Severe acne needs suicide risk checks: study

People receiving treatment for severe acne should be monitored forincreased risk of attempting suicide, but it's unclear whether that is caused by the condition or the drug, a study says.

Swedish researchers at the Karolinska Institute studied data from nearly 6,000 people who were prescribed the drug isotretinoin, marketed under various brand names includingAccutane, between 1980 and1989. The medication has been commonly prescribed to treat serious acne since the 1980s.

The scientists could not say whether it was the acne or the treatment thatled to suicide attempts among those using the drug.

They even suspect that patients whose acne improved after treatment might still be unhappyif there were no major improvements in their social lives.

The scientists comparedpatient information with hospital discharge records and death registers from 1980 to 2000. According to the records, 128 of the people surveyed were admitted to a hospital after a suicide attempt.

'Not a trivial condition'

"Severe acne is not a trivial condition," wrote Anders Sundstrom and colleagues. "It is associated with an increased risk of attempted suicide."

Experts found the number of suicide attempts increased between one and three years after the start oftreatment, but the highest risk appeared to be within six months after the treatment ended. Treatment typically lasted several months, with some patients needing repeated therapy, the report said.

Sundstrom and colleagues emphasized that acne-related suicide attempts are rare one for every 2,300 people taking the acne drug.

Overall,there are13 suicides per 100,000 young adults in the U.S., and experts estimate that for every suicide there are about 11 attempts.

"All patients with acne of a severity for which isotretinoin is [needed] should have psychosocial factors and suicidal intent monitored,"Parker Magin and John Sullivan of the University of Newcastle and University of New South Wales wrotein a commentary accompanying the Swedish study. "Given the extended period of risk, families of patients may also have a role in this monitoring."

The study, paid for by the Swedish Research Council,was published Friday in the medical journal BMJ (British Medical Journal).

Health Canada approved Accutanein 1982 to treat the worst cases of acne that cannot be cleared up with other treatments. The departmentwarned about an association betweenAccutaneanddepression or suicidal thoughtsin young people in 2001.