We prescribe isotretinoin in many cases of acne vulgaris specially nodulocystic acne and in a few other diseases. Isotretinoin has many adverse events like depression, emotional lability, suicidal ideation, anxiety disorders and so on. We should screen a patient for psychiatric adverse events during each follow up visit who is on isotretinoin therapy. Are you in favor of screening? What screening tool should we use? Why these psychiatric events develop?
This is the most recent article seen:
Suuberg, Alessandra. “Psychiatric and Developmental Effects of Isotretinoin (Retinoid) Treatment for Acne Vulgaris.” Current therapeutic research, clinical and experimental vol. 90 27-31. 10 Feb. 2019, doi:10.1016/j.curtheres.2019.01.008
The evidence does not appear consistent but would suggest that since psychiatric side effects may occur (as severe as suicidal ideation or psychosis), screening would be wise.
(The Beck inventory is frequently used and could be repeated at regular intervals. Adding something like a Mini Mental Status Exam would work.)
Devising your own tool in the form of a self rating scale of possible symptoms could be most appropriate.
Harasit Kumar Paul , very good question. I hadn't thought of this, but I have seen this happen a lot clinically (symptoms of psychiatric illness secondary to isotretinoin therapy)
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