Accutane Acne Treatment information by Ray Sahelian, M.D. Accutane side effects, risk, caution, safety and danger, hair loss and dry skin, sexual dysfunction

Accutane is a medicine used since 1982 for the treatment and prevention of severe acne. See this acne link for suggestions on how to treat acne naturally with diet, proper food selection, and supplements. Accutane should only be used by those with severe acne who have failed all other treatments. The dose of Accutane should be kept to a minimum that works in order to minimize side effects. Swiss drugmaker Roche Holding AG stopped selling its acne drug Accutane in 2009 since it has reached the end of its life cycle and is losing ground to generic alternatives. Generics have been available since 2002.

How Accutane works to reduce pimples
The inflammation in acne is caused in part by an increased secretion of sebum (oily substance) from glands in the skin (sebaceous glands). The sebum provokes inflammation, and the inflammation resolves (heals) with the formation of a scar (keratinization). Exactly how Accutane works is not known in precise detail; however, it appears that Accutane treats acne by reducing the secretion of sebum. If less sebum is secreted it is likely that there will be less inflammation and keratinization. Roche Laboratories Inc., is the maker of Accutane acne medication.

Source of Accutane

Accutane acne drug belongs to a family of compounds called retinoids, derivatives of vitamin A. It's known that large doses of retinoids can damage the developing fetal nervous system, which is why Accutane cannot be given to pregnant women.

Accutane side effects, safety, risks, cautions - Accutane danger
Accutane has serious short term and long term side effects as discussed below. Low dose Accutane pill is preferable if it works. You may consider a low dose treatment initially to avoid the more long term serious side effects with high dose Accutane pill. Dietary changes may reduce the need for high dose use of the drug. Besides the side effects mentioned below, headache is a common short term Accutane side effect.

I took 40mg Accutane two times a day for 6 months. I stopped the medication 3 months ago. About 4 months ago I noticed significant hair loss. This has continued for all 4 months. My dermatologist claims I have telogen effluvium as a result. Since I took the full course of Accutane, will I lose all my hair? If so, can I expect it to grow back?
    In many cases hair loss continues for several weeks after stopping the acne drug, and then it stabilizes. In some cases hair can regrow again and it others it may be permanent. It is difficult to predict in any one individual whether the hair loss will reverse or not.

Lawsuits
In Feb 2010, a New Jersey jury required Hoffmann-La Roche pharmaceutical company that makes Accutane to pay a $25 million judgment in a lawsuit filed by an Alabama man who blamed the drug for his inflammatory bowel disorder. Andrew McCarrell of Moody, Ala., aged 38, took the acne drug in his 20s. He says Hoffmann-La Roche Inc. failed to adequately warn of its side effects. McCarrell eventually had his colon removed. Hoffmann-La Roche stopped selling the drug in June 2009. It cited generic competition and the cost of defending against lawsuits, which have sought to blame the drug for suicidal behavior and birth defects.

Gastrointestinal Accutane Side effects

People taking the acne drug Accutane appear to run an increased risk of developing inflammatory bowel disease.  American Journal of Gastroenterology, July 2006.

Liver and Cardiac Accutane side effects, danger, risk

Accutane seems to raise the danger for potential heart and liver problems more than doctors had expected. The findings came from lab tests on 13,772 patients taking the popular acne drug and underscore the need to closely monitor people taking Accutane, which is sold as Accutane and in three generic versions. Abnormal results for cholesterol and liver function were more common than expected in those using Accutane. Most dermatologists already knew Accutane could increase levels of cholesterol, liver enzymes and blood fats called triglycerides that can raise the risk of heart disease. But the new study found higher than expected percentages of patients developing these abnormal lab results.

Accutane hair loss
Accutane is a common cause of hair loss by many teenagers and young adults who use it for the treatment of their moderate to severe acne. Some users notice their hair loss immediately after taking the Accutane pills, some suffer the hair loss during the Accutane treatment, and some face the hair loss even after stopping the Accutane pills. The best option for those who have hair loss from Accutane is to find natural ways to treat their acne through diet and thus perhaps dietary changes may reduce the Accutane dosage required or more frequent breaks can be taken. For information on hair loss, see the link.

Psychiatric Danger Accutane side effects

Accutane is a synthetic oral retinoid that has efficacy against severe, recalcitrant, nodulocystic acne. Since its introduction to the market, Accutane has been associated with a variety of adverse psychiatric effects, including depression, psychosis, mood swings, violent behavior, suicide, and suicide attempts.

