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A consideration in prescribing lithium to adolescents is the potential development or worsening of cystic acne. In these situations, clinicians may hesitate to prescribe isotretinoin, due to case reports of depression and suicide. In a study funded in part by litigators against the manufacturer, researchers performed brain imaging among 28 individuals (mean age, 29) to investigate whether isotretinoin is associated with the imaging changes reported with depression. For obvious ethical reasons, participants with current psychiatric disorders were excluded.
In this open-label, nonrandomized pilot study, researchers recruited isotretinoin-naïve patients whose doctors were planning to switch their therapy for treatment-resistant acne. Fifteen pa…