Annabel Wright, 15, was prescribed isotretinion, which is sold under the brand name Roaccutane, in the months before she died on 1 May 2019.
She was found dead in her bedroom in her family home near Ripon in North Yorkshire. Her mother, Helen Wright, told an inquest on Thursday that they were not properly warned about the drug’s more serious side effects.
The drug was also linked to a further nine deaths by suicide in 2019. According to the medicines regulator, the safety of isotretinoin was kept under continuous review in the UK and across Europe.
Here’s everything you need to know about Roaccutane and what side effects it might have:
What is Roaccutane?
Roaccutane is the brand name for isotretinoin capsules. According to the NHS, the oral medication is a very effective treatment for severe acne and four out of five people who use it see their skin clear up after four months.
However, it can only be prescribed by a specialist doctor, who will also supervise the person taking Roaccutane due to potentially serious side effects.
How does it work?
Roaccutane belongs to a group of medicines called retinoids and works by reducing the amount of sebum produced by glands in the skin.
Reducing sebum, an oily substance, also reduces bacteria and inflammation. The drug also opens clogged pores, helping acne to clear, according to MedicineWise.
Who can take Roaccutane?
Teenagers and adults with severe acne can take Roaccutane to treat the skin condition. However, it is not suitable for people who have had an allergic reaction to isotretinoin, soya (an ingredient in the capsule) or any other medication in the past.
People with an inherited digestive disorder called fructose intolerance should also not take Roaccutane as the capsules contain sorbitol, a type of sugar alcohol.
It is also important not to become pregnant while using the medication and for at least a month after stopping, as isotretinoin can harm an unborn baby.
What are the common side effects?
The most common side effects of Roaccutane include skin becoming more sensitive to sunlight, dry eyes, throat and nose, nosebleeds, headaches, and general aches and pains.
Dry skin and lips are also very common side effects, which can be relieved by wearing lip balm and moisturiser.
The NHS warns patients taking Roaccutane against having any waxing, dermabrasion or laser skin treatments while taking the medication and for at least six months after stopping due to the risk of scarring or skin irritation.
What are the serious side effects?
According to the NHS, serious side effects from Roaccutane are rare and happen in fewer than one in 1,000 people.
These include anxiety, aggression and violence, changes in mood, or suicidal thoughts. The Medicines and Healthcare products Regulatory Agency (MHRA) warns that depression, anxiety and other psychiatric disorders have been reported in patients treated with the drug.
“Very rarely, suicidal thoughts, or suicide attempts, and suicide have been reported,” the agency said.
The NHS adds: “It’s very rare, but isotretinoin capsules can sometimes cause depression or make it worse, and even make people feel suicidal.”
Some people may show signs of pancreatitis, including severe stomach pain, diarrhoea, nausea and vomiting, or signs of gastrointestinal bleeding if they have bloody diarrhoea.
Other serious side effects also include a serious skin rash that peels or has blisters, and difficulty moving arms or legs, and painful, bruised areas of the body, indicating muscle weakness.
Some people may experience symptoms of liver or kidney problems, such as skin or the whites of the eyes turning yellow, difficulty peeing or feeling very tired, persistent headache and sudden changes in eyesight.
If you experience any of these symptoms, you should stop taking the capsules and call a doctor immediately.
You can contact the Samaritans helpline by calling 116 123. The helpline is free and open 24 hours a day every day of the year.
You can also contact Samaritans by emailing email@example.com. The average response time is 24 hours.