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People using isotretinoin should watch for symptoms of depression, including: Acting on dangerous impulses Anger Changes in weight or appetite Fatigue Feeling worthless, helpless or guilty Irritability Loss of pleasure or interest in things they typically enjoy Restlessness or trouble concentrating Sadness or hopelessness Sleeping too much or too little Suicidal thoughts Worsening school or work performance In one study published in JAMA Dermatology, researchers found 17,829 reports of adverse psychiatric events associated with isotretinoin from 1997 through 2017