IT HAS been hailed as a miracle drug for the 500,000 teens who will try it this year – a pill that can cure even the worst cases of acne within weeks and dry up the crippling embarrassment that goes with it.
But the drug, Accutane, has also been blamed for the scores of suicides and attempted suicides of teenagers who slipped into inexplicable depression soon after taking it.
One teen who is convinced that Accutane almost caused her to take her life is 17-year-old Amanda Callais.
A straight-A student from Denham Springs, La., she began taking Accutane when she was 14. Her experience on the drug was harrowing.
After a short period of depression, during which she slept for long periods and lost interest in eating and in her personal hygiene, she tried to commit suicide.
“I got into an argument with my parents,” she says. “It wasn’t a bad argument. I hadn’t had a bath in two days, and my Mom just says, ‘You need to take a bath! Take a bath!’
“I blew up. I didn’t want to take a bath. I didn’t want to do anything. I just wanted to sleep. That night, I wrote an entry in my journal about how I just wanted to go to sleep and never wake up. I took my bath.
“Later, I felt completely alone. I felt like no one, no one was there for me. I felt so alone and so desperate. I went into the kitchen and got all the over-the-counter pain relievers I could find.
“I went to my room and took them all, one by one. I took about 40 of them. And then I lay down and went to sleep. I woke up about 3 a.m. I crawled to the bathroom and started throwing up the pills I had taken.
“My parents woke up and heard me.”
Amanda was rushed to the hospital, where doctors saved her life by pumping her stomach. Over the next several months, her grades fell and she alienated most of her friends, lost weight and cut herself whenever she could.
“My parents took my bedroom door off of its hinges so I couldn’t lock myself in my room. They were scared I would try to kill myself again. My mom locked up every pill in the house. Tylenol, Aleve, everything,” she says.
“My dad’s hunting gun was locked away. There was no way to kill myself in my house. My 9-year-old sister, Kaitlin, became my keeper. I was never left alone.
“I thought about killing myself each and every day.”
Throughout this time, she tells February’s issue of CosmoGirl!, she was still taking daily doses of Accutane and her acne had all but disappeared. She stopped taking the drug when reports of a link with suicide and depression appeared in the media.
Almost immediately, she says, the depression lifted and her life returned to normal. Her studies got back on track, and she attends a special school for gifted children.
No one agrees on the number of teens who have killed themselves while taking Accutane. The Food and Drug Administration says it has reports of 66 related suicides and 104 attempted suicides since the pill was marketed in 1982.
Witnesses told a recent congressional hearing that the number Accutane-related suicides may be as high as 84 or as low as 31.
AMONG the kids who killed themselves while taking Accutane is B.J. Stupak, the 17-year-old son of Rep. Bart Stupak of Michigan. The teenager, an athlete and president of his senior class, shot himself in the head with his father’s gun after a prom party.
“I have no doubt that Accutane led my son to kill himself,” the congressman said. “B.J. loved life. He had everything going for him.
“B.J. had not shown signs of depression, and if we had known that this drug could cause depression . . . or suicide, he would never have come into contact with Accutane.”
Accutane, manufactured by Hoffman-La Roche, had a long and troubled history before becoming an $800-million-a-year best seller.
It was first developed nearly 30 years ago as an anti-cancer drug, but it was found to cause birth defects.
Its potential for treating acne by drying the production of oil in the glands beneath the skin was discovered almost by accident.
The discovery gave the drug new life, and it was approved by the FDA for treating acne in 1982. But birth defects continued to be a problem, and by 1988, women using the drug had to use two forms of birth control to be certain not to get pregnant.
Hoffman-La Roche, recognizing the link between depression and acne, began marketing the drug as an anti-depressant on the theory that by treating acne, it could cure depression among some teens. This did not meet with FDA approval, and the manufacturer was ordered to stop this marketing approach in 1998.
In 1997, French authorities had noticed a link between suicides and Accutane, and issued a warning to European users. American users were not informed of the discovery.
The next year, after a handful of suicides and suicide attempts among Accutane users in the United States, the FDA ordered Hoffman-La Roche to include a warning with the product. Many dermatologists, unaware of the warning, continued to prescribe the drug.
The manufacturers reject a cause-and-effect link between suicide and Accutane. Hoffman-La Roche spokeswoman Melissa Ziriakus said after the Stupak suicide: “A careful review of the drug-safety database by a Harvard University suicide expert and a former FDA epidemiologist concluded that Accutane does not cause depression or suicidal thoughts.”
ACCUTANE supporters note that hundreds of thousands of people use it each year without committing suicide or experiencing bouts of depression. One of the teens who used Accutane without any adverse effects was B.J. Stupak’s older brother, Ken.
Many dermatologists remain unconvinced by the criticisms of Accutane.
“Accutane is a very effective drug in the treatment of the severest form of acne,” Dr. Stanley Carman said.
“But the lion’s share of Accutane prescriptions go to the group of individuals with the highest suicide rate – young males. It is not very surprising that there are a number of suicides among Accutane users.
“You would have to show that the suicide rates went up dramatically among Accutane users,” the doctor said, “and that number just isn’t there.”