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Dermatology
Research
Use of isotretinoin and risk of depression in patients with acne: a systematic review and meta-analysis
  1. Changqiang Li1,
  2. Jianmei Chen2,
  3. Wo Wang3,
  4. Ming Ai2,
  5. Qi Zhang2,
  6. Li Kuang2
  1. 1 Department of Dermatology, The Affiliated Hospital of Southwest Medical University, Luzhou, China
  2. 2 Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
  3. 3 Mental Health Center, University-Town Hospital of Chongqing MedicalUniversity, Chongqing, China
  1. Correspondence to Dr Li Kuang; kuangli0308{at}163.com

Abstract

Objective This study aimed to investigate the association between the use of isotretinoin and the risk of depression in patients with acne.

Design This was a meta-analysis in which the standardised mean difference (SMD) and the relative risk (RR) were used for data synthesis employing the random-effects model.

Setting Studies were identified via electronic searches of PubMed, Embase and the Cochrane Library from inception up to 28 December 2017.

Participants Patients with acne.

Interventions Studies comparing isotretinoin with other interventions in patients with acne were included.

Results Twenty studies were selected. The analysis of 17 studies showed a significant association of the use of isotretinoin with improved symptoms compared with the baseline before treatment (SMD = −0.33, 95% CI −0.51 to −0.15, p<0.05; I 2=76.6%, p<0.05)). Four studies were related to the analysis of the risk of depression. The pooled data indicated no association of the use of isotretinoin with the risk of depressive disorders (RR=1.15, 95% CI 0.60 to 2.21, p=0.14). The association of the use of isotretinoin with the risk of depressive disorders was statistically significant on pooling retrospective studies (RR=1.39, 95% CI 1.05 to 1.84, p=0.02), but this association was not evident on pooling prospective studies (RR=0.85, 95% CI 0.60 to 2.21, p=0.86).

Conclusions This study suggested an association of the use of isotretinoin in patients with acne with significantly improved depression symptoms. Future randomised controlled trials are needed to verify the present findings.

  • acne
  • depression
  • isotretinoin
  • meta-analysis

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

https://doi.org/10.1136/bmjopen-2018-021549

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    Footnotes

    • Patient consent for publication Not required.

    • Contributors CQL and LK contributed to conception and design. CQL, JMC, WW, MA, QZ and LK contributed to data acquisition or analysis and interpretation of data. CQL, JMC, WW, MA, QZ and LK were involved in drafting the manuscript or revising it critically for important intellectual content. All authors have given final approval of the version to be published.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data sharing statement Extra data can be accessed via the Dryad data repository at http://datadryad.org/ with the doi: 10.5061/dryad.ft545hs.

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