Posted by SalArmy4me on September 4, 2001, at 17:54:32
In reply to Acne and Anti-Depressant Medication, posted by sweetmarie on September 4, 2001, at 17:26:58
Journal of the American Academy of Child and Adolescent Psychiatry. Volume 40(5) May 2001 pp 505-506 IMPROVEMENT OF ACNE IN DEPRESSED PATIENTS TREATED WITH PAROXETINE:
To the Editor:
When prescribing the antidepressant agent paroxetine, a selective serotonin reuptake inhibitor (SSRI), to patients with depression, I have observed a profound improvement in the facial acne of a number of adolescents and adults.
I first observed the positive effect of paroxetine on acne in 1994, when I treated a white woman in her late 30s for severe depression. The woman also had facial acne, which disappeared after she took paroxetine 20 mg daily for about 1 month.
Another case involved a 27-year-old woman from a Caribbean island whose depression and social anxiety prohibited her from performing the duties of her job in marketing, so she accepted a position as a file clerk at a bank. The woman also had a serious case of facial acne. She responded very well to paroxetine 20 mg daily, and her face became blemish-free. Consequently, her confidence and self-esteem levels increased dramatically and her depression eventually disappeared; she felt more comfortable with her appearance and resumed her career in marketing.
From these two incidental situations, I decided to target paroxetine to the adolescent population and discovered promising results.
One of my first adolescent cases involved a 17-year-old male patient with depression. He had poor socialization skills and inadequate academic performance, and he was absent from school once or twice a week. He also had a severe case of acne. This patient’s depression responded remarkably well to treatment with paroxetine, and he demonstrated an increase in social involvement and an improvement in school attendance and academic performance. After his facial acne disappeared, he developed a positive self-image and expressed contentment with his treatment.
Another case involved a 14-year-old African-American female patient. Approximately 1 year before this report on her case, she was discharged from a hospital and prescribed an SSRI (fluoxetine 10 mg daily) for depression. I began treating her shortly after her discharge and immediately noticed that she was painfully shy, reclusive, and socially uncomfortable. During the initial evaluation, she attempted to conceal her face from me. Because this patient exhibited less than an optimal response to the initial SSRI and reported severe headaches, I discontinued the medication and prescribed paroxetine 10 mg daily. Within 6 to 8 weeks, the changes in her depression and facial acne were remarkable. Her self-confidence improved dramatically, and she now perceives herself as physically beautiful.
I am currently treating three adolescents who have exhibited positive effects of treatment with paroxetine. The first patient is a 13-year-old girl with facial acne. She had reported extremely poor peer relationships; she was frequently derided by her peers because of her appearance. She has responded very well to paroxetine 10 mg daily for the past 6 months, as evidenced by an alleviation of depression, an improvement in self-esteem, and the disappearance of her facial acne. She now takes pride in her appearance and has made new friends. During our last interaction, she disclosed that she is involved in a boyfriend–girlfriend relationship.
The other case involves two African-American siblings whom I have been treating for depression and anxieties over the past several years. Within the past couple of months, the brother and sister (aged 16 and 14 years, respectively) complained about facial acne. Until this point, they had been taking sertraline, another SSRI agent, for more than a year. I switched their medication to paroxetine 10 mg daily and, in my most recent consultation with them, witnessed two acne-free complexions. The siblings and their grandmother, who is their caretaker, expressed extreme delight with the overall improvements.
I have found that paroxetine is the only effective SSRI that improves facial acne while treating depression. Studies show that certain skin diseases may lead to depression and even suicidal ideation (Gupta and Gupta, 1998).
In the cases described in this study, the depressed adolescents were compliant with treatment, especially upon learning that paroxetine reduces breakouts of facial acne. For the most part, the acne improved without the assistance of other medications. I hypothesize that the chemical properties of paroxetine may affect certain agents or receptors that can improve the condition of facial acne.
Hamid Moussavian, M.D.
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