Accutane and Depression

The active ingredient in the acne drug Accutane seems to cause depression-related behavior in mice. Accutane, also sold generically as isotretinoin, has been linked to reports of depression and suicidal behavior among users. However, human studies have yielded conflicting results as to whether the drug itself contributes to these problems. Depression is a complex disorder and, therefore, difficult to pin down to a single cause. For example, Accutane users often have severe acne, which itself may lead to depression. Because the new study was conducted in mice, researchers were able to examine the direct effects of Accutane's active ingredient on signs of depression -- which, in mice, manifests as listless, sedentary behavior. They found that mice given the drug every day for six weeks began to show such lethargy during tests that gauged their stress responses. In contrast, the animals showed no movement problems in other situations, including tests of physical coordination. This suggests the drug's effects were depression-related, according to the researchers, led by Dr. Kally C. O'Reilly of the University of Texas at Austin. Accutane might alter the regulation of brain chemicals like dopamine and serotonin, which are implicated in depression. Another possibility is that the drug might affect the production or survival of cells in brain regions linked to depression. Between 1982 and 2000, the U.S. Food and Drug Administration received 431 reports of depression, suicide or suicidal behavior among Accutane users. Neuropsychopharmacology, September 2006.

Sexual dysfunction
Seeing as you are a medical doctor, I thought you might be interested to know that my sexual difficulties occurred age 35 after taking 2 courses of anti-acne drug Roaccutane (Accutane in the US). I went from having a very strong sex drive to pretty much none at all almost overnight. Five years later the problem remains - there is loss of feeling and a disconnect between brain and genitals. I have discovered through research on the internet that many people have had the same experience as me and yet there are no warnings of loss of libido / impotence, erectile dysfunction as side effects of this drug. Had I been warned this could happen, I would never have taken it. Few doctors seem to be aware of this link between Accutane and sexual difficulties, hence it is difficult to get help/be taken seriously. All I can do now is to explore herbal treatments and hope that something works for me.

Accutane acne medication Dose

The recommended dose of Accutane acne medication is 0.5 mg per kg of body weight daily. The daily dose usually is administered in two divided doses for 14 to 20  weeks. Accutane acne medication should be taken with food.
 

Accutane drug Interaction

Accutane is closely related to vitamin A. Therefore, the use of both vitamin A and Accutane at the same time may lead to vitamin A side effects. Additional drugs that may interact with Accutane include alcohol, benzoyl peroxide, salicylic acid, or other drying medicines used for acne; corticosteroids (example: prednisone); medicines for seizures; other drugs that make you more sensitive to the sun such as sulfa drugs; progestin-only birth control hormones (examples: 'Minipills' like Aygestin, Micronor, Nor-QD or injectable / implantable products such as Depo-Provera or Norplant.

Danger Accutane and Pregnancy

Accutane is known to cause birth defects when used during pregnancy. Accutane can cause brain and heart defects in infants if a woman takes it during or immediately before pregnancy. Women who take it must have pregnancy tests and use birth control or abstain from sex.

Accutane dosage interval
A single course of Accutane therapy for 15 to 20 weeks has been shown to result in prolonged remission of acne in many patients. If a second course of Accutane therapy is needed, it should not be initiated until at least ten weeks after completion of the first course, because experience has shown that patients may continue to improve while off Accutane. The suggested Accutane dosage range is 0.5 to 1.0 mg per kg per day given in two divided doses with food. Accutane is better absorbed with food. During treatment, the dosage may be adjusted according to response of the disease and/or the appearance of clinical side effects. Adult patients whose disease is very severe with scarring or is primarily manifested on the trunk may require dosage adjustments up to 1.5 mg/kg/day.

Accutane review
It appears that Accutane is very helpful in severe cystic acne when no other treatment has worked. However, it is suggested to try as much of the dietary approach in order to reduce the severity of the acne and hence reduce the required Accutane dosage. The less dosage of Accutane, the less the side effects.

Accutane lawsuit
In May of 2007, Swiss drugmaker Roche Holding AG was found guilty by not warning a patient of the bowel disease risks associated with its potent acne medicine Accutane. A New Jersey jury awarded the patient $2.5 million in damages. The trial was the first of about 400 U.S. lawsuits involving Accutane, which has been on the market since 1982. Roche plans to appearl. "Notwithstanding the verdict, the cause of inflammatory bowel disease remains unknown and there is no reliable scientific evidence that Accutane causes inflammatory bowel disease," the company said in a statement. Andrew McCarrell, a 36-year-old computer manager from Alabama, said he had undergone multiple surgeries, including having his colon removed, after taking the drug in 1995. His symptoms included chronic diarrhea and incontinence, according to court documents.

