Saturday, September 23, 2006

Roaccutane in the News (South Africa) Part Two

Original article can be found here
(Courtsy of Indepentent Online)

'No link between acne drug and suicide'

January 14 2002 at 06:27PM

By Erika de Beer

Dermatologists on Monday strongly defended the acne drug Roaccutane which some parents claim has caused their teenage children to commit suicide.

"That is the biggest load of rubbish," said Dr Steve van Heerden, a private dermatologist in Pretoria.

Roche, the manufacturer of Roaccutane, said a major study had indicated no evidence of any increase of psychiatric disorders being associated with Roaccutane therapy compared to the general population.

Only two parents had complained to him so far
Dr Antonie Zietsman, also from Pretoria, said a recent media article mentioned 20 patients on Roaccutane who had taken their own lives.

However, there were about nine million people worldwide using the drug.

"To my mind this is ridiculous."

There were many elderly people who took half a Disprin daily to thin their blood and prevent strokes.

Nobody would think of blaming suicides among them on Disprin, said Zietsman.

Nobody could claim a later suicide on the use of the drug years earlier
He had been treating people with very severe acne problems with Roaccutane for the last 18 years.

"I've never ever had one patient who committed suicide."

Zietsman said only two parents had complained to him so far.

Shortly after a media report about Roaccutane appeared, a mother phoned and told him that her daughter, for whom he had prescribed the drug, was depressed.

"I said she should stop taking the drug."

The other was a case of a teenager with a lot of typical teenager problems, he said.

The issue of Roaccutane and depression featured strongly recently after it turned out that a 15-year-old boy who flew a light aircraft into a building in the United States, had used the drug.

But Zietsman said the boy was also a loner and had an acne problem which aggravated his bad self image.

"All of a sudden Roaccutane gets the blame... As the old saying goes: If you want to hit a dog you can always find a stick."

He conceded that Roaccutane had a number of side-effects, but added that it was a chemical related to Vitamin A.

Van Heerden said Roche and dermatologists accepted that some individual users did show some mood changes.

This was indicated in the leaflet inserted in the packages and the information booklet provided to users.

However, of about 3 500 patients he had treated with Roaccutane over the past 15 years, only about five had experienced such effects, and in all these cases there were other issues involved which contributed to their adolescence problems.

"Dermatologists feel that we see far more cases of suicide because of the way they look. Personalities can change when they look clear... at the end of the treatment."

Dr Edward Berry of the Universitas hospital in Bloemfontein agreed. Acne was more likely the cause of depression, he said.

He would not withhold the drug from a patient because of the possibility of depression.

"It is a fantastic medicine. It is a dermatological wonder drug."

Van Heerden said Roaccutane was a major drug used in all dermatology practices.

In South Africa it had been available for 22 years.

The major risk of the drug is that women should not become pregnant while using it, as it could cause abnormalities in babies.

The manufacturer had known this and warned about it from the time it was first used, he said.

Roche also warned that all patients using it who showed serious mood swings or threatened suicide should be either referred to a psychiatrist, taken off the drug, or given anti-depressants.

Known side-effects included dryness of the mouth, eyes, skin and mucous membranes. Tests for that and for high cholesterol in advance would indicate whether a patient was suitable for the treatment, said Berry.

According to Van Heerden, the treatment lasted a maximum of four to six months.

Zietsman said it took about 14 days before it was out of the system altogether, so nobody could claim a later suicide on the use of the drug years earlier.

Roche said in its statement: "Based on all the data currently available, no causal relationship between Roaccutane and various psychiatric events has been established. The psychiatric events reported in association with Roaccutane therapy reflect the multiple risk factors in the population of adolescent and young adults afflicted with the disfiguring disease of acne." - Sapa

Roaccutane in the News (South Africa) Part One

Original article can be found here
(Courtsy of Beeld Newspaper)

Tieners se monster

Antoinette Pienaar

Aknee is een van tieners - en velspesialiste - se grootste nagmerries, skryf Antoinette Pienaar.

Die ander kinders het hom agter sy rug ``pizzagesig'' genoem.

