Re: Accutane should be over the counter.

June 2, 2002

Here is just one of the many reasons it should not.

Accutane® (isotretinoin) can permanently affect your sex life, reducing libido

and sexual sensation.

In some cases it may also induce sexual dysesthesias in which sexual sensations

feel like

" pins and needles " instead of being normally pleasant. If you or someone you

know has been

affected by any of these problems, please continue reading.

While there are many drugs that interfere with one or more aspects of sexuality

while the user

is taking them, with one exception all of these problems resolve once the drug

is discontinued.

The only drug that can permanently affect libido and sexual pleasure in some

people is Accutane®

(isotretinoin), used in the treatment of severe recalcitrant nodular acne. Roche

Laboratories,

the manufacturer of Accutane, claims to be unaware of any such adverse effects.

However, I

have firsthand knowledge that their ignorance of this matter is, well, fishy. I

called Roche

in January of 1991 to discuss this problem which had been reported by a patient.

Perhaps not

surprisingly they claimed to have never heard of any link between Accutane and

long-term sexual

dysfunction. When I called again in March of 1999 I was told the same thing,

which caused me

to question their credibility. They'd never heard of it? Bull. I've heard of

several cases,

and I'm not exactly the clearinghouse for the adverse effects of Accutane. Roche

states that

the " exact mechanism of action of Accutane is unknown. " Well, if they don't even

know how it

suppresses acne, perhaps they are equally unaware of how it affects the body in

other ways.

The case that I presented to Roche in 1991 was one that should have caused them

to seriously

consider that Accutane's sexual effects were a cause for concern. In this case,

the patient

took several courses of Accutane over a period of years. With each course of

treatment the

patient experienced reduced libido and altered sexual sensation. Instead of

being pleasant,

his sexual sensation was markedly unpleasant and felt similar to the sensation

that people

perceive when they strike their " funny bone " (ulnar nerve at the elbow). These

symptoms would

decrease somewhat when the patient stopped taking Accutane, but they never

totally resolved.

The patient concluded that the problems would abate entirely once he had been

off Accutane

for a longer time. The patient took additional courses of Accutane over the

following years

to control his acne, each time experiencing an exacerbation of the symptoms

while on the Accutane

and a reduction in the symptoms after discontinuing Accutane. After the final

course of Accutane,

the patient was alarmed that the symptoms persisted for more than a decade.

Whenever a scientist is presented with a case in which reintroduction of a drug

induces problems

that had abated once the drug was discontinued, and this concordance between

symptoms and drug

use continues over a number of cycles, it is virtually impossible to conclude

that there is

no connection between the drug and the problem. Therefore, Roche should not have

dismissed

or ignored the case I reported to them.

While I have heard of several cases linking Accutane and long-term sexual

dysfunction, I am

certain that there are many cases which have not yet come to my attention.

Besides me, there

are millions of other doctors in the world who may have fielded similar reports

from their

patients. Furthermore, I think that many people just suffer in silence if they

have a sexual

problem since it can be very difficult to discuss your sex life with someone

even if he is

a physician. The patient discussed above waited eight years before he mustered

the courage

to discuss his problem, and he's probably not the only one who is reluctant to

discuss sexual

dysfunction.

June 2, 2002

Here is just one of the many reasons it should not.

Accutane® (isotretinoin) can permanently affect your sex life, reducing libido

and sexual sensation.

In some cases it may also induce sexual dysesthesias in which sexual sensations

feel like

" pins and needles " instead of being normally pleasant. If you or someone you

know has been

affected by any of these problems, please continue reading.

While there are many drugs that interfere with one or more aspects of sexuality

while the user

is taking them, with one exception all of these problems resolve once the drug

is discontinued.

The only drug that can permanently affect libido and sexual pleasure in some

people is Accutane®

(isotretinoin), used in the treatment of severe recalcitrant nodular acne. Roche

Laboratories,

the manufacturer of Accutane, claims to be unaware of any such adverse effects.

However, I

have firsthand knowledge that their ignorance of this matter is, well, fishy. I

called Roche

in January of 1991 to discuss this problem which had been reported by a patient.

Perhaps not

surprisingly they claimed to have never heard of any link between Accutane and

long-term sexual

dysfunction. When I called again in March of 1999 I was told the same thing,

which caused me

to question their credibility. They'd never heard of it? Bull. I've heard of

several cases,

and I'm not exactly the clearinghouse for the adverse effects of Accutane. Roche

states that

the " exact mechanism of action of Accutane is unknown. " Well, if they don't even

know how it

suppresses acne, perhaps they are equally unaware of how it affects the body in

other ways.

