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Jay M Truitt, Jason S Reichenberg, Kevin G Sharghi, Shirlene M Sampson, Randall K Roenigk, Michelle Magid
INTRODUCTION: Isotretinoin, previously marketed as Accutane®, is an oral retinoid medication that is used to treat acne and other cutaneous disorders. Although the data is conflicting, previous reports suggest a causal relationship between isotretinoin and depression. When reviewing these previous reports, many patients who were diagnosed as 'depressed' did not undergo a thorough psychiatric evaluation and/or were not diagnosed according to the criteria of the Diagnostic and Statistical Manual of Mental Disorders (DSM)...
April 18, 2018: Giornale Italiano di Dermatologia e Venereologia: Organo Ufficiale, Società Italiana di Dermatologia e Sifilografia
Leah K Spring, Andrew C Krakowski, Murad Alam, Ashish Bhatia, Jeremy Brauer, Joel Cohen, James Q Del Rosso, Lucia Diaz, Jeffrey Dover, Lawrence F Eichenfield, Geoffrey C Gurtner, C William Hanke, Marla N Jahnke, Kristen M Kelly, Shilpi Khetarpal, Megan A Kinney, Moise L Levy, James Leyden, Michael T Longaker, Girish S Munavalli, David M Ozog, Heidi Prather, Peter R Shumaker, Elizabeth Tanzi, Abel Torres, Mara Weinstein Velez, Abigail B Waldman, Albert C Yan, Andrea L Zaenglein
Importance: The notion that systemic isotretinoin taken within 6 to 12 months of cutaneous surgery contributes to abnormal scarring or delayed wound healing is widely taught and practiced; however, it is based on 3 small case series from the mid-1980s. Objective: To evaluate the body of literature to provide evidence-based recommendations regarding the safety of procedural interventions performed either concurrently with, or immediately following the cessation of systemic isotretinoin therapy...
August 1, 2017: JAMA Dermatology
Rungarun Kriangkrai, Suconta Chareonvit, Sachiko Iseki, Visaka Limwongse
OBJECTIVE: Excess treatment of 13-cis-RA (Accutane(®)) on pregnant women induces craniofacial malformation found in infants. However, the effect of folic acid on 13-cis-RA-induced cellular damages of developing midfacial processes is still unknown. The purpose of this study was to investigate the pretreatment effect of folic acid (FA) on 13-cis-RA-induced cellular damage in developing midfacial processes in rat embryos. MATERIALS AND METHODS: The rat embryos at developing midfacial processes were performed by whole embryo culture in vitro, in the presence of 13-cis-RA (20 µM) with or without pre-treatment of FA (100 µM)...
2017: Open Dentistry Journal
Bahman Guyuron, Michelle Lee
BACKGROUND: Thicker nasal skin blunts the definition of the underlying osseocartilaginous frame and the delicate topography of the nose posing additional challenges in producing desirable tip definition. Despite the recognized challenge in this patient population, there is a paucity of literature on how to overcome this problem. PURPOSE: The goal of this article is to provide a systematic algorithm to manage patients with thick nasal skin. METHOD: Approach to the thick nasal skin patient begins with an evaluation of the etiology of their skin thickness...
April 2017: Aesthetic Plastic Surgery
Pedram Hamrah, Yureeda Qazi, Bashar Shahatit, Mohammad H Dastjerdi, Deborah Pavan-Langston, Deborah S Jacobs, Perry Rosenthal
PURPOSE: To investigate morphological changes of the corneal epithelium and subbasal nerves in patients with corneal allodynia using in vivo confocal microscopy (IVCM). DESIGN: Case-control study of patients with corneal allodynia and healthy controls. METHODS: Ten eyes of six patients were diagnosed with corneal allodynia at a single center and compared to fifteen healthy eyes. IVCM of the central cornea was performed on all subjects and controls...
January 2017: Ocular Surface
Patricia Guzman Rojas, Roxana Gallegos Lopez, Alessandra Ciliotta Chehade, Yolanda Scavino, Alejandro Morales, Martín Tagle
We describe a case of a teenage patient with the diagnosis of drug induced autoimmune hepatitis. The patient is a 16 years old female, with the past medical history of Hashimoto’s hypothyroidism controlled with levothyroxine, who started treatment with Isotretionin (®Accutane) 20 mg q/12 hours for a total of 3 months for the treatment of severe acne. The physical examination was within normal limits and the results of the laboratory exams are: Baseline values of ALT 28 U/L, AST 28 U/L. Three months later: AST 756 U/L, ALT 1199U/L, alkaline phosphatase 114 U/L, with normal bilirrubin levels throughout the process...
