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Dermatol Ther. 2019 Nov;32(6):e13104. doi: 10.1111/dth.13104. Epub 2019 Oct 14.

Depression, isotretinoin, and folic acid: A practical review.

Author information

1
Mansoura Dermatology, Venerology and Leprology Hospital, Mansoura, Egypt.
2
Department of Dermatology and Venereology, Military Medical Academy of Belgrade, Serbia.
3
Department of Dermatology, University of Health Sciences, Gazi Yaşargil Training and Research Hospital, Diyarbakır, Turkey.
4
Department of Psychiatry, University of Health Sciences, Gazi Yaşargil Training and Research Hospital, Diyarbakır, Turkey.
5
Clinic for Mental Disorders "Dr Laza Lazarevic", Belgrade, Serbia.
6
Department of Dermatology, University of Rome "G. Marconi", Rome, Italy.
7
Unit of Plastic and Reconstructive Surgery, Department of Emergency and Organ Transplantation, University of Bari, Bari, Italy.
8
Department of Dermatology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.

Abstract

Isotretinoin (ISO) is a first-generation retinoid discovered in 1952 and approved by the FDA for the treatment of nodulocystic acne in 1982. The anti-inflammatory properties of ISO have found its use in disorders other than acne. ISO can create psychiatric problems, including depression and suicidal ideation. These neuropsychiatric problems are very similar to disorders secondary to hyperhomocysteinemia (HHcy), vitamin B12, and folic acid (vitamin B9) deficiencies. Given that previous literature suggested folate supplementation improved the efficacy of traditional antidepressant medications, clinicians may wish to consider folate supplementation for patients with depression or possible depressive symptoms, such as acne patients with genetic susceptibility. Brain-derived neurotrophic factor may be a cytokine-specific screening biomarker in immune-based antidepressive therapy.

KEYWORDS:

depression; folic acid; low dose isotretinoin

PMID:
31587447
DOI:
10.1111/dth.13104

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