Naked Science Forum

Life Sciences => Physiology & Medicine => Topic started by: Kittycat on 03/10/2005 21:55:18

Title: Acutane
Post by: Kittycat on 03/10/2005 21:55:18
Hello all,

My son is desperate to get rid of his acne. Many are now having good results with this drug.
It concerns me because of the altering affect on the skin.
Does it actually change the DNA? Does it only change the skin or other parts of our body?
Any long term side affects?
All advice welcomed,
Thanks, KC
PS. We are consulting with our doctor. Just dislike the idea of drugs esp. scarry ones[:0]

His grace is sufficient and His strength is made perfect in my weakness
Title: Re: Acutane
Post by: ROBERT on 09/12/2005 16:05:41
Serious side-effects have been reported with (Ro)accutane,
most famously psychiatric ones:-

"suicidal ideation, suicide attempts, suicide, depression, psychosis, aggression, violent behaviors.
Of the patients reporting depression, some reported that the depression subsided with discontinuation of therapy and recurred with reinstitution of therapy."

Roaccutane product information:-
http://www.rocheusa.com/products/accutane/pi.pdf

BBC news item:-
http://news.bbc.co.uk/1/hi/health/218028.stm

As acne and the onset of psychiatric illness can often coincide (adolescence),
 then it is difficult to definitively say whether this his drug has caused psychiatric illness.
Title: Re: Acutane
Post by: ROBERT on 21/09/2006 16:21:25
" Scientists link acne drug to depression
By Nic Fleming, Medical Correspondent

(Filed: 19/09/2006)

A link between an acne drug and depression has been shown for the first time, scientists said yesterday.

Since Roaccutane was introduced in the early 1980s several reports have suggested that suicides and attempted suicides have been caused by mood swings in patients taking the medication.

Roche, the manufacturer, added a warning to its packaging in 1988 that patients should tell their doctors if they had a history of depression.

Dr Sarah Bailey, of Bath University, and colleagues at the University of Texas showed that mice given the drug exhibited more depressive behaviour than those not given it.

Her study, published in this month's Neuropsychopharmacology journal, says: "Establishing a link between the active molecules in the drug and a change in depression-related behaviour, albeit in mice, is an important step in our understanding of the drug's effects in the wider context of brain function.

"To date, the only evidence for any link with patients has come from case reports and such data are complicated by the psychosocial effects of having severe acne.

This is a very effective medication for acne and the side effects occur for only five to 10 per cent of people taking it. People on Roaccutane should follow the advice on the packaging by reporting past and family history of depression to their GPs and family members should keep an eye on people taking this medication."

Some 3,300 prescriptions for Roaccutane were issued in Britain last year and 18,100 for a cream with the same active ingredients.

Dr Bailey showed that adult male mice injected with Roaccutane exhibited depressive behaviour such as trying to escape less and spending more time immobile than those not given the drug.

Roaccutane is one of a group of medicines called retinoids – vitamin A-related compounds known to affect the development of the nervous system.

In recent years scientists have become increasingly interested in their effects on brain functions such as memory and learning.

The family of David Roberts, a student from Liverpool who hanged himself last year after taking the drug, said the tablets had made him depressed.

Prof David Nutt, the head of psychopharmacology at Bristol University, said the research could help doctors to understand the drug's mechanisms.

He added: "However, it is important to stress that the only way to really find out whether this can be harmful to humans is to study with more precision the effects in humans."

The Medicines and Healthcare products Regulatory Agency said: "The safety of isotretinoin [the active ingredient of Roaccutane] remains under close and constant scrutiny."

Roche said: "Although we warmly welcome scientific research, we would caution about concluding that this work in 24 mice, 12 of which received the active agent, is indicative of the effects of isotretinoin in humans." "

http://www.telegraph.co.uk/news/main.jhtml?xml=/news/2006/09/19/nacne19.xml
Title: Re: Acutane
Post by: neilep on 21/09/2006 17:30:19
Cripes !!..Thanks for this Robert.

I immediately went upstairs to check my sons tube of OXY and am relieved to find it contains no Roaccutane.  Ah !!..but I now see that the article relates to a prescription remedy. Fortunately my son hasn't got it that bad.

Incredible how they discover these associations.

Men are the same as women, just inside out !
Title: Re: Acutane
Post by: Karen W. on 21/09/2006 18:21:27
My 18 year old has had it real bad for about 6 years, It is just now clearing as he has begun shaving the last couple of years.. Its the clearest its been for years, he uses all the oxy clean products, but if he misses a day or two with those it gets worse!

Karen
Title: Re: Acutane
Post by: gecko on 22/09/2006 03:15:51
keep your child mentally sound, its worth the red dots...
Title: Re: Acutane
Post by: ArmenArtist on 22/09/2006 04:40:20
What is funny, is that acne is supposed to be caused by stress-depression.

Thus, a pill gives you depression as a side effect, when it is the cause?

