Fakta Terkini Penggunaan Isotretinoin yang Diduga Menyebabkan Inflammatory Bowel Disease dan Depresi

Oleh :

Graciella N T Wahjoepramono

Isotretinoin, modalitas pilihan untuk acne sedang-berat, telah dikaitkan dengan efek samping berupa inflammatory bowel disease (IBD) dan depresi. Meski demikian, beberapa studi yang lebih baru justru mendapatkan hasil yang menentang hubungan antara isotretinoin dan kedua risiko efek samping tersebut.[1-3]

Risiko Efek Samping Isotretinoin

Di antara berbagai modalitas terapi yang tersedia untuk acne, isotretinoin atau retinoid (vitamin A) sintetis merupakan salah satu agen dengan efikasi tinggi, terutama untuk terapi acne sedang hingga berat. Sebuah tinjauan pustaka dari 11 uji klinis terkontrol menyimpulkan bahwa isotretinoin lebih superior dibandingkan plasebo maupun antibiotik sistemik.[4]

Sumber: AT Lima, jpogi, Wikimedia commons, 2010.

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Referensi

1. Miqdad MA, Alatta L, Abdelsamad A, et al. Isotretinoin-Induced Inflammatory Bowel Disease: Is There a Real Association? Cureus. 2022 Oct 2;14(10):e29825. doi: 10.7759/cureus.29825.
2. Ren Y, Ren Z, Zhao S, et al. Chronic administration of isotretinoin induces depressive- and anxiety-like behaviors by altering the neuroactive ligand-receptor interaction pathway in adolescent mice. Transl Psychiatry. 2025 Nov 20;16(1):28. doi: 10.1038/s41398-025-03750-4.
3. Gupta N, Ray M, Shayya A, McGinnis S, Marson J, Jagdeo J. Isotretinoin Does Not Increase the Risk of Inflammatory Bowel Disease: A TriNetX Retrospective Cohort Analysis. J Drugs Dermatol. 2025 Dec 1;24(12):1168-1172. doi: 10.36849/JDD.9168.
4. Vallerand I, Lewinson R, Farris M, Sibley C, Ramien M, Bulloch A et al. Efficacy and adverse events of oral isotretinoin for acne: a systematic review. British Journal of Dermatology. 2018;178(1):e79-e79
5. Zaenglein A L, Pathy A L, Schlosser B J, Alikhan A, Baldwin H E, Berson D S et al., Guidelines of Care for the Management of Acne Vulgaris. Journal of American Academy of Dermatology. 2016; 74 (5): 945-973.
6. Bharmal R, Anderson S. Exacerbation of inflammatory bowel disease with isotretinoin. JRSM Short Reports. 2010;1(7):1-2.
7. Pigatto P, Fioroni A, Riva F, Brugo M, Morandotti A, Altomare G et al. Effects of Isotretinoin on the Neutrophil Chemotaxis in Cystic Acne. Dermatology. 1983;167(1):16-18.
8. Marks D, Harbord M, MacAllister R, Rahman F, Young J, Al-Lazikani B et al. Defective acute inflammation in Crohn's disease: a clinical investigation. The Lancet. 2006;367(9511):668-678.
9. Grenier E, Maupas F, Beaulieu J, Seidman E, Delvin E, Sane A et al. Effect of retinoic acid on cell proliferation and differentiation as well as on lipid synthesis, lipoprotein secretion, and apolipoprotein biogenesis. American Journal of Physiology-Gastrointestinal and Liver Physiology. 2007;293(6):G1178-G1189.
10. Yu CL, Chou PY, Liang CS, et al. Isotretinoin Exposure and Risk of Inflammatory Bowel Disease: A Systematic Review with Meta-Analysis and Trial Sequential Analysis. Am J Clin Dermatol. 2023 Sep;24(5):721-730. doi: 10.1007/s40257-023-00765-9.
11. Lamberg L. Acne Drug Depression Warnings Highlight Need for Expert Care. JAMA. 1998;279(14):1057.
12. Wysowski D, Pitts M, Beitz J. An analysis of reports of depression and suicide in patients treated with isotretinoin. New England Journal of Medicine. 2001;45(4):515-519.
13. Hong Ng C, Schweitzer I. The Association Between Depression and Isotretinoin Use in Acne. Australian & New Zealand Journal of Psychiatry. 2003;37(1):78-84.
14. Gradwohl K, Verghese M, Rosenblatt AE. Mood changes and clinical decision making in adolescent patients on isotretinoin therapy for acne vulgaris. Pediatr Dermatol. 2023 May-Jun;40(3):494-496. doi: 10.1111/pde.15324.
15. Oliveira J, Sobreira G, Velosa J, Telles Correia D, Filipe P. Association of Isotretinoin with Depression and Suicide: A Review of Current Literature. Journal of Cutaneous Medicine and Surgery. 2017;22(1):58-64.
16. Mufaddel A, Elnour A, Omer A, Alshora E. Psychiatric Comorbidity in Patients with Acne. Open Journal of Psychiatry. 2017;07(03):176-185.
17. Tasoula E, Gregoriou S, Chalikias J, Lazarou D, Danopoulou I, Katsambas A et al. The impact of acne vulgaris on quality of life and psychic health in young adolescents in Greece: results of a population survey. Anais Brasileiros de Dermatologia. 2012;87(6):862-869.
18. Hanisah A, Omar K, Azhar Shah S. Prevalence of acne and its impact on the quality of life in school-aged adolescents in Malaysia. Journal of Primary Health Care. 2009;1(1):20.
19. Tan NKW, Tang A, MacAlevey NCYL, Tan BKJ, Oon HH. Risk of Suicide and Psychiatric Disorders Among Isotretinoin Users: A Meta-Analysis. JAMA Dermatol. 2024 Jan 1;160(1):54-62. doi: 10.1001/jamadermatol.2023.4579.
20. Orenay OM, Temel B, Capci AK, Bal ZI, Karaosmanoglu N. Evaluation of isotretinoin effects on depression, sleep apnea and sleep quality. Cutan Ocul Toxicol. 2024 Jun;43(2):129-133. doi: 10.1080/15569527.2024.2340435.