Part of the controversy has to do with whether or not Accutane caused depression and an increase in suicidal thoughts or actions in patients. Some patients committed suicide while taking the medication, but evidence suggests that severe acne itself causes depression, potentially making patients susceptible to suicidal thoughts and actions before they began taking Accutane.
A study published in the Journal of Investigative Dermatology studied the link between acne severity and mental health of teenagers. As reported by the Los Angeles Times on 9/17/10, researchers found that 11 percent of teens overall experienced episodes of suicidal thoughts. But those who said they had "substantial" acne were 80 percent more likely to report having suicidal thoughts than patients who had less severe acne or no acne.
According to researchers, the more severe the acne, the higher the risk of suicidal thoughts. Since patients with more severe acne are more likely to try a medication such as Accutane, those patients may already have been at risk of depression and increased suicidal thoughts or actions.
The courts have already heard some lawsuits alleging that Accutane is linked to an increased risk of inflammatory bowel disease.
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Both ulcerative colitis and Crohn's disease typically involve periods of flare-ups, where the intensity of the illness is worse, and periods of remission, during which patients experience few or no symptoms.
Some Accutane patients say they suffered inflammatory bowel disease and needed surgery to remove part of all or part of the the bowel. Many say inflammatory bowel disease has had a dramatic impact on their life, forcing them to remain close to home and to avoid social situations.
So far, all cases heard by the courts have resulted in favorable verdicts for the plaintiff, although one award was reversed on appeal.