A clear chemical link has been established between the acne drug Roaccutane and the history of depression and suicide associated with its usage, according to researchers at the University of Bath.
Writing in the journal Experimental Biology and Medicine a team of scientists, lead by Dr. Sarah Bailey of the Department of Pharmacy & Pharmacology, reported on their discovery that the drug, also known as Accutane, reduced the availability of the neurotransmitter serotonin; low levels of which have consistently been linked to a number of psychiatric symptoms including aggression, anxiety disorders, and suicidal ideation.
"Serotonin is an important chemical that relays signals from nerve cells to other cells in the body", said Dr. Bailey, "our findings suggest that Roaccutane might disrupt the way serotonin is produced and made available to cells…this could result in problems associated with low levels of serotonin, which might include depression".
Previous research by the same scientists, and reported on by NewsTarget last year (http://www.newstarget.com/020463.html), suggested that the drug caused depressive behaviour in mice; but until now an underlying reason for the link has remained elusive, despite a history of tragic suicide deaths associated with its use.
In 2002, 15-year-old student pilot Charles Bishop crashed a Cessna plane into the Bank of America building in Tampa, Florida prompting a $70 million wrongful death lawsuit, filed by relatives who believed that Accutane had induced Bishop to commit suicide.
Similarly, in 2004 Jason Spiller, a teenager from Devon in the UK, was found hanging in a barn at his family home two weeks after beginning a course of acne treatment, despite having had no previous history of depression.
Since 2000, Accutane has consistently appeared in the FDA’s adverse events database as one of the top ten drugs reported as having been linked to psychological side effects. The drug remains the only non-psychiatric medication to have been in the top ten; ranking as high as 4, 5 and 10 in number of reports related to depression, serious depression and suicide respectively, according to a 2001 review published in the Journal of the American Academy of Dermatology.
Following these reports, Congressman Bart Stupak, whose son committed suicide using a firearm while taking Accutane, forced a 2002 House Oversight and Investigation Subcommittee hearing on safety issues related to the medication. "Accutane is a dangerous drug that causes birth defects and adverse psychiatric reactions", said Congressman Stupak at the time.
Roaccutane was first licensed by the FDA for the treatment of acne in 1982, but was plagued by reports of adverse side effects from the very beginning of its being available for prescription. 1983 saw the first reports of the drug being associated with birth defects, while by 1985 its package insert warned physicians of its possible inducement of depression.
A 1990 report from the FDA stated that around 12,000 Accutane-related abortions and more than 1000 related birth defects had occurred since the drug had gone to market eight years earlier. Other side effects associated with using the drug since then include hepatitis, rectal bleeding, osteoporosis, high cholesterol and hearing loss; in addition to more than 180 reports of suicide. According to the FDA, only 1% of suicide adverse events are reported, suggesting that the actual figure could be as high as 18,000. Likewise, the World Health Organisation database contains around 1000 reports of
attempted or committed suicide, thus worldwide adverse event figures have been estimated to be as high as 100,000.
Despite this, manufacturer Hoffman-La Roche has up until now denied any link between the use of Roaccutane and serious behavioural side effects, citing a lack of scientific proof as to how the drug could cause depression or suicide.
About the authorMichael Jolliffe is a health writer, and an expert on nutritional and environmental influences on health and disease. He is also a qualified nutritional therapist, and runs a consultancy in Harpenden, Hertfordshire (UK).
He is a member of the British Association for Nutritional Therapy, International Society for Orthomolecular Medicine and the Life Extension Foundation.
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