Dream pill could be drug nightmare

Creams hadn't worked. Antibiotics hadn't either. Soaps barely made a dent. So my dermatologist made me an offer I couldn't refuse: the possibility of clear skin for the rest of my life. The catch? Five months of chapped lips, dry skin and increased sunburn vulnerability. Worst of all, the prospect of sorting through horror stories about vision impairment, bone, muscle and stomach problems, depression and even suicide.

This controversial pill is called Accutane, and I chose to risk these serious side effects when I began a five-month course of the drug earlier this year. Accutane, often prescribed to patients with severe or unresponsive acne, requires careful consideration and a questioning of one's priorities.

According to dermatologist Todd Colonna, Accutane attacks acne differently than other treatments. "It's a Vitamin A derivative that works by shriveling up the sebaceous glands, which cause acne," he says. "They'll eventually grow back, but the idea is to keep you clear until your twenties and then hopefully the problem will take care of itself."

Down and out

Accutane, prescribed to 500,000 people every year, has received a lot of attention since its introduction in 1982.

In the fall of last year, the drug came under fire after Congressional Representative Bart Stupak's son committed suicide during his Accutane treatment. After hearings about the drug's psychological effects, the FDA mandated that all patients receive brochures outlining possible side effects and sign a paper saying they understand the risks associated with treatment.

Staying well-informed can help nip a potentially serious situation in the bud. Senior Rebecca DuRivage-Jacobs recounts the psychological effects that the drug had on her. "I had really bad mood swings and even crying spells," she says.

I experienced similar symptoms on a smaller scale when the start of the school year proved rough. After I finished Accutane, though, my motivation levels were higher and school didn't seem like such a burden.

This illustrates a key problem with diagnosing Accutane's psychological effects—difficulty distinguishing the everyday stresses of teenage life from true depression. When I went in for my monthly checkup with the dermatologist, my parents and I used to joke that half the warning signs for depression that the doctor would check for—mood swings, irritability, unusual sleep patterns, trouble concentrating—described every teen in America.

Colonna asserts that the Accutane-depression link is nothing more than a myth. "There have been studies looking at thousands of teenagers that found that the rates of suicide were equal in patients who were on Accutane, those on antibiotics [for acne], and those on nothing at all," he says.

He also points out that anecdotes are often more convincing than statistics and says that positive reactions are rarely reported. "You hear these horror stories about depression, but I think many people end up feeling better about themselves because of their clear skin-those are the stories you never hear about."

On the side

The most pesky and common side effect is the relentless chapping. Though my dry lips were the most visible effect, several others proved problematic. My joint pain was easily taken care of with a couple of Advil; others were not so lucky. Senior Mike Coe had serious problems with skeletal aches. "About two months into it, I started having serious joint pain, which the doctor didn't tell me anything about. I eventually quit soccer because of it," he says.

Like Coe, I experienced a side effect about which I was not explicitly warned. Late in my treatment I started having vision problems. Panicking, I saw the ophthalmologist, fearing that Accutane had caused a serious problem in my brain. She calmly explained that it was simply dryness of the eye that hadn't completely gone away after I finished Accutane.

Though my doctor had told me that my eyes would get dry, he never said that it would cause blurry vision. Ophthalmologist Colleen Joseph believes that doctors should work harder to ensure that patients know what to look for. She points out that some of the other acne treatments can have some of the same effects.

This confirms what I found all along: that the intense media hype about the drug made my time on Accutane much more turbulent. Once I was armed with enough knowledge to cut through the controversy, hassle-free clear skin was worth taking the risk.