But then again, how can you know be depressed with acne?  Chicken or egg?
Title: Re: Acutane
Post by: iko on 22/09/2006 13:35:56
I really don't care if anybody's depression leads to acne and/or cavities and viceversa.  The point here should be how to treat safely and effectively a very common skin disease (the most frequent is psoriasis).


In my personal opinion (I'm not a specialist) Retinoids could be useful and safe topically, on the skin, where the problem is.  If anything has to be used 'systemically' in acne, taken by mouth, adsorbed and aimed to work from the 'inside', they should be antibiotic substances -the revolutionary drugs from the past century- of the specific kind that had been tested safe and effective for this particular skin disease.
My dear old friends 'Zitro' & 'Doxy' could certainly help...why friends? It is a long story, you would collapse for too much boredom after the first few pages.
quote:

Azithromycin versus tetracycline in the treatment of acne vulgaris
.
Acne vulgaris affects a large number of young adults and often presents with facial and truncal involvement. Systemic antibiotics are used for the treatment of papulopustular and cystic lesions.
We sought to determine the efficacy and safety of azithromycin versus tetracycline in the treatment of acne vulgaris.
A randomized, investigator-blind, clinical trial was carried out for 3 months at the outpatient clinic of Emam Khomeini University Hospital, Ahwaz, Iran. A total of 290 patients with moderate to severe papulopustular acne vulgaris were allocated to two groups, azithromycin and tetracycline, for 3 months of treatment. Azithromycin 500 mg was prescribed for 3 consecutive days a week for 1 month and then 250 mg every other day for the following 2 months. Tetracycline 1 g was similarly prescribed: daily for 1 month and then 500 mg daily for the following 2 months.
Both antibiotics were effective in reducing inflammatory lesions and improving acne. Azithromycin produced a slightly higher percentage of improvement compared with tetracycline (100 cases/84.7% vs 94 cases/79.7%).
 Conclusion: Azithromycin is a safe and effective alternative in the treatment of inflammatory acne.

...from a recent report by iranian researchers: Rafiei R, Yaghoobi R.       in: J Dermatolog Treat. 2006;17(4):217-21.



Actually a crystal-clear example of a properly conducted clinical study.
Of course there is a problem. 'Zitro' is a well tolerated and highly effective drug: it costs money.
Take care
iko

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=AbstractPlus&list_uids=16971315&query_hl=2&itool=pubmed_docsum

...what a coincidence!...even here vitamin D may be involved (sunlight surely is)...
 
quote:
Serum levels of vitamin D metabolites in isotretinoin-treated acne patients

...We found a significant fall in the level of 1,25-dihydroxyvitamin D (p less than 0.01)...
...early changes in the metabolism of vitamin D in patients on retinoid treatment.
by Rodland O. et al.   in Acta Derm. Venereol.1992;72(3):217-9.


http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=AbstractPlus&list_uids=1357865&query_hl=4&itool=pubmed_docsum

...'normal' sunlight exposure may not help:
quote:
Seasonal variations in the severity of acne vulgaris

...The improvement of acne in summertime or the aggravation of acne in winter is a traditional dermatologic opinion. Ultraviolet rays are thought to be beneficial in the treatment of acne. In the existing literature there is no proof of this. The purpose of this study was to find out whether or not acne generally worsens in winter.
One hundred and thirty-nine patients were asked if their acne worsens in winter or in summertime, whether it improves seasonally, or if they didn't notice any change with the seasons.
About one-third of the patients reported an aggravation of their acne in winter, but also approximately one-third of the patients complained about an aggravation of their acne in summer. Another third did not notice any change.
CONCLUSIONS: Sun-bathing may be beneficial for psychologic reasons and may produce euphoric effects, but we do not see any reason to treat acne with ultraviolet radiation because of all its negative effects on the skin.
from:  Gfesser M and Worret WI  Int.J.Dermatol.1996 Feb;35(2):116-7.



...and cod liver oil?
It's a mystery to me...
iko
Title: Re: Acutane
Post by: ROBERT on 22/09/2006 17:23:45
Acne is caused by hormones, severe acne could be due to unusually high hormone levels,
 high hormone levels can cause extreme moods (agression/depression).

So it is possible that the same mechanism which causes the severe acne also causes suicidal mood,
 and the acne treatment is blameless, (an association being mistaken for a cause).
Title: Re: Acutane
Post by: iko on 22/09/2006 20:42:48
You are right, Robert.
I assumed that the cases of suicide related to retinoids had been found significantly higher than in acne-without-accutane...
iko
Title: Re: Acutane
Post by: iko on 28/09/2006 18:55:25
little bits from "complementary" medicine are a good easy reading...

Treatments for Adult Acne

Acne is a very common disease of the tiny fat glands at the base of hair follicles.

The purpose of these follicular glands, most prevalent on the face, is to keep the skin moisturized. Common bacteria can irritate the hair follicles, which ultimately causes the fat gland to rupture and impact the pore. This can lead to blackheads, whiteheads, or the more serious “zits” which are inflamed and pus-filled pores. Deep acne can create permanent scars. While stress and genetics are certainly contributing factors in acne, diet plays a major role. Another key factor is excess androgen (testosterone) production which increases the size and activity of the fat glands in the hair follicles. Concentrated minerals and vitamins can help improve your biochemistry and promote clear, healthy skin.

