O uso de Isotretinoína no tratamento da acne severa: avaliação do risco de depressão e outras alterações psiquiátricas

Severe acne is a dermatological condition that negatively affects patients quality of life, both physically and emotionally. When conventional treatments are not effective, isotretinoin is a frequently used alternative. Although its effectiveness in treating severe acne is well-established, its use has been associated with adverse mental health effects, including depression, anxiety, and suicidal ideation, raising concerns about the relationship between the drug and psychiatric disorders. The main objective of this study is to understand the psychological effects of isotretinoin use in the treatment of severe acne, focusing on the development of symptoms such as depression, anxiety, and suicidal ideation. Specific objectives include investigating the impact of isotretinoin on mental health, exploring the chemical mechanisms related to mood changes, and suggesting strategies for monitoring and providing emotional support during treatment. This study is a systematic review of the literature conducted through databases such as PubMed, Scopus, and Web of Science. Articles published between 2010 and 2025 that investigated the relationship between isotretinoin and psychiatric disorders were analyzed. The research followed PRISMA guidelines and included observational studies and randomized clinical trials. The results indicate that, while isotretinoin is highly effective in treating severe acne, its use may be related to the worsening of psychiatric symptoms, especially in individuals with emotional vulnerability. Studies show that alterations in neurotransmitter levels, such as serotonin and dopamine, may be a contributing factor. However, the exact relationship between the drug and psychiatric disorders is not yet fully understood. Isotretinoin use, while effective in treating severe acne, should be accompanied by rigorous psychological care. Patients with a history of emotional disorders should be closely monitored, and the administration of the drug should be adjusted as needed. Multidisciplinary collaboration is essential to ensure that the dermatological benefits of the treatment are not outweighed by the psychiatric risks.