The case that I presented to Roche in 1991 was one that should have caused them

to seriously

consider that Accutane's sexual effects were a cause for concern. In this case,

the patient

took several courses of Accutane over a period of years. With each course of

treatment the

patient experienced reduced libido and altered sexual sensation. Instead of

being pleasant,

his sexual sensation was markedly unpleasant and felt similar to the sensation

that people

perceive when they strike their " funny bone " (ulnar nerve at the elbow). These

symptoms would

decrease somewhat when the patient stopped taking Accutane, but they never

totally resolved.

The patient concluded that the problems would abate entirely once he had been

off Accutane

for a longer time. The patient took additional courses of Accutane over the

following years

to control his acne, each time experiencing an exacerbation of the symptoms

while on the Accutane

and a reduction in the symptoms after discontinuing Accutane. After the final

course of Accutane,

the patient was alarmed that the symptoms persisted for more than a decade.

Whenever a scientist is presented with a case in which reintroduction of a drug

induces problems

that had abated once the drug was discontinued, and this concordance between

symptoms and drug

use continues over a number of cycles, it is virtually impossible to conclude

that there is

no connection between the drug and the problem. Therefore, Roche should not have

dismissed

or ignored the case I reported to them.

While I have heard of several cases linking Accutane and long-term sexual

dysfunction, I am

certain that there are many cases which have not yet come to my attention.

Besides me, there

are millions of other doctors in the world who may have fielded similar reports

from their

patients. Furthermore, I think that many people just suffer in silence if they

have a sexual

problem since it can be very difficult to discuss your sex life with someone

even if he is

a physician. The patient discussed above waited eight years before he mustered

the courage

to discuss his problem, and he's probably not the only one who is reluctant to

discuss sexual

dysfunction.

June 2, 2002

Here is just one of the many reasons it should not.

Accutane® (isotretinoin) can permanently affect your sex life, reducing libido

and sexual sensation.

In some cases it may also induce sexual dysesthesias in which sexual sensations

feel like

" pins and needles " instead of being normally pleasant. If you or someone you

know has been

affected by any of these problems, please continue reading.

While there are many drugs that interfere with one or more aspects of sexuality

while the user

is taking them, with one exception all of these problems resolve once the drug

is discontinued.

The only drug that can permanently affect libido and sexual pleasure in some

people is Accutane®

(isotretinoin), used in the treatment of severe recalcitrant nodular acne. Roche

Laboratories,

the manufacturer of Accutane, claims to be unaware of any such adverse effects.

However, I

have firsthand knowledge that their ignorance of this matter is, well, fishy. I

called Roche

in January of 1991 to discuss this problem which had been reported by a patient.

Perhaps not

surprisingly they claimed to have never heard of any link between Accutane and

long-term sexual

dysfunction. When I called again in March of 1999 I was told the same thing,

which caused me

to question their credibility. They'd never heard of it? Bull. I've heard of

several cases,

and I'm not exactly the clearinghouse for the adverse effects of Accutane. Roche

states that

the " exact mechanism of action of Accutane is unknown. " Well, if they don't even

know how it

suppresses acne, perhaps they are equally unaware of how it affects the body in

other ways.

The case that I presented to Roche in 1991 was one that should have caused them

to seriously

consider that Accutane's sexual effects were a cause for concern. In this case,

the patient

took several courses of Accutane over a period of years. With each course of

treatment the

patient experienced reduced libido and altered sexual sensation. Instead of

being pleasant,

his sexual sensation was markedly unpleasant and felt similar to the sensation

that people

perceive when they strike their " funny bone " (ulnar nerve at the elbow). These

symptoms would

decrease somewhat when the patient stopped taking Accutane, but they never

totally resolved.

The patient concluded that the problems would abate entirely once he had been

off Accutane

for a longer time. The patient took additional courses of Accutane over the

following years

to control his acne, each time experiencing an exacerbation of the symptoms

while on the Accutane

and a reduction in the symptoms after discontinuing Accutane. After the final

course of Accutane,

the patient was alarmed that the symptoms persisted for more than a decade.

Whenever a scientist is presented with a case in which reintroduction of a drug

induces problems

that had abated once the drug was discontinued, and this concordance between

symptoms and drug

use continues over a number of cycles, it is virtually impossible to conclude

that there is

no connection between the drug and the problem. Therefore, Roche should not have

dismissed

or ignored the case I reported to them.

While I have heard of several cases linking Accutane and long-term sexual

dysfunction, I am

certain that there are many cases which have not yet come to my attention.

