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'Accutane debate placeholder thread'

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You are unbelievable jimmy :clap:

Did you not read my post? Or do you want me to spell it for you?

I did and this is my last post in this topic [of course untill I find more valuable study].

Good night.

Edited by VanceAstro
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What do you think the incidence of UC from Accutane is?

Around 1 in 1000 or 2000 or 5000?

Does it really matter if you're the one facing the consequences?

Evidently not.

However, should someone be denied/scared from a drug that is most likely going to improve their quality of life just because of its rare (and often yet unproven) severe side effects that may affect 1 in 2000 or 1 in 5000 people?

Should automobile driving be banned just because a very small percentage of people die from car crashes?

Should people who end up with a rare severe side effect from Accutane discourage others from taking it when it is mostly likely going to improve their quality of life?

The rare unpredictable severe side effects are certainly tragic, but ALL drugs have them.

post-145613-1302908728_thumb.jpg

Source: http://www.ncbi.nlm.nih.gov/pmc/articles/P.../pdf/ar2373.pdf

Ibuprofen kills 1 in ~5000 people from gastrointestinal bleeding and kills another 1 in ~6000 from a heart attack.

Ibuprofen is available over the counter.

Edited by biggs881
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Should automobile driving be banned just because a very small percentage of people die from car crashes?

Ibuprofen kills 1 in ~5000 people from gastrointestinal bleeding and kills another 1 in ~6000 from a heart attack.

Ibuprofen is available over the counter.

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What do you think the incidence of UC from Accutane is?

Around 1 in 1000 or 2000 or 5000?

Does it really matter if you're the one facing the consequences?

Evidently not.

However, should someone be denied/scared from a drug that is most likely going to improve their quality of life just because of its rare (and often yet unproven) severe side effects that may affect 1 in 2000 or 1 in 5000 people?

Or 1 in 100, you don't know, I don't know, in fact: no one knows for sure. You're totally missing the point. I'm not against Accutane (on the contrary), yet I don't promote it like candy either. The only intention of your post was to provoke VanceAstro, nothing else.

Should automobile driving be banned just because a very small percentage of people die from car crashes?

Populist talk, driving a car is not comparable to taking a medicine to improve a condition that can be devastating to many. You might as well have mentioned kitchen chairs...

Ibuprofen kills 1 in ~5000 people from gastrointestinal bleeding and kills another 1 in ~6000 from a heart attack.

Ibuprofen is available over the counter.

Your point being what? Accutane should be available over the counter? Ibuprofen should be a prescription drug? This is a non-discussion.

I'm not arguing you or any other poster in this thread, I'm just telling you to stop repeating the same story over and over again. Your point is clear, now move on.

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Your point being what? Accutane should be available over the counter? Ibuprofen should be a prescription drug? This is a non-discussion.

I'm not arguing you or any other poster in this thread, I'm just telling you to stop repeating the same story over and over again. Your point is clear, now move on.

Edited by biggs881
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Guest Modestm
Let's get to the question the audience wants answered: Why can you not concede that Accutane is a crude chemotherapeutic which is essentially an abomination and a misappropriation of nature that gets passed falsely as legitimate science? *Moderator edit - Do not pretend to be a moderator*

The terms "abomination" and "misappropriation of nature" are meaningless propaganda.

The assertion that accutane is a crude chemotherapeutic is true but tremendously misleading: ALL modern medicine is crude. In another 50 or 100 years when we have a firm grasp on nano-technology maybe things won't be. But the fact that it is the closest thing to a cure for acne that exists means it is the most legitimate scientific approach to acne that exists. It's also not all that crude when you consider that our primary means of transportation, metal cages propelled by controlled explosions, hasn't fundamentally changed in over a 100 years.

I apologize that I spread propaganda; but you can take solace in the fact that if Isotretinoin is ever removed from the market place you will still be able to poison yourself (of course, in a strictly controlled and scientific manner) with copious amounts of vitamin A, in order to induce unspecific and systemic cell apoptosis. Isotretinoin, is an abomination, for the aforementioned reason. Also, consider: "Isotretinoin may down-regulate telomerase and hTERT, inhibiting "cellular immortalization and tumorigenesis."

http://www.ncbi.nlm.nih.gov/pmc/articles/P...?tool=pmcentrez

Isotretinoin, when used at (.5-1mg/kg/day) is a misappropriation of nature, because it effectively amplifies levels of 13-cis-retinoic acid in the body to levels which are inextricably linked to hypervitaminosis-A.

