head JofIMAB
Journal of IMAB - Annual Proceeding (Scientific Papers)
Publisher: Peytchinski Publishing Ltd.
ISSN: 1312-773X (Online)
Issue: 2023, vol. 29, issue3
Subject Area: Medicine
DOI: 10.5272/jimab.2023293.5112
Published online: 20 September 2023

Case report
J of IMAB. 2023 Jul-Sep;29(3):5112-5115
Tatyana Telbizova1ORCID logoCorresponding Autoremail, Svetlin Varbanov2ORCID logo,
1) Department of psychiatry and medical psychology, Medical University – Varna, MHAT "St. Marina" – Varna, Bulgaria.
2) Department of health care, Sliven Affiliate, Medical University – Varna, MHAT "St. Marina" – Varna, Bulgaria.

Isotretinoin is an effective treatment for severe and resistant forms of acne. It has proven potential for inducing dose-dependent psychiatric side effects, especially in some vulnerable groups of patients.
Objective: The aim of the present article is to report a case of a 22-year-old woman with a family history of schizophrenia who was diagnosed with acne. After unsuccessful antibiotic treatment of acne, a panic disorder accompanied by depressive symptoms manifested. Isotretinoin 20 mg/day was used as а second step of the dermatological treatment for a period of four months, along with psychotropic treatment for panic disorder – sertraline 50 mg/day and flupentixol 1,5 mg/day. When the dose of Isotretinoin was increased to 40 mg/day, paranoid delusions occurred. The manifestation of psychotic symptoms required discontinuation of all medications and initiation of antipsychotic therapy with quetiapine. The psychotic symptoms completely disappeared when the dose of quetiapine was increased to 300 mg/day.
Conclusion: The presented case emphasizes the need for increased vigilance about the manifestation of psychiatric symptoms, especially in patients with a family history, current or past medical history of mental disorder. In such cases, consultation with a psychiatrist before starting treatment with Isotretinoin is recommended in order to better clarify the benefits and the risks of the treatment. The endogenous origin of the psychosis was discussed in the differential diagnostic plan, which requires long-term monitoring of the mental state.

Keywords: Isotretinoin, acne, psychosis, psychiatric side effects,

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Please cite this article as: Telbizova T, Varbanov S. Isotretinoin induced psychotic symptoms. J of IMAB. 2023 Jul-Sep;29(3):5112-5115. [Crossref - 10.5272/jimab.2023293.5112]

Corresponding AutorCorrespondence to: Tatyana Telbizova, MD, PhD, Department of psychiatry and medical psychology, Medical University of Varna, UMHAT "St. Marina", Varna; 1, Hristo Smirnenski Blvd., 9000, Varna, Bulgaria; E-mail: telbizova@gmail.com

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Received: 07 February 2023
Published online: 20 September 2023

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