation in Pediatric Acne Patients: A Retrospective Cohort Study","volume":"91","author":"Paljarvi T.","year":"2024","journal-title":"Journal of the American Academy of Dermatology"},{"issue":"3","key":"e_1_2_11_32_1","doi-asserted-by":"crossref","first-page":"195","DOI":"10.1007\/s40272-019-00340-y","article-title":"Comparison of Quality of Life, Depression, Anxiety, Suicide, Social Anxiety and Obsessive\u2010Compulsive Symptoms Between Adolescents With Acne Receiving Isotretinoin and Antibiotics: A Prospective, Non\u2010Randomised, open\u2010label study","volume":"21","author":"Erdo\u011fan Y.","year":"2019","journal-title":"Paediatric Drugs"},{"issue":"2","key":"e_1_2_11_33_1","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1007\/s40719-022-00223-7","article-title":"Adolescent Suicide\u2010Understanding Unique Risks and Opportunities for Trauma Centers to Recognize, Intervene, and Prevent a Leading Cause of Death","volume":"8","author":"Hink A. B.","year":"2022","journal-title":"Current Trauma Reports"},{"key":"e_1_2_11_34_1","doi-asserted-by":"crossref","first-page":"943","DOI":"10.2147\/CCID.S234231","article-title":"Challenges and Solutions in Oral Isotretinoin in Acne: Reflections on 35\u2009Years of Experience","volume":"12","author":"Bettoli V.","year":"2019","journal-title":"Clinical, Cosmetic and Investigational Dermatology"},{"issue":"2","key":"e_1_2_11_35_1","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1007\/s40257-013-0014-z","article-title":"Important Controversies Associated With Isotretinoin Therapy for Acne","volume":"14","author":"Wolverton S. E.","year":"2013","journal-title":"American Journal of Clinical Dermatology"},{"key":"e_1_2_11_36_1","doi-asserted-by":"crossref","first-page":"731","DOI":"10.2147\/CCID.S406235","article-title":"Beyond the Surface: A Deeper Look at the Psychosocial Impacts of Acne Scarring","volume":"16","author":"Zhou C.","year":"2023","journal-title":"Clinical, Cosmetic and Investigational Dermatology"},{"issue":"2","key":"e_1_2_11_37_1","doi-asserted-by":"crossref","first-page":"388","DOI":"10.1016\/j.jaad.2022.10.031","article-title":"Isotretinoin and the Risk of Psychiatric Disturbances: A Global Study Shedding New Light on a Debatable Story","volume":"88","author":"Kridin K.","year":"2023","journal-title":"Journal of the American Academy of Dermatology"},{"issue":"24","key":"e_1_2_11_38_1","doi-asserted-by":"crossref","DOI":"10.1097\/MD.0000000000026035","article-title":"The Analysis of Acne Increasing Suicide Risk","volume":"100","author":"Xu S.","year":"2021","journal-title":"Medicine (Baltimore)"},{"issue":"5","key":"e_1_2_11_39_1","doi-asserted-by":"crossref","first-page":"515","DOI":"10.4103\/0019-5154.190102","article-title":"The Psychosocial Impact of Acne Vulgaris","volume":"61","author":"Hazarika N.","year":"2016","journal-title":"Indian Journal of Dermatology"}],"container-title":["Pediatric Dermatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/pde.70296","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/pde.70296","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/pde.70296","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T00:25:03Z","timestamp":1784679903000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/pde.70296"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,21]]},"references-count":38,"alternative-id":["10.1111\/pde.70296"],"URL":"https:\/\/doi.org\/10.1111\/pde.70296","archive":["Portico"],"relation":{},"ISSN":["0736-8046","1525-1470"],"issn-type":[{"value":"0736-8046","type":"print"},{"value":"1525-1470","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,21]]},"assertion":[{"value":"2025-11-22","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-05","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-07-21","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"pde.70296"}}