Acne patients on isotretinoin less likely to engage in suicidal behaviour

Engaging in suicidal behaviour is less likely among acne patients prescribed isotretinoin compared to the general population, according to an analysis of a large commercial insurance claims database.

A team of investigators conducted a retrospective cohort study using the IBM MarketScan Research Databases, which contain commercial insurance claims in the US. They identified acne patients who were prescribed isotretinoin or oral antibiotics between 2011 and 2017 and diagnosed with psychiatric disorders or suicidal behaviour.

The study included a total of 72,555 acne patients. Suicidal ideation or attempt was nearly one and a half times more likely among patients in the general population than those prescribed isotretinoin (adjusted odds ratio [AOR], 1.47, confidence interval [CI], 1.27–1.70; p<0.0001).

On the other hand, a psychiatric diagnosis was less likely among the general population (AOR, 0.87, 95 percent CI, 0.84–0.89; p<0.0001) and acne patients prescribed antibiotics (AOR, 0.88, 95 percent CI, 0.85–0.91; p<0.0001) than acne patients treated with isotretinoin.

Furthermore, the prevalence of suicidal behaviour was lower during isotretinoin treatment than in the year prior to isotretinoin treatment (0.22 percent) and in the year following treatment (0.34 percent; p=0.004).

“Further exploration into the slight increase in suicidal behaviour seen in isotretinoin patients 1 year after therapy is warranted,” the investigators said.

The study was limited by the exclusion of individuals with public insurance and those who were not insured. In addition, the data in the study relied on the accuracy of the medical coding.