I also like your analogy with modern cars; you rhetoric convinced me I am effectively driving a model "T" Ford.

Edited by Modestm
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Guest Modestm
An abomination that has helped many such as You and I. I laughed when i read misappropriation of nature i don't even know how to reply to that.

Yes, I concur, we were lucky to get away with it. And, I guess laughing is a legitimate response, when one is confronted with an inconvenient truth: so don't feel too bad.

Edited by Modestm
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New study on Accutane and inflammatory bowel disease

Alhusayen, R (2010). "Isotretinoin and Inflammatory Bowel Disease: Population-Based Study". Journal of investigative dermatology (0022-202X), 130, p. S70.

Case reports and small observational studies suggest that isotretinoin, a popular medication for nodulocystic acne, may cause Inflammatory Bowel Disease (IBD). To explore this association, we conducted a retrospective cohort study in the province of British Columbia (BC), Canada from January 1st, 1997 to December 31st, 2008. All provincial residents were categorized into one of three groups according to use of isotretinoin, topical acne products, or none of these medications. the main outcome measure was the adjusted rate ratio for the risk of IBD with untreated patients as the reference group. A secondary analysis examined patients with a history of IBD prior to exposure. Among 1,764,017 BC residents, 47,189 were prescribed isotretinoin. After adjusting for potential confounders, we observed an increased risk of IBD among young adults exposed to isotretinoin [rate ratio (RR) 1.51; 95% confi dence interval (CI) 1.12, 2.04). However, an increased risk was also seen with topical acne products (RR 1.18; 95% CI 1.00, 1.39). In the secondary analysis, exposure to isotretinoin among IBD patients did not increase the risk of IBD flare up (RR 0.72; 95% CI 0.48, 1.23). In fact, isotretinoin exposure was associated with decreased risk compared to topical acne products (RR 0.52; 95% CI 0.29, 0.92). In conclusion, we found increased risk of IBD after isotretinoin exposure. Given that the risk was also increased in the topical acne products group, drugs classes unlikely to cause IBD, the increased risk is likely related to acne vulgaris rather than acne interventions. We also found a decreased risk for IBD flare up following isotretinoin exposure.
Edited by biggs881
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Guest Modestm

It seems that a more realistic probability for isotretinoin to cause gastrointestinal issues is actually higher than 20%, rather than the often cited <1%, according to this article. The article seems to imply that that this 20% likelihood of gastrointestinal distress was discovered by Roche themselves; it seems that Hoffman-LaRoche have incriminated themselves.

http://www.drugalert.org/news/2010/08/23/r...ffects-approval

Anyone who wants to indulge in some more light hearted reading should read this scathing indictment of the FDA:

http://www.cspinet.org/new/200606271.html

My favourite excerpt: “The FDA’s centennial is not so much a time to celebrate, but to mourn the FDA’s gradual descent into irrelevancy,†said CSPI executive director Michael F. Jacobson. “The great Republican president Theodore Roosevelt would be sick to his stomach if he could see how Harvey Wiley’s hard-charging tiger of an agency became such a pliant pussycat.â€

Edited by Modestm
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Okay no offense for all those Pro Accutane but I have posted on the negative experiences thread. The amazing thing is there is only a couple people trolling here bashing on the poor people that have had issues...especially major ones. These studies that you keep siting are amazingly very limited test subjects and information. The one that someone keeps posting about the two negative side effects were pregnant people keep leaving out the very bottom line in there post. That the ones that had little or no side effects were doing less than .25mg/kg a day. Do you realize how small of a dose that is? Considering most users of tane were getting anywhere between 1 and 2 mg/kg a day. It has been proven that Isotretinoin can be good in small doses but so can Vitamin A. Would you prescribe someone 20,000 IU of Vitamin A per day doubt you would. Vitamin is actually safer than the Synthetic Iso.

