It seems irrational to me that so many people fear this drug. Where I live, in England, medicine is tightly regulated and patient safety is taken very seriously. If a drug harms a lot of people it DOES NOT stay on the market for decades. If accutane was so bad it WOULD NOT be available in the UK. The horror stories you hear are RARE cases. I do not believe accutane causes depression, I think it is much more likely that acne itself is getting people down. Accutane is not a psychoactive drug, it does not cross the blood-brain barrier (like alcohol, or cannabis, or ecstasy, or whatever) so I do not believe it can effect mood. I just think people are irrationally afraid. Accutane is harsh on the body, but so is drinking alcohol or catching a cold/flu. 99% of people who take the drug are fine and will not suffer long term damage.
It is because Accutane is a serious drug, and actually does quite commonly cause long term side effects, especially ocular ones. I suffer from permanent night vision impairment. In all honesty, I will take that over the acne, but decisions like that should not be made lightly.