Accutane acne treatment questions
Q. I read your Accutane review and wanted to say I agree with it. I am a dermatologist practicing in Cleveland, Ohio, and I find Accutane is a great medication when used as a last resort.

Q. I have adult acne, does Accutane work for adult acne or only for teenage acne?
   A. Accutane works for both adult and teenage acne.

Q. I am a 38 year old female that has cystic acne on my chin. I took Accutane when I was 25, and did not experience any bad side effects from it. My dermatologist suggested I do a second treatment of Accutane, but I am terrified that my experience the second time around will be far less pleasant. Do you know if the chance for negative side effects increases if Accutane is repeated? How common is it to lose your hair?
   A. We have not looked into this matter in any great detail, so we are not sure if a second round of Accutane would have a higher likelihood of side effects. Our guess would be that it does, but we can't be sure. Hair thinning can occur in 10 to 25 percent of users.

Q. I followed treatment with Accutane acne medication at the age of 16 years, now I have 23 years. While taking Accutane I had no problem apart from that I psychologically double-checked always my actions. Later, when treatment was completed around 2 months I started to feel a drop of energy, as a lack of confidence and I had the impression of having symptoms of paranoid because I thought that people was always judging me and i had to verified. 5 months later I had suicidal thoughts but very light, and I got a girlfriend and my symptoms of paranoid reappeared because I thought she was cheating me with someone else and strong suicidal thoughts reappeared to with symptoms of social-phobia . At that time I went to the hospital and the psychiatrist suggested to my parents put me into a centre for child because I was not on depression but with great thoughts of suicide. i stayed in the centre for 4 months and when i got out i was well. Do you think Accutane acne medication has played in my psychological state.
   A. It is possible that Accutane treatment played a role in the mood disorder but I can't be certain.

Q. I was just wondering if there were any major contraindications to using Accutane along with a multivitamin supplement and whether there would be a benefit or risk.
   A. I don't think there would be a major problem using a mineral and vitamin supplement with Accutane medication.

I took Accutane over two years ago and have progressively gotten a worsening of side effects. Is there any way to reverse this? I have searched and searched for answers and the only information I can gather is that a gene cyp26a1 is supposed to be effective in controlling excess retinoic acid in the body. I'm holding out hope for some kind of solution and any kind of advice you can give me would be most appreciated.
    I have not studied this topic in great detail, but a healthy diet with lots of fish, fish eggs or fish oils, fresh vegetable juices and a minimum consumption of junk foods would help, along with exercise and deep sleep.

I/m 22 years old from Israel. I have many health problems including Gilbert disease but mainly fibromyalgia that causing me alot of pains. Unfortunately i just started Accutane for the third time because of persistent acne mostly in the back, and i already have alot of dry eyes and more pains. i know that Accutane can pressure the liver yet there are some inconclusions about Gilbert and its affect. i think that my previous Accutane attempts may have caused my fibro and my years of dry eyes, and maybe it has something to do with bad liver and alot of toxins in my body because of that. i just bought milk thistle here, and i bought the green herbs itself.
i put it in a glass of water and drink it after 15 minutes and i wanted to know if it has the same affect as pills? i bought it in health store, is it the good part of the milk thistle? I'm not sure what to do with the Accutane as it did help only in 5 days and with the minimum of 10 mg. I'm not sure if you can help me with that-but you know of a cumolative affect of this medication if i already took it in the past? (last time when i was 18) or maybe its very affective now because im 22 and after adolescence? because a few days ago before i started my back was in a very bad situation. i will try and do a cleanse in the coming days and keep drinking 2 cups
of milk thistle herb a day hoping for a help.
    This acne medication does have cumulative effect but I am not sure if the long period of 4 years could still have an influence.
 

I need to know if drinking alcohol while taking Accutane is bad, and in what way. Recently (past few weeks), I drink fairly heavily (5-7 drinks) on one night out of the week, with maybe the occasional drink now and then. Sometimes, though rarely, I drink heavily on two nights of the week. I am on 120 mg of Amnesteem. I know there is the liver issue since they both damage it. But what I really want to know is: Does alcohol reduce the effects of Accutane Amnesteem?
    I am not aware of any studies that show the benefits of this acne medication are reduced by once or twice weekly consumption of alcohol.