Isotretinoin-Induced Delusional Disorder, Somatic Subtype

Area of Science:

• Psychiatry
• Dermatology
• Pharmacology

Background:

• Isotretinoin is a vitamin A derivative used for severe acne.
• Psychiatric side effects, including depression and psychosis, are documented.
• Severe acne treatment requires careful monitoring of potential adverse effects.

Observation:

• A young male developed psychosis, diagnosed as delusional disorder, somatic subtype.
• No prior psychiatric history or family history was noted.
• Psychosis onset correlated with an increased isotretinoin dosage from 40 mg/day to 80 mg/day.

Findings:

• The patient experienced isotretinoin-induced psychosis.
• Discontinuation of isotretinoin led to symptom improvement.
• Low-dose quetiapine was effective in managing the psychosis.

Implications:

• This case underscores the potential for severe psychiatric adverse events with isotretinoin, even in individuals without predisposing factors.
• Clinicians should be vigilant for psychosis in patients treated with isotretinoin, particularly after dosage escalation.
• Early recognition and management, including drug discontinuation and appropriate psychiatric treatment, are crucial for patient recovery.