http://www.acne.org/messageboard/Accutane-Vitamin-t74417.html

The post isn't scientific by any means and if someone could find more scientific data I would be interested to see it. He does however make since in what he is saying. Do any or you pro-Accutaners understand what 13-cis-retinoic acid is or does?

http://www.chemocare.com/bio/cisretinoic_acid.asp

Take a look at that link. This is what ISO was intended for....and I think I trust them a little better than Roche because they are using this drug for what it was intially intended for. Accutane was morphed into an Acne drug after they realized it works on Acne. The drug doesn't know that your other cells are good cells it just knows hey I have cells to slow proliferation and kill yay!! This in turn causes cell death systemically. I have more links to recent studies done in the last year or so as to the effects of ISO on the brain and other body chemicals and cells. Does this drug cause hormone problems? Most definetly. Long Term? No one is really sure because the drug has only been really getting out there over the last 25 years....and so many people like me didn't realize the corelation until 12 years after taking the drug and realizing there has to be more to my problems than just crappy luck. No one in my entire family has hormone imbalances like me and guess what I am the only one that took accutane. Did I take any other special drugs.....nope. Really health person until Accutane. I guess what I am trying to say is people should be a lot more considerate than trying to disprove sufferers. If it worked for you with no side effects great!!!. If things starting biting you in the ass in about 3-10 yrs after taking it. You won't be able to say you weren't warned.

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New study on Accutane and inflammatory bowel disease

Alhusayen, R (2010). "Isotretinoin and Inflammatory Bowel Disease: Population-Based Study". Journal of investigative dermatology (0022-202X), 130, p. S70.

Case reports and small observational studies suggest that isotretinoin, a popular medication for nodulocystic acne, may cause Inflammatory Bowel Disease (IBD). To explore this association, we conducted a retrospective cohort study in the province of British Columbia (BC), Canada from January 1st, 1997 to December 31st, 2008. All provincial residents were categorized into one of three groups according to use of isotretinoin, topical acne products, or none of these medications. the main outcome measure was the adjusted rate ratio for the risk of IBD with untreated patients as the reference group. A secondary analysis examined patients with a history of IBD prior to exposure. Among 1,764,017 BC residents, 47,189 were prescribed isotretinoin. After adjusting for potential confounders, we observed an increased risk of IBD among young adults exposed to isotretinoin [rate ratio (RR) 1.51; 95% confi dence interval (CI) 1.12, 2.04). However, an increased risk was also seen with topical acne products (RR 1.18; 95% CI 1.00, 1.39). In the secondary analysis, exposure to isotretinoin among IBD patients did not increase the risk of IBD flare up (RR 0.72; 95% CI 0.48, 1.23). In fact, isotretinoin exposure was associated with decreased risk compared to topical acne products (RR 0.52; 95% CI 0.29, 0.92). In conclusion, we found increased risk of IBD after isotretinoin exposure. Given that the risk was also increased in the topical acne products group, drugs classes unlikely to cause IBD, the increased risk is likely related to acne vulgaris rather than acne interventions. We also found a decreased risk for IBD flare up following isotretinoin exposure.

70_pdfsam_jid2010238a.pdf

________________________________________________________________________________

Now, I could sit here and start claiming that acne itself definitely causes inflammatory bowel disease, leaving everyone on this site at risk and worried. However, this study should be considered preliminary, just like the other studies investigating Accutane and inflammatory bowel disease.

Yes good information....the only thing they didn't mention what topical were associated with increased risk and what level of increased risk was it? I mean there is topical ISO....so who knows.

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Here is text I have taken word for word from the ipledge booklet:

Stomach area (abdomen) problems. Certain Symptoms may mean that your inernal organs are being damaged. These organs include the liver, pancreas, bowel (intestines), and esophogus (connection between the mouth and the stomach). If your organs are damaged, they may not get better even after you stop taking isotretinoin. Stop taking isotretinoin and call your doctor if you get:

-severe stomach, chest or bowel pain

-trouble swallowing or painful swallowing

-new or worsening heartburn

-diarrhea

-rectal bleeding

-yellowing of your skin or eyes

-dark urine

So yes, my bad, it doesn't specifically mention Chron's or IBS. But damaged internal organs are.

Key word "may". Certainly if you do stupid things on Accutane like drink excessively then you could get liver/kidney/pancreas damage, but there is no definitive evidence (only anecdotal reports and personal observations) that Accutane by itself can cause significant organ damage.

