Suicidal Zit Medicine? J'Accutane!

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When a fifteen year-old of Middle Eastern descent who expressed sympathy for Osama bin Laden crashed a small, stolen plane into a Tampa skyscraper last month, killing only himself, few expected acne medication to get the blame. In fact, most people probably thought they had a rough idea what caused the incident: some combination of politics and youthful emotional instability.

The New York Times went with the acne medication story on January 9, though, in a piece noting that the young pilot took Accutane, a medication for severe acne that some parents have blamed for causing suicidal impulses in their teenagers. The article doesn't come right out and accuse Accutane, of course. That would be irresponsible. It does, however, note that Accutane has been the subject of federal inquiries due to suicides, while completely failing to note what the normal rate of suicide for young people in a comparable cohort would be: "The Food and Drug Administration says 147 people taking Accutane, which affects the central nervous system [scary!], committed suicide or were hospitalized for suicide attempts from 1982 to May 2000," says the Times, which tells us exactly nothing.

Even without any baseline for comparison, one might reasonably wonder whether kids with severe acne are prone to commit suicide in higher than normal numbers, with or without Accutane.

Luckily, John Allen Paulos (author of the revealing volume A Mathematician Reads the Newspaper) takes the analysis a step farther in an article for ABCNews.com. He notes that some three million teens have probably taken Accutane since 1982, making their rate of suicide approximately one in 20,000. Sounds bad, I suppose, but are the Accutane-users more suicidal than average teens? Well, the normal teen suicide rate, never mentioned in the Times article, is about two in 20,000 twice as bad as the rate amongst Accutane sufferers. That's right, despite bereaved parents blaming Accutane for their losses, Accutane-users appear less likely to commit suicide. Accutane probably has no real connection to suicide at all and this figure may well be just a meaningless fluke, but it might also be, as Paulos suggests, that Accutane use decreases the rate of suicide by helping teens feel that they're overcoming a major source of anxiety in their lives: acne. Somehow, this story seems less likely to catch on with the press, though: a chemical doing what it's supposed to and improving people's lives isn't as exciting as a chemical creating self-destructive teenage robots.

How many parents, though, will read that Times article and avoid giving their children the medication in a misguided effort to prevent suicide?