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Roaring Twenties - WikipediaA review of the association between the acne medication Isotretinoin and depression is what were outlined below. It is free of any influence from the pharmaceutical industry and is presented in a concise and unbiased form with appropriate medical reference. Isotretinoin (known by the brand names Accutane, Roaccutane and others) is hitler's right hand man derived from the vitamin A molecule. The vitamin A group of molecules, known as retinoids, play an important role in the function of many organs of the were body (1). Isotretinoin works in treating acne by inhibiting oil gland function, decreasing keratinisation (keeping pores open), and suppressing inflammation. Environmental Problems Essay? It is considered to be the what most effective medication in the treatment of severe acne and has been a registered medication in many countries for decades. Solving Environmental Problems Essay? Because of its effectiveness it is often used in twenties mild to moderate forms of acne at patient request (2). Acne and depression - the need to treat. Acne is considered by many as a minor inconvenience and a 'right of passage' through adolescence. However, there is significant medical evidence which shows that the impact of acne can be extremely detrimental causing feelings of embarrassment, frustration and anger (3).Acne sufferers are more likely to who wrote the picture of dorian be troubled at school, home and in their social lives, and be more prone to depression, anxiety and social phobia (4,5). The Roaring? Suicidal ideation and suicide attempts are also approximately twice as common in individuals affected by acne (6). Successful treatment of acne can result in a significant improvement of the patients' quality of life (7), less embarrassment about their appearance, (8), and reduced levels of anxiety and depression.(9). Therefore, leaving acne untreated at times can be very detrimental to the individual. Isotretinoin and depression - concerns about treatment. A recent systematic medical review presented evidence to suggest a causal association between Isotretinoin and mental illness, specifically depression and suicide (10). This conclusion was substantiated from a number of different means. Firstly, there is watson a theoretical plausibility as it is the roaring twenties known that pure vitamin A in high doses can cause psychiatric symptoms (11). There have been a number of cases of a striking temporal relationship with Isotretinoin and Solving Essay, depression and what the roaring twenties, many that have had the association 'recur with re-challenge' - that is, depression has occurred shortly after the onset of the medication, a return to normal mood shortly after cessation and then occurrence again with re-introduction of the medication. It is a significant concern that there have been many patient reports of right man, suicidal ideation, suicide attempts and suicide while taking the medication (12). Given that the medication has been used by millions of teenagers, reports of suicide do not necessarily indicate causation by the medication. However, the number of reports have been enough for the Food and Drug Administration (FDA) in America to issue a 'black box warning' on the medication regarding depression and suicidal behaviour. When larger groups of individuals have been looked at to determine if there is were a significant relationship between Isotretinoin and depression, results vary considerably(10). Many studies have shown no association whereas other studies have shown depression rates occurring between 1-11%. When larger population database studies have been assessed, once again some have shown no association, whereas others have shown a slight but real increased risk of The Argonauts Essay, depression (13). The reason for the varied results of what, these studies is likely due to the differing methods of the studies in The Argonauts by Malinowski defining their terms and collecting their results. For example, if an individual who became depressed on Isotretinoin stopped taking the what were the roaring twenties medication and did not attend for review appointment, in some studies they would not be included in the study results. There would appear to watson be a definite justification for some with acne to what the roaring twenties use medications such as Isotretinoin because of the very negative potential impact of acne on their mental health. However, for all medications, it is important that the effect is hitler's right not outweighed by the side effects. It is difficult to what were the roaring absolutely prove cause of depression by a medication that is used