January 2016: Revista de Gastroenterología del Perú: órgano Oficial de la Sociedad de Gastroenterología del Perú
Neil F Goodman, Rhoda H Cobin, Walter Futterweit, Jennifer S Glueck, Richard S Legro, Enrico Carmina
Polycystic Ovary Syndrome (PCOS) is recognized as the most common endocrine disorder of reproductive-aged women around the world. This document, produced by the collaboration of the American Association of Clinical Endocrinologists (AACE) and the Androgen Excess and PCOS Society (AES) aims to highlight the most important clinical issues confronting physicians and their patients with PCOS. It is a summary of current best practices in 2015. PCOS has been defined using various criteria, including menstrual irregularity, hyperandrogenism, and polycystic ovary morphology (PCOM)...
November 2015: Endocrine Practice
Maude Ludot, Stephane Mouchabac, Florian Ferreri
Isotretinoin (Accutane) is a treatment for severe acne that is resistant to other forms of treatment, including antibiotics and topical treatments. The prescription of this drug has been controversial ever since its initial marketing in 1982. It is the only non-psychotropic drug in the Food and Drug Administration top 10 drugs found to be associated with depression. Recently, Bremner et al published an extensive review (until 2010) of the evidence for the association of retinoic acid (RA) with depression and suicide...
June 22, 2015: World Journal of Psychiatry
K B Hoover, C G Miller, N C Galante, C B Langman
UNLABELLED: This study compared the effects of pediatric acne treatment with two isotretinoin formulations on bone mineral density. We demonstrated no difference in the effect of the two formulations. No effect on pediatric bone mineral density was identified for either formulation. INTRODUCTION: Isotretinoin (13-cis-retinoic acid) is a treatment for recalcitrant nodular acne with a purported effect on bone mineral density (BMD). The side effects of isotretinoin on vertebral bone were evaluated to assess the safety of a new FDA-approved isotretinoin formulation: Lidose-isotretinoin (Cip-Iso)...
October 2015: Osteoporosis International
Parvez Vora, Chitra Venugopal, Sheila K Singh
Neuroblastoma (NB), an embryonal tumour of the sympathetic nervous system, is thought to originate from undifferentiated neural crest cells and is known to exhibit extremely heterogeneous biological and clinical behaviors. Occurring in very young children, the median age at diagnosis is 17 months and it accounts for 10% of all pediatric cancer mortalities. The standard treatment regimen for patients with high-risk NB includes induction and surgery followed by isotretinoin or Accutane (13-cis retinoic acid) treatment, which is shown to induce terminal differentiation of NB cells...
November 30, 2014: Oncotarget
Misha M Mutizwa, David M Sheinbein
With Roche's withdrawl of Accutane from the U.S. market in 2009, isotretinoin has only been available in its generic form. Many clinicians fail to realize that for approval by the U.S. Food and Drug Administration, a generic medication must have a bioequivalence between 80 percent and 125 percent of that of the innovator product. This potential variability in bioavailability between branded and generic medications is important to keep in mind with isotretinoin, given the implications for achieving a sustained remission in acne patients...
January 15, 2013: Dermatology Online Journal
Lee Black
No abstract text is available yet for this article.
August 1, 2006: Virtual Mentor: VM
Amit Agarwal
Drug developers are grappling with the impact of personalized medicine on their portfolios. The combination of molecular diagnostics with targeted biologic therapies has been hailed as a recent innovation with few historical analogs to guide behavior. However, if the definition of companion diagnostics is broadened to include any drug whose FDA approved label requires diagnostic testing before prescription then over 50 drugs across multiple therapeutic areas arise. Most importantly for current drug developers, these drugs represent a wide variety of market situations and with sufficient historical data to evaluate different commercialization strategies for the combination...
