BACKGROUND AND OBJECTIVE: Isotretinoin is a systemic agent widely used in the treatment of severe acne vulgaris. Previous studies have reported that isotretinoin use may be associated with depression, anxiety, and sleep disorders. The aim of this study was to evaluate changes in sleep quality, anxiety, and depression in patients with acne vulgaris during isotretinoin treatment.
MATERIALS AND METHODS: This retrospective analysis of prospectively collected data included 155 patients receiving isotretinoin treatment at a tertiary dermatology outpatient clinic in Turkey between January 2023 and December 2024. The Pittsburgh Sleep Quality Index (PSQI), Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), and Global Acne Grading System (GAGS) were administered to patients before treatment, at the end of the first month, and at the end of the third month of treatment. Patients with a history of psychiatric disorders, use of psychotropic medications, or systemic diseases affecting sleep or mood were excluded from the study.
RESULTS: Isotretinoin treatment was associated with a significant reduction in acne severity over the 3-month follow-up period. A transient increase in depressive and anxiety symptoms was observed during the first month of treatment, followed by a significant improvement by the third month. Overall, isotretinoin treatment was not associated with a significant deterioration in sleep quality throughout the study period.
CONCLUSION: Isotretinoin treatment was associated with a significant reduction in acne severity, depression, and anxiety, while no significant overall change in sleep quality was observed. The temporary increase in depression and anxiety observed at the end of the first month may be related to the cutaneous side effects of isotretinoin. Further prospective studies are needed to better clarify the neuropsychiatric effects of isotretinoin.
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