The reason why I said 720 is not a good sample size is not so much because of the sample size itself, but because of the conclusion that is drawn from it.

The findings of this study indicate that isotretinoin in the treatment of acne is a safe drug, with no serious long-term side-effects.

No. This tells us that isotretinoin is generally a safe drug and that serious long-term side-effects are very unlikely. Not that there are none.

But if the severe side effects are rare, let's say they affect 1 out of 1,000 (or even fewer ) people, then we shouldn't be shocked that in a group of 720 people that there wasn't someone with severe side effects. If they did affect approximately 1 out of every 1,000 people then there is roughly a 28% that no one in the group would have had severe side effects, and if the side effects were even rarer, then it's even more likely that they were missed. 28% (or greater) is too significant for the study to make such an absolute claim.

OK let's go with your idea that 1 out of every 1000 people (0.1%) get a significant side effect from Accutane. MEANWHILE, approximately 90% of those same people get cleared by Accutane (please ask me for references), the very reason they go on the drug in the first place.

Your original advice to the OP was that it's "not worth it" to stay on Accutane.

I hope you and he now see that it is.

LOL I love when people quote Ipledge you know why....it was fucking to late for most of us

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Very frustrating when people don't read the entire thread before posting stuff that's been covered probably 5 times...

Nobody is denying that severe side effects happen; believe me we know they do. The point is that, like all drugs, they are rare (<1%) even at higher Accutane doses - despite extensive media coverage to the contrary.

Charlie, neither of your links worked and you need to read posts #1030, 1110 and 1113 in this thread.

I've never seen a peer-reviewed scientific study showing that the prevalence of SEVERE side effects (depression, IBD, erectile dysfunction, severe joint pain, organ damage etc.) is greater than 1% from ANY dose of Accutane used regularly in acne.

Have you?

Edited by biggs881
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Okay here you go bud. Now this is in more than 1% in this study but the group is a small group larger study needs to be done just like most of the others out there.

http://www.medicaljournals.se/acta/content...1013&html=1

Next Post

http://jcem.endojournals.org/cgi/content/abstract/80/4/1158

Small group again but marked Androgen Receptor binding capacity.....hmmm.

http://www.nature.com/ijo/journal/v28/n5/abs/0802613a.html

Again maybe not a life or death problem now...but I would still call this a really bad side effect...because of co-morbidity.

Visit My Website

You may not believe this stuff or you may think it is small beans...but even a 1% chance is still to high especially when a lot of patients weren't actually told of these side effects before 2005.

Visit My Website

http://www.ncbi.nlm.nih.gov/pubmed/9298137

http://www.ncbi.nlm.nih.gov/pubmed/6238729

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC295603/

http://www.landesbioscience.com/journals/d.../article/15331/

I have the full article to this one if you are interested let me know and I can email it to you.

http://en.wikipedia.org/wiki/Retinoic_acid

http://www.ncbi.nlm.nih.gov/pubmed/20128787

http://ajp.psychiatryonline.org/cgi/content/full/162/5/983

http://www.ncbi.nlm.nih.gov/pubmed/15251924

Again Biggs I am not trying to say your a liar...because like I said I am sure it works for some people...but the studies are coming more and more in favor of increases adverse risk....and though we can't always know what side effects are going to be from any drug.....I want to point out one last time...this was intended for Cancer....giving a cancer treatment to an otherwise health adolescent in my opinion just seems ludacris and proves the drug a bit dangerous

Edited by Charlie84
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Not one of those studies answered my question.

We're talking about clinically significant/diagnosable severe side effects in human beings, not about references to vague changes in hormones/brain metabolism that have not been shown to affect people in their daily lives.

So I ask again:

I've never seen a peer-reviewed scientific study showing that the prevalence of SEVERE side effects (depression, IBD, erectile dysfunction, severe joint pain, organ damage etc.) is greater than 1% from ANY dose of Accutane used regularly in acne.

Have you?

Edited by biggs881
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Not one of those studies answered my question.

We're talking about clinically significant/diagnosable severe side effects in human beings, not about vague references to changes in hormones/brain metabolism that have not been shown to affect people in their daily life.