Elke keer as hy 'n gesprek met 'n meisie wou aanknoop, het sy haar met 'n flou verskoning uit die voete gemaak.

Vir Martin Moss (22), grafiese ontwerper van Johannesburg, het erge aknee die laaste jare sy sosiale en emosionele lewe byna in die wiele gery.

Hy het twee keer die akneemiddel isotretinoïen (Roaccutane) gebruik die omstrede ``wondermiddel'' wat telkemale al die skuld gekry het vir depressie, selfmoord en psigiatriese versteurings onder jong mense.

``Mense is wreed. Die eerste ding wat hulle van jou sien, is jou gesig. Ek het binne minute besef my gesprek met 'n meisie gaan nêrens heen nie. Ek wil nie vlak wees nie, maar 'n meisie met 'n slegte vel sal my dalk nou ook effens afsit. Dit is 'n natuurlike reaksie.''

Moss het nie gemoedsversteurings ondervind nie. ``Ek is nie 'n depressiewe mens nie. Die newe-effekte was 'n droë vel en nou en dan 'n bloedneus. My vel is nou skoon en ek is baie meer selfversekerd.''

Isabell Tereh (18) van Murrayfield in Pretoria se matriekafskeid verlede jaar het soos 'n berg voor haar gelê. Sy het gedroom van 'n elegante rok met 'n oop rug, maar het gesukkel met aknee tot op haar rug en skouers. ``Dit het begin toe ek 13 was. Ek het alle middels probeer en was te skaam om bloese met dun bandjies te dra omdat ek so selfbewus was.''

Tereh het in Julie isotretino¨en begin gebruik. Haar vel het binne 'n paar maande so opgeklaar dat sy haar droomrok kon dra.

``Ek kon voorheen nooit uitgaan sonder 'n dik laag onderlaag aan nie en dan was daar die voortdurende vrees dat ek dit sou afsweet en dat almal vir my sou kyk. Die meeste van my vriendinne het pragtige velle.

``Ek was neerslagtig vóórdat ek die middel begin gebruik het. Namate my vel opgeklaar het, het mense my begin komplimenteer. Ek het opgeruimd geword. Dit is onregverdig dat die medisyne die skuld kry.

``Ek het baie meer selfvertroue en dink nie eens meer aan my vel nie. Waar ek voorheen soggens elke puisie getel het, was ek deesdae net vinnig my gesig en begin my dag.''

Dr. Steve van Heerden, 'n dermatoloog van Brooklyn in Pretoria, sê hy het al 3 000 pasiënte met isotretino¨en behandel, ook sy eie kind.

``Altesame 60% van akneepasiënte is tussen 15 en 25 jaar oud. Ek sien deesdae kinders van so jonk as 11 en vroue van tot 40 of 50 wat daarmee sukkel. Daar is geen verklaring voor nie. Maar dis een van dermatoloë se grootste nagmerries.''

Ná puberteit is daar 'n skielike styging in manlike geslagshormone (testosteroon) by seuns en meisies. Volgens Van Heerden het dit 'n regstreekse uitwerking op die talgkliere wat groei, aktief word en meer sebum (velolie) afskei. Porieë slaan toe, swart- en witkoppies vorm en dit kan lei tot aknee.

Behandeling wissel van salf vir ligte aknee tot antibiotika, hormoonbehandeling en uiteindelik as laaste uitweg isotretino¨en. Dié bylae 5-middel maak die talgkliere kleiner, verminder olieproduksie en die verstopping van porieë en werk inflammasie teen. Dis duur sowat R1 000 per maand, en word vir minstens vyf maande voorgeskryf.

``Ek sien deesdae 'n groter bewustheid oor aknee. Die samelewing aanvaar nie onvolmaaktheid nie. Studies in Engeland het bewys dat in werkonderhoude teen mense met slegte velle gediskrimineer word op dieselfde wyse as teen mense wat oorgewig is,'' sê Van Heerden.

