Psychosis during treatment with isotretinoin

Isotretinoin, the 13-cis isomer of all-trans-retinoic acid, is a retinoid and thus a derivative of vitamin A. It has been used successfully since the 1980s to treat severe recalcitrant nodular acne [Sundstrom et al. 2010], but various case reports have suggested that isotretinoin is associated with depression and suicidal behaviour [Citrome, 1998; Hazen et al. 1983; Wysowski and Swartz, 2005] and manic psychosis [Barak et al. 2005]. To the best of the authors’ knowledge, there have been hardly any reports of psychosis during treatment with isotretinoin.