Isotretinoin side effects acne drug by Ray Sahelian, M.D. polyneuropathy and sacroiliitis, depression, osteoporosis

Isotretinoin is used to treat a spectrum of dermatologic conditions, particularly acne vulgaris. Many side effects have been attributed to Isotretinoin. This drug is best reserved for severe cases of acne. Diet does play a role in acne, and I suggest you review my thoughts on the relationship of food to acne symptoms.

Common Isotretinoin side effects
Isotretinion may cause depression and mood changes. Some patients taking isotretinoin have experienced suicidal thoughts. Since its introduction to the market, isotretinoin has been associated with a variety of adverse psychiatric effects, including depression, psychosis, mood swings, violent behavior, suicide, and suicide attempts.
There is a possible risk that bones will become thinner which can lead to osteoporosis.
Isotretinoin use can cause inflammation around joints, and lead to tendonitis
Cholesterol and triglyceride levels may increase.
Liver enzyme elevation is possible.

Isotretinoin side effect of polyneuropathy and sacroiliitis
Dermatologists are advised to be alert to symptoms of polyneuropathy and sacroiliitis during treatment .

Isotretinoin side effect of agranulocytosis
A 15-year-old female patient exhibited agranulocytosis after the initiation of isotretinoin administration. Agranulocytosis is a rare but life-threatening side effect of isotretinoin use, and clinicians must be aware of agranulocytosis.

questions
I came across a note in an article that isotretinoin may deplete serotonin levels. I searched all through the literature, and could not find any mention with regard to neurotransmitter alterations? Was wondering what this theory is based on. I had persistent acne and am almost done with my isotretinoin cycle, however being that I also have depression, this concerns me.