``Dermatoloë aanvaar wel dat daar in enkele gevalle gemoedsversteurings met depressie en gedragsverandering en selfs selfmoordgedagtes voorgekom het by mense wat isotretino¨en gebruik. Studies toon egter dat die voorkoms van depressie en selfmoord eerder laer is onder isotretino¨en-pasiënte as die algemene bevolking.''

Van Heerden verwys na 'n voorval waarin 'n tienerseun van Johannesburg 'n paar jaar gelede selfmoord gepleeg het terwyl hy die middel gebruik het. ``Hy het geweldige huislike probleme gehad en het berading ontvang lank voordat hy die middel gebruik het.

``Sommige mense word totale introverte weens hul akneeprobleem. Ons sien keer op keer hoe hulle blom nadat hul velle opklaar.'' Desnieteenstaande lig hy sy pasiënte in oor moontlike gemoedsversteurings.

'n Roaccutane-aksiegroep het in 1998 'n webwerf (www.accutaneaction.com) geskep waar mense kan praat oor die impak van die middel. Dit is meestal negatiewe ervarings, waaronder psigiatriese versteurings en selfmoord.

Roche, die vervaardiger van die middel, hou vol dit is nie wetenskaplik bewys dat daar 'n verband tussen isotretino¨en en depressie en selfmoord is nie.

Die maatskappy sê daar is 64 gevalle van selfmoord aangemeld. Wêreldwyd het 12 miljoen mense die middel gebruik. Ondersoeke het getoon dat net 30 van die 64 mense wel die middel in hul bloed gehad het. Die voorkoms van selfmoord onder tieners in die algemene bevolking is egter heelwat hoër, tot 20 per 100 000.

Dr. Dylan Naidoo, 'n dermatoloog van Durban, sê tot 200 pasiënte besoek sy praktyk per dag, van wie 30% akneeprobleme het. Om veilig te wees, het hy dosisse verminder en word die middel vir langer tydperke voorgeskryf.

Me. Farheen Basheer, die praktyk se kliniese sielkundige, glo nie aknee of isotretino¨en veroorsaak depressie en selfmoord nie. ``Hulle moet meer navorsing doen daaroor. Tieners is emosioneel en sielkundig broos weens hormoon- en fisiologiese veranderings in die liggaam. Dit be¨nvloed hul streshantering.''

Volgens Basheer lei aknee dikwels tot 'n lae selfbeeld, onttrekking en in ernstige gevalle selfs sosiale fobies. Sy meen die mate waarin aknee 'n tiener be¨nvloed, hang ook af van sy lewensvaardighede en steunstelsel by die huis.

Dr. Dora Wynchank, 'n psigiater van Johannesburg, glo ook nie aknee kan ernstige kliniese depressie veroorsaak nie. ``Adolessensie word gekenmerk deur selfbeeldprobleme, gevoelens van isolasie en buierigheid. Gewoonlik is daar nie waarskuwingstekens vir selfmoord nie. Dit is 'n impulsiewe daad wat nie vir die ouers sin het nie.

``Woede is 'n normale deel van die rouproses en dit is nie ongewoon dat hulle iets die skuld wil gee vir hul kind se dood nie.''

Tuesday, September 19, 2006

Who have they been talking to?




ColorQuiz.comMJ took the free ColorQuiz.com personality test!

"Considers the existing circumstances disagreeable ..."


Click here to read the rest of the results.


Monday, September 18, 2006

Unspottable

I am here to ask, not unashamedly beg of someone, anyone, any group of someones with access to the means to help me to please do so.

It is a sad and pathetic tale. I'm the youngest of two children, the elder being my very blind brother. Two years ago I was retrenched and forced to move back in with my parents. As if that's not bad enough for my self-esteem, at almost 28 my skin is still stuck in puberty. This is extremely distressing as the weather is heating up in Sunny South Africa, and I have my high school reunion, and an extremely classy wedding to attend in a couple of months. I need Isotretinoin. My medical aid doesn't pay for it. I've got two jobs to make ends meet and need to cut expenses where possible.

If there is anyone out there with access to said medication, I am willing to do a blow-by-blow updated blog with pics and endorsements. Please just help me. I am desperatly unhappy with my skin's appearance and it is affecting my confidence.