ABSTRACT
Neuropsychiatric effects are far less common but have been a highly controversial topic since the first oral retinoid, isotretinoin, was introduced in 1982. In 1998, the United States Food and Drug Administration changed the warning label on the medication to include depression, psychosis, suicide ideation, suicide attempt, and suicide; however, since this warning was added, there has been a major controversy over the psychiatric side effects of isotretinoin. Retinoid treatment could alter neuronal functioning in the prefrontal cortex and may be responsible for the psychiatric effects seen with therapy. Any psychiatric effects seen from retinoid treatment are likely due to dysregulation of multiple regions of the brain, responsible for controlling emotion and behavior. Evidence for an association between isotretinoin and psychosis is found in several reported cases of hypervitaminosis A associated with psychotic symptoms. Some authors argue other systemic retinoids could have similar psychiatric effects as isotretinoin due to their similar structure.
