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Isotretinoin is a highly effective acne treatment, but case reports of associated depression have suggested that isotretinoin might have central effects. Vitamin A toxicity has been associated with a wide variety of psychiatric symptoms, such as personality changes, but no convincing data have shown that isotretinoin causes depression. Reasoning that for isotretinoin to cause depression it must have an effect on the brain, these authors used brain imaging to look for changes before and after isotretinoin treatment. In an open-label study, 28 acne patients underwent positron emission tomography (PET) and MRI scanning before and after 4 months of treatment with an antibiotic (15 patients; 14 receiving tetracyclines) or isotretinoin (1 mg/kg d…