TW Should the NHS stop prescribing this acne drug?

Question

The parents of young people who have killed themselves and patients unable to have sex are calling for the NHS to stop prescribing acne drug Roaccutane. 
Ed Henthorn said it had caused him erectile dysfunction, psychosis and suicidal thoughts.
And one man who believes his son killed himself after taking the drug said the risks "are just too high".
Manufacturer Roche said "millions of patients worldwide have benefited from taking the drug".
The majority of those who take the drug have a positive experience.
"I used to think about girls... but my feelings, thoughts, just faded away," Ed Henthorn told the BBC's Victoria Derbyshire programme.
He was 19 when he took Roaccutane. He describes his acne as mild but bad enough to want to treat.
After three weeks he started to experience side-effects, including reduced energy and sex drive. 
Then he experienced erectile dysfunction.
"That was why I decided to stop taking it," he said.
What does the NHS say about Roaccutane?
In its  guidance about the options available  for acne treatment, the NHS says Roaccutane (isotretinoin) is only recommended for severe cases of acne that haven't responded to other treatments.
The NHS acknowledges there have been reports of people experiencing mood changes while taking the drug. Its advice says, while there is no evidence these changes were caused by Roaccutane, patients should speak to their doctor immediately if they feel depressed or anxious, or if they have feelings of aggression or suicidal thoughts.
Roaccutane, the brand name the drug isotretinoin is most commonly marketed under, is used by about 30,000 people in the UK each year. 
Campaigners want it banned from NHS prescriptions, arguing its continuing side-effects mean its risks outweigh the benefits. 
Mr Henthorn said he still suffers five years after his last dose. 
He said it had thwarted his hopes of completing university and pursuing a career.
"I had psychosis, psychotic symptoms, suicidal thoughts. It was pretty overwhelming," he added.
"My life now is not the best. I'm just kind of at home. The drug's just turned my life upside down."
Warnings about depression and other psychiatric side-effects were added to the drug's patient information leaflet in 1998. 
Two years ago, a new warning was added to say some people would be affected by problems getting or maintaining an erection and lower libido. 
But Roche said while Roaccutane had side-effects - "like most medications... millions of patients worldwide have benefited from taking the drug".
It added: "Isotretinoin was a prescription-only medicine and therefore can only be safely used under the care and supervision of suitably qualified healthcare professionals.
"This way, specialists with the most experience can advise patients about the important safety issues associated with isotretinoin."
The article goes on and if you’re interested you can find it by the BBC titled: NHS ‘should not prescribe acne drug’
Should we stop prescribing this drug?

Accepted Answer

Coming from someone who took the stuff, while it did have some of the worst side effects I've  ever had from a medication, I don't regret taking it.  It was literally my last hope after 5 years of nothing working on my skin.  I was made fully aware of the risks and I decided that the benefits outweighed the risks in my case.  
Every medication has risks from aspirin to heart medication. But I don't think the handful of negative cases should determine whether something should be taken off the market when for the vast majority of people, it's been very positive.

Answer

I don’t think they should stop prescribing it. I took Accutane and am so glad I did. Many people are close to suicide or depression anyway because of their acne before they take Accutane— that’s a large part of the reason that people attribute their depression/suicide to Accutane— it actually already existed before taking the drug, and the drug exemplified it. 
Now, I’m sure that some people actually had Accutane cause their depression/suicide, but I’ve done a lot of research on it and from what I’ve learned is that it’s unclear just how many of the mental health side effects are preexisting or not.
Myself personally, I had moderate side effects that all ceased to exist after stopping it. And my acne 100% disappeared. 
Anyway, the point of Accutane is that it is supposed to be extremely closely monitored while taking it— I had to go in once a month and discuss side effects, undergo a urine test, and undergo a blood test. Prior to taking it, I also had to read an IPledge booklet & take a quiz on it monthly to show that I understood what I was getting into & that I would not become pregnant while using it. 
If at any point your side effects become severe, they are supposed to dock your daily dosage down to a smaller amount and if it does not help you are to cease usage immediately. But many people hide the severity until it’s too late because they don’t want to go back to having acne. 
It is one of those drugs that can be lifesaving in a special way, but it MUST be extremely carefully monitored and restricted in usage. I support it being prescribed under extremely careful supervision.

Answer

This is a hard one. Although they can read the side effects it has to make the decision to take it, a lot of people who have never experienced depression / suicidal thoughts etc might not realise how serious it can be. A lot of people do have the mind set that you can just stop thinking about suicide because they don’t understand it. Once you become suicidal it’s extremely hard to get help if you can’t stop thinking that life isn’t worth living.

Answer

When side effects are that severe, yes. They should pull the drug from the market. I have always been told if the drug makes me feel suicidal (more so then when I have an episode) to stop taking it.

Answer

I was on this twice, when I was 17 and then 22 it helped both times. I was more depressed with Cystic acne I had. My pimples were so bad. Here in Australia I had to have follow up appointments and so on. I had so many side effects but depression wasn’t one for me. 
It’s tough call, I think it should be prescribed and the patients carefully watched by loved ones and must have check ups in between. Maybe they could get 2 weeks medications at a time and have the review in order to have more prescribed

Answer

As someone who has side effects to many drugs it isnt the drugs fult if your felling different or having problems speak up to the doctor to find what best fits you

Answer

I took isotretinoin and I am so happy I did.  I took it last April for 5 months. Was it bad? Yes. I never had suicidal thoughts or depression but my face peeled really bad, my eyes were always yellow or red, i had chapped lips. But I wouldn’t change it for the world. I had moderate acne and I tried tons of medications, ointments and I went to cosmetologists but nothing worked besides accutane. As soon as you finish taking it the drug leaves your system system after 30 days. And a lot of side effects go away almost immediately. It is a powerful drug but for many of us it was a last resort and a life changer. I think it should be closely monitored and the person taking it must know all the side effects before starting.

Answer

Ive never used accutane but I thought the health risks were pretty well known.
I think with this particular drug its up to the patient and their dr to discuss risk vs benefit.
I dont think they should stop prescribing it, but patients need to be very closely monitored and informed.

Answer

Most drugs/medications have side effects. If they stop prescribing it then who knows what people are going to start wanting to not be prescribed anymore. It’s unfortunate but I don’t think that the negatives should determine rather it stays or goes if the positives outweigh the negatives. Everyone is different and has different experiences and every drug has its pros/cons with the side effects.

Answer

As long as the potential side effects are clear then there's no need to stop prescribing it

TW Should the NHS stop prescribing this acne drug?

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