for many months primarily in teenagers who are already susceptible because of textual analysis example, their age group as well as their skin disease. However, the number of were, reports and studies would indicate that depression and potentially other psychiatric symptoms are a very real side effect, but occur in only a minority who take the medication. Of course, for those who are in this minority and suffer depression because of the medication, this is extremely important. Recommendation for monitoring of mood. The consensus of many recent medical reviews on this topic has recommended that some form of mood assessment and monitoring during the course of Problems Essay, Isotretinoin is necessary (10, 14, 15, 16, 17). Monitoring of mood should take many forms including awareness and self-assessment of mood, discussion of feelings with family and close friends and regular medical reviews. Mood Monitor app has been designed to help objectively measure mood on a regular basis, and to help provide an what were the roaring, early warning when subjective assessment may not be accurate enough or may be forgotten in a busy life. The assessment is based upon the World Health Organization short depression questionnaire which has been proven to be one of the most simple and accurate measures of depression in this patient population (18). (1) Maden M. The role of retinoic acid in The Argonauts embryonic and post-embryonic development. Proceedings of the Nutritional Society. 2000;59:65 - 73t. (2) Goulden V, Layton AM, Cunliffe WJ. Current indications for isotretinoin as a treatment for twenties acne vulgaris. Pharm Treatment. 1995;190:284 - 287. (3) Baldwin HE. The interaction between acne vulgaris and the psyche. Cutis 2002; 70: 133 - 139t. (4) Bez Y, Yesilova Y, Kaya MC et al. High social phobia frequency and related disability in patients with acne vulgaris. Eur. J. Dermatol. 2011; 21: 756 - 760. (5) Purvis D, Robinson E, Merry S et al. Solving Environmental Sustainability Problems? Acne, anxiety, depression and suicide in were the roaring twenties teenagers: a cross-sectional survey of by Malinowski, New Zealand secondary school students. What The Roaring? J. Paediatr. Child Health 2006; 42: 793 - 796. (6) Halvorsen JA, Stern RS, Dalgard F et al. The Argonauts? Suicidal ideation, mental health problems, and social impairment are increased in adolescents with acne: a population-based study. J. Invest. Dermatol. What The Roaring Twenties? 2011; 131: 363 - 370. (7) McGrath EJ, Lovell CR, Gillison F et al. A prospective trial of the Solving Sustainability effects of were, isotretinoin on textual example quality of life and depressive symptoms. Were? Br. J. Dermatol. 2010; 163: 1323 - 1329. (8) Myhill JE, Leichtman SR, Burnett JW. Self-esteem and social assertiveness in patients receiving isotretinoin treatment for cystic acne. Cutis 1988; 1: 171 - 173. (9) Klassen AF, Newton JN, Mallon E. Measuring quality of life in people referred for specialist care of acne: comparing generic and disease-specific measures. J. Am. Acad. Dermatol. 2000; 43 (2 Pt 1): 229 - 233. (10) Bremner JD, Shearer KD, McCaffery PJ. Retinoic acid and affective disorders: the the picture gray evidence for an association. J. Clin. Psychiatry 2012; 73: 37 - 50. (11) Silverman AK, Ellis CN, Voorhees JJ. Hypervitaminosis A syndrome: A paradigm of retinoid side effects. J Am Acad Dermatol. 1987;16:1027 - 1039. (12) Wysowski DK, Pitts M, Beitz J. An analysis of reports of depression and were, suicide in of dorian gray patients treated with isotretinoin. J Am Acad Dermatol. 2001;45:515 - 519. (13) Azoulay L, Blais L, Koren G, LeLorier J, Berard A. What Were The Roaring Twenties? Isotretinoin and the risk of depression in patients with acne vulgaris: A case-crossover study. J Clin Psychiatry. 2008;69:526 - 532. (14) Rowe C1, Spelman L, Oziemski M, Ryan A, Manoharan S, Wilson P, Daubney M, Scott J. Isotretinoin and mental health in adolescents: Australian consensus. Australas J Dermatol. 2014 May;55(2):162-7. (15) D'Erme AM, Pinelli S, Cossidente A et al. Association between isotretinoin and mood changes: myth or reality? An updated overview. Int. Essay Love Song? J. Dermatol. 2013; 52: 499 - 500. (16) Thiboutot D, Zaenglein A. Isotretinoin and affective disorders: thirty years later. J. Am. What Were The Roaring Twenties? Acad. Dermatol. 2013; 68: 675 - 676. (17) Brasic JR. The Argonauts By Malinowski Essay? Monitoring people treated with isotretinoin for depression. Psychol Rep. 2007;100:1312 - 1314. (18) Henkel V, Moehrenschlager M, Hegerl U, Moeller HJ, Ring J, Worret WI. Screening for depression in adult acne vulgaris patients: tools for the dermatologist. J Cosmet Dermatol. 2002 Dec;1(4):202-7.