I took two courses of 40 mg accutane for 5 months each but acne came back in its nodular and cystic form . So i took 20 mg accutane daily+Azithromycin 500 mg thrice a week and continued this for a month. After that i started taking 20 mg accutane on every 15th day only and things are fine mentally and aesthetically. I am damn sure this will work for other too. These are just my experiences and I'm not responsible for any complications if you do this. So try at your own risk.