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By Shankar Vedantam
Accutane, the acne medicine that was prescribed
to a Florida youth who crashed a plane into a skyscraper on
Saturday, has long been controversial, with critics and proponents
debating whether the drug can cause depression and suicidal
behavior.
While no definite link has been demonstrated,
the Food and Drug Administration was concerned enough about
the possibility to require the drug carry a warning:
"Accutane may cause depression, psychosis
and, rarely, suicidal ideation, suicide attempts and suicide,"
states the medicine's warning label, which was agreed to jointly
by the agency and the manufacturer, Hoffmann-La Roche.
Steven Galson, acting director of the
FDA's Center for Drug Evaluation and Research, said one small
study had showed that "when people took Accutane [they]
became depressed and when they had the Accutane taken away,
the depression went away."
"That's the evidence that there could
be a causal link," he said.
Attention has focused again on Accutane
after investigators found that a prescription for the drug
had been written for Charles Bishop, 15, who crashed a small
airplane into a Tampa in January. Police said a note found
in the wreckage professed solidarity with Osama bin Laden.
After teachers described him as a bright and patriotic youth,
his behavior seemed all the more incomprehensible.
The St. Petersburg Times reported that
Bishop's parents had entered a suicide pact in 1984 while
they were teenagers. After a problem with paperwork prevented
them from getting married, the two tried to poison themselves
with car exhaust fumes.
When that failed, they reportedly decided
to slash each other with a butcher knife, which resulted in
Bishop's father being hospitalized with stab wounds. The couple
later had Bishop, got married and divorced.
Accutane has been on the market since
1982 and has been used by hundreds of thousands of people.
A half-million prescriptions were written in the United States
last year, the manufacturer said.
It is reserved for intractable cases of
acne and is sold under an increased security prescription
system, mostly because pregnant women taking the medicine
are liable to have babies with birth defects. The medicine
is not given to pregnant women, and doctors strongly urge
women not to become pregnant while taking the medicine.
While the FDA has about 140 reports of
suicide after people took Accutane, the rate of suicide remains
extremely low,, making it difficult to pin down which cases
might have occurred anyway and whether cases were caused by
the medicine.
Carolyn Glynn, vice president for public
affairs at Hoffmann-La Roche, said the rate of suicide in
the group of 15- to 24-year-olds taking Accutane was lower
than the rate of the general population.
Washington
Post January 11, 2002; Page A02
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