So I ask again:

I've never seen a peer-reviewed scientific study showing that the prevalence of SEVERE side effects (depression, IBD, erectile dysfunction, severe joint pain, organ damage etc.) is greater than 1% from ANY dose of Accutane used regularly in acne.

Have you?

Wait so your saying that none of those posts point to any of those side effects.....well obviously you didn't read everything. Hippo-campus Reduction along with Hypothalamus reduction cause physchosis. It does prove that there is an IBD link what do you think UC is. Erectile dysfunction caused by hormonal imbalance of the hypogonadism. Reduction in Growth Hormone directly linked to severe joint pain....do you really think the drug itself causes those symptoms than your a fool. It causes secondary conditions called co-morbidity which then in turns gives us those symptoms. I work in a hospital....I have talked to many many colleagues and they all say that Isotretinoin is linked to all of the above mentioned side effects due to other organ damange. Frankly, it doesn't matter what the percentage is...they should have warned against this stuff. Then if we took the drug still then well maybe they would have a case....otherwise that is why they have lost 54 million dollars and counting.

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Everything you've said has been covered repeatedly in this thread. I'm not going to go over it again.

First and foremost, http://en.wikipedia.org/wiki/Correlation_d...imply_causation.

Second, the severe side effects are rare (<1%) and Accutane clears acne in >90% of people.

That's why Accutane characteristically improves quality of life and depressive symptoms in acne patients:

http://www.ncbi.nlm.nih.gov/pubmed/21137117

http://www.ncbi.nlm.nih.gov/pubmed/19126049

http://www.ncbi.nlm.nih.gov/pubmed/19382995

http://www.ncbi.nlm.nih.gov/pubmed/15897376

Yes, all of those studies were independent and not funded by drug companies.

Edited by biggs881
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Yes sorry for me getting a little over zealous....I apologize. Ignorance in this case isn't bliss. I don't want to scare people I just want them to be aware of the possibilities and that a percentage albeit maybe small amount do have life altering effects that are negative. Those of us that took at 12-15 have an increased risk most likely because of our age. Do I regret taking the drug I am not sure I am the fence....do I think Roche should pay for my medical bills for the rest of my life if I am on synthetic hormones then yes. All I am saying is we as a populous need to demand this kind of testing be done before it is given to the populous for an otherwise harmless condition than image.

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Everything you've said has been covered repeatedly in this thread. I'm not going to go over it again.

First and foremost, http://en.wikipedia.org/wiki/Correlation_d...imply_causation.

Second, the severe side effects are rare (<1%) and Accutane clears acne in >90% of people.

That's why Accutane characteristically improves quality of life in acne patients:

http://www.ncbi.nlm.nih.gov/pubmed/21137117

http://www.ncbi.nlm.nih.gov/pubmed/19126049

http://www.ncbi.nlm.nih.gov/pubmed/19382995

http://www.ncbi.nlm.nih.gov/pubmed/15897376

FYI, all of those studies were independent and not funded by drug companies.

Biggs your really the only one fighting this so hard I am not sure why...do you have money in these companies? Why else would an otherwise healthy person all of a sudden develop the above conditions with no family history or other drugs or even medical procedures done to them. It would be different if I had a family history of low testosterone.....hypothyroidism, GH Defiency, joint problems, or even IBS but I don't....I am just trying to say that the connection seems closer than not. I am sorry for whatever reason you feel that bashing the people and trying to make them feel like they don't have any explanation for there problems. I am sure that in 40 years from now.....things will be different.

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Everything you've said has been covered repeatedly in this thread. I'm not going to go over it again....

Same for all your past and future arguments. This is really old. Take it to PM.

THIS thread is for debate posts that get moved from other threads. NOT for debating forever and ever, the same things over and over again.

Closed for some calm to descend upon all involved and to give mods a break from constantly checking this thread to make sure it abides by the board rules.

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Who cares about some small inconsistency with Wikipedia! The young lady in the initial post was worried that Isotretinoin is a dangerous drug that may have been banned. The point is this: yes, it is a dangerous drug, that is very poorly understood, misused and championed by desperate teenagers and unscrupulous and negligent dermatologists who withhold the truth to get across the line. The fact that it has not been banned is just a formality.

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