Isotretinoin Induced Sexual Dysfunction: A Critical Appraisal and Systematic Review

Abstract

Aims: There have been reports and concerns about potential side effects of isotretinoin causing sexual dysfunction. There has been insufficient up-to-date evidence supporting such a claim. We aimed to provide coverage of the current literature that links the relationship between isotretinoin and developing sexual dysfunction. Methods: To systematically search Medline and Embase databases to identify articles that explore the relationship between sexual dysfunction in patients who are either under isotretinoin or have been taking it. The search terms used were "Isotretinoin", "Isotretinoin/adverse effects"," 13-cis-retinoic acid", "Accutane", "oral retinoid", "sexual dysfunction", "libido"," sexual activity"," sexual activity", "sexual interest", and "sexual desire". Results: This review included and analyzed nine human studies: three cohort studies, two case reports, three pharmacovigilance reports, and one letter to the editor of an article. The study included 14,226 patients. Only (n=335) patients reported sexual dysfunction. The most frequent dose was 0.7mg/kg/day, ranging between 0.5 and 1 mg/kg/day. According to the Oxford evidence-based medicine scale, most studies are categorized as level 4. Conclusion: Several studies used in the article are low in overall methodological quality; therefore, the evidence linking isotretinoin causing sexual dysfunction is weak. More studies are encouraged to reach valid conclusions.