No association between isotretinoin and impulsivity in patients with moderate-to-severe acne vulgaris.

Background: Acne vulgaris (AV) is one of the common dermatologic diseases that usually affects people during adolescence. Reports have shown that isotretinoin, the first-line therapy option for moderate-to-severe AV, could lead to mood disturbances and suicidality. Impulsivity is the tendency to act prematurely without foresight and is a significant risk factor for suicidality. This study aimed to test the hypothesis that isotretinoin would lead to an increase in impulsivity.
Methods: Seventeen patients with AV were enrolled. The study was planned as a naturalistic 3-month follow-up study. Beck Anxiety Inventory (BAI), Beck Depression Inventory (BDI), Barratt Impulsiveness Scale (BIS), Go/No-go Task (GNG), and Balloon Analog Risk Task (BART) were administered before and after the isotretinoin treatment.
Results: We found a significant improvement in the severity of anxiety (P = 0.015; t = 2.72) and depression symptoms (P = 0.08; t = 3.04) in AV patients at the end of 3 months. Self-report impulsivity characteristics with BIS stayed unchanged (P = 0.434; t = 0.80). Besides, no statistically significant difference was found in behavioral task results associated with response inhibition with GNG (P = 0.52; t = 0.65) and impulsive decision-making with BART (P = 0.842; t = -0.20). However, there was a significant decrease in omission errors, with GNG suggesting improvement in attention domain (P = 0.020; W = 90.0) after the follow-up.
Conclusions: It has been demonstrated that isotretinoin treatment improves the severity of depression, anxiety symptoms, and attention performance in AV patients. However, there was no significant change in patients' impulsivity severity based on self-reports and behavioral performances based on GNG and BART.
(© 2023 The Authors. International Journal of Dermatology published by Wiley Periodicals LLC on behalf of the International Society of Dermatology.)