September 15, 2012: New Biotechnology
Janet Shin, T Craig Cheetham, Linda Wong, Fang Niu, Elizabeth Kass, Monica A Yoshinaga, Mike Sorel, Jeffrey S McCombs, Stephen Sidney
BACKGROUND: Preventing fetal exposure to isotretinoin is widely acknowledged as an important safety issue. The iPLEDGE program is the latest in a series of Food and Drug Administration-mandated risk management programs designed to prevent pregnancies in female patients of childbearing potential (FCBP) taking isotretinoin. OBJECTIVE: We sought to evaluate the effect of iPLEDGE relative to the prior risk management program (system to manage Accutane-related teratogenicity [SMART]) on the risk of isotretinoin fetal exposure in FCBP in a managed care setting...
December 2011: Journal of the American Academy of Dermatology
Ruta Ganceviciene, Christos C Zouboulis
Summary Isotretinoin (13-cis retinoic acid) is the most potent known inhibitor of sebum production. The multiple modes of action for isotretinoin, including suppression of sebaceous gland activity, normalization of the pattern of keratinization within the sebaceous gland follicle, inhibition of inflammation, reduction of growth of Propionibacterium acnes in a secondary manner and, as currently shown, normalization of the expression of matrix tissue metalloproteinases and their inhibitors make this compound the single most effective in the treatment of severe recalcitrant nodulocystic acne, and in the prevention of acne scarring...
March 2010: Journal der Deutschen Dermatologischen Gesellschaft, Journal of the German Society of Dermatology: JDDG
Sherry A Ferguson, Kimberly J Berry
Use of the anti-acne drug, Accutane (ACC) (isotretinoin, 13-cis-retinoic acid), has been associated with neuropsychiatric events ranging from depression in animal models to depression and suicide ideation in humans. Our studies, however, have consistently indicated few effects on measures of depression in male and female rats. Still, the comorbidity of depression and anxiety suggests that anxiety assessments in ACC-treated rats could be informative. Such assessments must be balanced with measures of activity since drug-induced activity alterations may impact the expression of anxiety-like behaviors...
September 2010: Neurotoxicology and Teratology
Linda C Schaffer, Charles B Schaffer, Susan Hunter, Amber Miller
BACKGROUND: Isotretinoin (Accutane(R)) has been available for the treatment of severe cystic acne for about twenty-five years. There have been several reports of adverse psychiatric reactions to isotretinoin, including depressive symptoms and suicide. However, there have been only three case reports of patients with bipolar disorder (BD) who experienced an untoward psychiatric side effect while receiving isotretinoin treatment. In this study, the psychiatric side effects from isotretinoin were assessed in a larger group of BD patients than has previously been reported...
May 2010: Journal of Affective Disorders
Toby L Schonfeld, N Jean Amoura, Christopher J Kratochvil
The United States Food and Drug Administration (FDA), in collaboration with pharmaceutical manufacturers, have recently implemented a heavily revised risk-management program for patients on isotretinoin (Accutane), a drug with known and pronounced teratogenic effects. This revised risk management plan places significant burdens on both providers and patients in the hopes of achieving its goal of reducing fetal exposure to isotretinoin. The main focus of this paper is to discuss the burdens of various aspects of the program in relationship to potential corresponding benefits...
2009: Journal of Law, Medicine & Ethics: a Journal of the American Society of Law, Medicine & Ethics
Marsha M Dopheide, Russell E Morgan
Isotretinoin (ISO, 13-cis-retinoic acid) is commonly prescribed as Accutane for the treatment of acne. ISO is a known teratogen and the physical side effects of the drug have been well documented. However, possible psychological risks associated with the drug have yet to be determined. Retinoid receptors are abundant in the striatum and hippocampus, brain structures involved in implicit and explicit memory processes, respectively. The current study examined whether ISO influenced implicit or explicit memory processes using a two-stage radial-arm maze (RAM) task...
December 2008: Pharmacology, Biochemistry, and Behavior
Junko Ishikawa, Chihiro Sutoh, Akinori Ishikawa, Hiroyuki Kagechika, Hitoshi Hirano, Shoji Nakamura
Retinoids influence cellular processes such as differentiation, proliferation and apoptosis via retinoic acid receptor (RAR) and retinoid X receptor (RXR), and have therapeutic applications in several cancers and dermatologic diseases. Recent reports indicate that depression occasionally occurs in patients using the acne drug Accutane, the active component of which is 13-cis-retinoic acid (13-cis-RA). Although impairment of serotonin (5-HT)-expressing neurons, including morphologic changes, is thought to be associated with depressive symptoms, the effects of 13-cis-RA on 5-HT neurons have not been examined...
May 2008: European Journal of Neuroscience
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