Besides me, there

are millions of other doctors in the world who may have fielded similar reports

from their

patients. Furthermore, I think that many people just suffer in silence if they

have a sexual

problem since it can be very difficult to discuss your sex life with someone

even if he is

a physician. The patient discussed above waited eight years before he mustered

the courage

to discuss his problem, and he's probably not the only one who is reluctant to

discuss sexual

dysfunction.

June 2, 2002

Was this on standard dose Accutane course, or the low dose (10mg

daily or every other day) reccommended for cea treatment?

> Here is just one of the many reasons it should not.

>

> Accutane® (isotretinoin) can permanently affect your sex life,

reducing libido and sexual sensation.

> In some cases it may also induce sexual dysesthesias in which

sexual sensations feel like

> " pins and needles " instead of being normally pleasant. If you or

someone you know has been

> affected by any of these problems, please continue reading.

>

> While there are many drugs that interfere with one or more aspects

of sexuality while the user

> is taking them, with one exception all of these problems resolve

once the drug is discontinued.

> The only drug that can permanently affect libido and sexual

pleasure in some people is Accutane®

> (isotretinoin), used in the treatment of severe recalcitrant

nodular acne. Roche Laboratories,

> the manufacturer of Accutane, claims to be unaware of any such

adverse effects. However, I

> have firsthand knowledge that their ignorance of this matter is,

well, fishy. I called Roche

> in January of 1991 to discuss this problem which had been reported

by a patient. Perhaps not

> surprisingly they claimed to have never heard of any link between

Accutane and long-term sexual

> dysfunction. When I called again in March of 1999 I was told the

same thing, which caused me

> to question their credibility. They'd never heard of it? Bull. I've

heard of several cases,

> and I'm not exactly the clearinghouse for the adverse effects of

Accutane. Roche states that

> the " exact mechanism of action of Accutane is unknown. " Well, if

they don't even know how it

> suppresses acne, perhaps they are equally unaware of how it affects

the body in other ways.

>

> The case that I presented to Roche in 1991 was one that should have

caused them to seriously

> consider that Accutane's sexual effects were a cause for concern.

In this case, the patient

> took several courses of Accutane over a period of years. With each

course of treatment the

> patient experienced reduced libido and altered sexual sensation.

Instead of being pleasant,

> his sexual sensation was markedly unpleasant and felt similar to

the sensation that people

> perceive when they strike their " funny bone " (ulnar nerve at the

elbow). These symptoms would

> decrease somewhat when the patient stopped taking Accutane, but

they never totally resolved.

> The patient concluded that the problems would abate entirely once

he had been off Accutane

> for a longer time. The patient took additional courses of Accutane

over the following years

> to control his acne, each time experiencing an exacerbation of the

symptoms while on the Accutane

> and a reduction in the symptoms after discontinuing Accutane. After

the final course of Accutane,

> the patient was alarmed that the symptoms persisted for more than a

decade.

>

> Whenever a scientist is presented with a case in which

reintroduction of a drug induces problems

> that had abated once the drug was discontinued, and this

concordance between symptoms and drug

> use continues over a number of cycles, it is virtually impossible

to conclude that there is

> no connection between the drug and the problem. Therefore, Roche

should not have dismissed

> or ignored the case I reported to them.

>

> While I have heard of several cases linking Accutane and long-term

sexual dysfunction, I am

> certain that there are many cases which have not yet come to my

attention. Besides me, there

> are millions of other doctors in the world who may have fielded

similar reports from their

> patients. Furthermore, I think that many people just suffer in

silence if they have a sexual

> problem since it can be very difficult to discuss your sex life

with someone even if he is

> a physician. The patient discussed above waited eight years before

he mustered the courage

> to discuss his problem, and he's probably not the only one who is

reluctant to discuss sexual

> dysfunction.

>

June 2, 2002

Was this on standard dose Accutane course, or the low dose (10mg

daily or every other day) reccommended for cea treatment?

> Here is just one of the many reasons it should not.

>

> Accutane® (isotretinoin) can permanently affect your sex life,

reducing libido and sexual sensation.

> In some cases it may also induce sexual dysesthesias in which

sexual sensations feel like

> " pins and needles " instead of being normally pleasant. If you or

someone you know has been

> affected by any of these problems, please continue reading.

>

> While there are many drugs that interfere with one or more aspects

of sexuality while the user

> is taking them, with one exception all of these problems resolve

once the drug is discontinued.

