I saw your post and I thought maybe i would share a quick point on Accutane from my personal knowledge about it, I’d that’s ok? Dr M is the expert, and I am in no way trying to intercept your question nor am I any authority on the subject, I am just a regular “member” on this site who wants to better my own health and learn from Dr Mariano and others on this site. So here’s my two cents. You don’t mention why you want or need Accutane. If it is for Acne, then I can only say that from my own experience, when my Dermatologist discussed the idea of rx’ing me it, it seemed to be “More of a hassle” to obtain it and he wanted me to get written permission from a Psychiatrist because of the concerns about the possible side effects it may have on people taking anti depressant meds and the SUICIDE issue that you mentioned in your question to Dr M. I personally did not want to go thru all the hassle that it seemed to have to go thru to get it, and after I had researched Accutane more in detail, to be honest with you, It kind of scared me a little bit after reading about it’s chemical make up and all of the other things it can possibly do to a person. I chose to go with an anti-biotic med and a topical gel both , rx’d by my dermatologist and it worked out fine for me. But as you know already I’m sure, everyone is different in so many ways !

Just a little of my own personal views on Accutane. Just trying to help out with a quick reply as I just so happened to have had a few minutes to add this quick reply. Hope it helped you somehow ? Geno

@Figuring 2583 wrote:

Hi Dr. M,

I’m wondering what you think about the dangers of Accutane and whether any specific treatment options are available for those who have used it in the past.

I used it over 15 years ago and it was at that point that I started to have hormonal issues.

As you may know, Accutane directly affects cholesterol metabolism (patients are required to monitor their lipids while using it) and it has been linked to suicides.

For those people who have used this drug in the past is there anything you recommend they discuss with their doctors?

Accutane is an effective treatment for severe, treatment-resistant acne. In my experience, the patients in my care haven’t had serious problems when they were simultaneously treated for severe acne by their dermatologist with Accutane and myself for their mental health problems.

Severe acne is disfiguring. It may impair a person’s ability to socialize and form relationships. It may cause the affected person to develop poor self-esteem and depression or other mental illness. This, itself, increases the risk for suicide.

Accutane has significant risks. These include adverse effects resembling Vitamin A toxicity. This includes birth defects. Accutane also, infamously, has a significant risk for contributing to depression and suicide.

Thus, it is important for patients to discuss all relevant issues with their physician – including any prior history of mental illness, to discuss how adverse effects will be handled (including the risk for depression and suicide, and how treatment is going to be monitored.

Already, there is a strict program physicians and their patients have to use in order for the patient to receive Accutane.

Accutane may be medically necessary as a treatment in some patients. Given the risks, safety considerations and risk management are very very important.