Top Four Treatment Approaches for Acne

Clean Up Your Diet To Improve Bowel And Liver Function
We all know that fatty foods are implicated in pimples – so make your best effort to completely eliminate pizza, fries and dairy products from your diet. What is less well known is the negative effect on the skin (and your health in general) from eating processed carbohydrates (candy, soda, commercial baked goods). Many dermatologists have noted insulin seems to help acne, which suggests that high refined carbohydrate diets contribute to the problem. People in a variety of cultures all over the world who eat only what they hunt or grow rarely have acne.
Increase your daily consumption of green leafy vegetables.
Your digestive tract contains much of the highly active immune tissue in the body: Eating right and eliminating toxins daily will help not only your face, but your energy and well-being for the rest of your life. Figure out what it takes (vigorous exercise, prune juice, more water, ground flax seeds, etc.) to have a complete, easy-to-pass bowel movement at least once daily.
   
Take Healing Vitamins
High-dose Vitamin A is the m
ost important. The prescription variety (Retinol) can damage your liver. Even natural Vitamin A, in high doses, can pose risks, it can be very effective in treating acne. It is imperative for women using high dose Vitamin A therapy to avoid pregnancy because of possible fetal malformation. Also, be forewarned that high dose Vitamin A will probably cause drying of lips and skin, and should not be used for longer than 3 continuous months. A recommended dose is 100,000 IUs daily for 4 weeks, then 75,000 IUs daily for 2-4 weeks, then 50,000 IUs daily for 2-4 weeks. This therapy works by reducing the fat (sebum) build-up in the pores.
Another important fat-soluble vitamin for the skin is Vitamin D.
Think of it as liquid sunshine. Acne is typically worse in the winter, and tends to be more severe in climates with lower levels of UV light. Sunburns are certainly not good for your skin, but lots of fresh air and a light tan from daily sun exposure generally improves the complexion. For those of you who live in climates with low or variable amounts of sunshine, or who have photosensitive skin, you can get Vitamin D in a bottle – good old Cod Liver Oil.
Several companies make very tasty varieties (lemon/lime, orange, and even peach flavored). One teaspoon of Cod Liver Oil usually provides the requisite 400 IUs of Vitamin D daily. Cod Liver Oil is also an excellent source of Vitamin A. The importance of Vitamin C, as usual, cannot be overstated. It is the single most important agent in connective tissue healing, which includes skin repair. Use at least 2 grams of Vitamin C daily, ideally in a powdered form. All the B vitamins, including folic acid, help with both skin and nerve function, but niacin (Vitamin B3), applied topically, may be the most important of the B’s for treating acne. This is a new therapy, and probably works by enhancing local breakdown of androgens. Your local pharmacist should be able to provide niacin or niacinamide in a gel or spray form, which is applied after cleansing, twice daily until your skin improves.
   
Take Healing Minerals

Zinc is a co-factor in more than 75% of repair systems in the body. Use 50 mg twice daily or until the zinc tastes really metallic – a sign that your body has plenty of zinc on-board.
Sulfur is a potent natural anti-microbial, and the main reason that garlic and onions are useful foods in speeding the healing of flus or infections. They are naturally high in sulfur compounds. Unless you are sensitive to sulfur (for example to the “sulfa” class of antibiotics), this bright yellow mineral may be an important adjunct to your skin healing routine.
Chromium (to stabilize blood sugar, which will help keep you out of the cookie jar), 200 mcg daily, and <b>Selenium</b> 200-400 mg daily, are two other important trace minerals, critical for optimum immune function.
   
Try To Avoid Harsh Chemicals Or Abrasive Scrubbing Agents On Your Skin

Minimize make-up, especially foundations. If possible, wash your face with water only: start with a warm washcloth, then splash with briskly cold water. You can close up your pores with a natural skin toner made with lemon/lime or rosewater. Aloe gel is nice if the skin feels hot or raw. For deep cleansing and rehydration consider an application of a beaten raw egg yolk. Leave on for 15 minutes before rinsing with water only. Occasionally you could use an over-the-counter benzyl peroxide product to “dry up” zits overnight. Be cautious about over-doing topical applications, however. It bears repeating that washing the face with water only is best, but if that doesn’t feel clean enough, use a gentle exfoliant (something oatmeal based is gentler than fruit seeds or fruit acids) followed by a light toner. Avoid soap because it is too drying for the skin.
 
Selected References
“Is Acne Fed by the Western Diet?”  Archives of Dermatology. Dec 19.2002, Cordain and Berson.   
Encyclopedia of Natural Medicine, Murray and Pizzorno. Acne chapter.
Archived discussions on acne: Clinical Support Network (CSN)
Naturally Clear Skin Care Acne Control Treatments (or call 1-888-24-CLEAR) for topical niacin spray

...slightly modified from:    http://www.dremilykane.com/acne.html


iko