> The only drug that can permanently affect libido and sexual

pleasure in some people is Accutane®

> (isotretinoin), used in the treatment of severe recalcitrant

nodular acne. Roche Laboratories,

> the manufacturer of Accutane, claims to be unaware of any such

adverse effects. However, I

> have firsthand knowledge that their ignorance of this matter is,

well, fishy. I called Roche

> in January of 1991 to discuss this problem which had been reported

by a patient. Perhaps not

> surprisingly they claimed to have never heard of any link between

Accutane and long-term sexual

> dysfunction. When I called again in March of 1999 I was told the

same thing, which caused me

> to question their credibility. They'd never heard of it? Bull. I've

heard of several cases,

> and I'm not exactly the clearinghouse for the adverse effects of

Accutane. Roche states that

> the " exact mechanism of action of Accutane is unknown. " Well, if

they don't even know how it

> suppresses acne, perhaps they are equally unaware of how it affects

the body in other ways.

>

> The case that I presented to Roche in 1991 was one that should have

caused them to seriously

> consider that Accutane's sexual effects were a cause for concern.

In this case, the patient

> took several courses of Accutane over a period of years. With each

course of treatment the

> patient experienced reduced libido and altered sexual sensation.

Instead of being pleasant,

> his sexual sensation was markedly unpleasant and felt similar to

the sensation that people

> perceive when they strike their " funny bone " (ulnar nerve at the

elbow). These symptoms would

> decrease somewhat when the patient stopped taking Accutane, but

they never totally resolved.

> The patient concluded that the problems would abate entirely once

he had been off Accutane

> for a longer time. The patient took additional courses of Accutane

over the following years

> to control his acne, each time experiencing an exacerbation of the

symptoms while on the Accutane

> and a reduction in the symptoms after discontinuing Accutane. After

the final course of Accutane,

> the patient was alarmed that the symptoms persisted for more than a

decade.

>

> Whenever a scientist is presented with a case in which

reintroduction of a drug induces problems

> that had abated once the drug was discontinued, and this

concordance between symptoms and drug

> use continues over a number of cycles, it is virtually impossible

to conclude that there is

> no connection between the drug and the problem. Therefore, Roche

should not have dismissed

> or ignored the case I reported to them.

>

> While I have heard of several cases linking Accutane and long-term

sexual dysfunction, I am

> certain that there are many cases which have not yet come to my

attention. Besides me, there

> are millions of other doctors in the world who may have fielded

similar reports from their

> patients. Furthermore, I think that many people just suffer in

silence if they have a sexual

> problem since it can be very difficult to discuss your sex life

with someone even if he is

> a physician. The patient discussed above waited eight years before

he mustered the courage

> to discuss his problem, and he's probably not the only one who is

reluctant to discuss sexual

> dysfunction.

>

June 2, 2002

Was this on standard dose Accutane course, or the low dose (10mg

daily or every other day) reccommended for cea treatment?

> Here is just one of the many reasons it should not.

>

> Accutane® (isotretinoin) can permanently affect your sex life,

reducing libido and sexual sensation.

> In some cases it may also induce sexual dysesthesias in which

sexual sensations feel like

> " pins and needles " instead of being normally pleasant. If you or

someone you know has been

> affected by any of these problems, please continue reading.

>

> While there are many drugs that interfere with one or more aspects

of sexuality while the user

> is taking them, with one exception all of these problems resolve

once the drug is discontinued.

> The only drug that can permanently affect libido and sexual

pleasure in some people is Accutane®

> (isotretinoin), used in the treatment of severe recalcitrant

nodular acne. Roche Laboratories,

> the manufacturer of Accutane, claims to be unaware of any such

adverse effects. However, I

> have firsthand knowledge that their ignorance of this matter is,

well, fishy. I called Roche

> in January of 1991 to discuss this problem which had been reported

by a patient. Perhaps not

> surprisingly they claimed to have never heard of any link between

Accutane and long-term sexual

> dysfunction. When I called again in March of 1999 I was told the

same thing, which caused me

> to question their credibility. They'd never heard of it? Bull. I've

heard of several cases,

> and I'm not exactly the clearinghouse for the adverse effects of

Accutane. Roche states that

> the " exact mechanism of action of Accutane is unknown. " Well, if

they don't even know how it

> suppresses acne, perhaps they are equally unaware of how it affects

the body in other ways.

>

> The case that I presented to Roche in 1991 was one that should have

caused them to seriously

> consider that Accutane's sexual effects were a cause for concern.

In this case, the patient

> took several courses of Accutane over a period of years. With each

course of treatment the

> patient experienced reduced libido and altered sexual sensation.

Instead of being pleasant,

> his sexual sensation was markedly unpleasant and felt similar to

the sensation that people

> perceive when they strike their " funny bone " (ulnar nerve at the

elbow). These symptoms would

> decrease somewhat when the patient stopped taking Accutane, but

they never totally resolved.

> The patient concluded that the problems would abate entirely once

he had been off Accutane

> for a longer time. The patient took additional courses of Accutane

over the following years

> to control his acne, each time experiencing an exacerbation of the

symptoms while on the Accutane

> and a reduction in the symptoms after discontinuing Accutane. After

the final course of Accutane,

> the patient was alarmed that the symptoms persisted for more than a

decade.

>

> Whenever a scientist is presented with a case in which

reintroduction of a drug induces problems

> that had abated once the drug was discontinued, and this

concordance between symptoms and drug

> use continues over a number of cycles, it is virtually impossible

to conclude that there is

> no connection between the drug and the problem. Therefore, Roche

should not have dismissed

> or ignored the case I reported to them.

>

> While I have heard of several cases linking Accutane and long-term

sexual dysfunction, I am

> certain that there are many cases which have not yet come to my

attention. Besides me, there

> are millions of other doctors in the world who may have fielded

similar reports from their

> patients. Furthermore, I think that many people just suffer in

silence if they have a sexual

> problem since it can be very difficult to discuss your sex life

with someone even if he is

> a physician. The patient discussed above waited eight years before

he mustered the courage

> to discuss his problem, and he's probably not the only one who is

reluctant to discuss sexual

> dysfunction.

>

June 2, 2002

Was this on standard dose Accutane course, or the low dose (10mg

daily or every other day) reccommended for cea treatment?

> Here is just one of the many reasons it should not.

>

> Accutane® (isotretinoin) can permanently affect your sex life,

reducing libido and sexual sensation.

> In some cases it may also induce sexual dysesthesias in which

sexual sensations feel like

> " pins and needles " instead of being normally pleasant. If you or

someone you know has been

> affected by any of these problems, please continue reading.

>

> While there are many drugs that interfere with one or more aspects

of sexuality while the user

> is taking them, with one exception all of these problems resolve

once the drug is discontinued.

> The only drug that can permanently affect libido and sexual

pleasure in some people is Accutane®

> (isotretinoin), used in the treatment of severe recalcitrant

nodular acne. Roche Laboratories,

> the manufacturer of Accutane, claims to be unaware of any such

adverse effects. However, I

> have firsthand knowledge that their ignorance of this matter is,

well, fishy. I called Roche

> in January of 1991 to discuss this problem which had been reported

by a patient. Perhaps not

> surprisingly they claimed to have never heard of any link between

Accutane and long-term sexual

> dysfunction. When I called again in March of 1999 I was told the

same thing, which caused me

> to question their credibility. They'd never heard of it? Bull. I've

heard of several cases,

> and I'm not exactly the clearinghouse for the adverse effects of

Accutane. Roche states that

> the " exact mechanism of action of Accutane is unknown. " Well, if

they don't even know how it

> suppresses acne, perhaps they are equally unaware of how it affects

the body in other ways.

>

> The case that I presented to Roche in 1991 was one that should have

caused them to seriously

> consider that Accutane's sexual effects were a cause for concern.

In this case, the patient

> took several courses of Accutane over a period of years. With each

course of treatment the

> patient experienced reduced libido and altered sexual sensation.

Instead of being pleasant,

> his sexual sensation was markedly unpleasant and felt similar to

the sensation that people

> perceive when they strike their " funny bone " (ulnar nerve at the

elbow). These symptoms would

> decrease somewhat when the patient stopped taking Accutane, but

they never totally resolved.

> The patient concluded that the problems would abate entirely once

he had been off Accutane

> for a longer time. The patient took additional courses of Accutane

over the following years

> to control his acne, each time experiencing an exacerbation of the

symptoms while on the Accutane

> and a reduction in the symptoms after discontinuing Accutane. After

the final course of Accutane,

> the patient was alarmed that the symptoms persisted for more than a

decade.

>

> Whenever a scientist is presented with a case in which

reintroduction of a drug induces problems

> that had abated once the drug was discontinued, and this

concordance between symptoms and drug

> use continues over a number of cycles, it is virtually impossible

to conclude that there is

> no connection between the drug and the problem. Therefore, Roche

should not have dismissed

> or ignored the case I reported to them.

>

> While I have heard of several cases linking Accutane and long-term

sexual dysfunction, I am

> certain that there are many cases which have not yet come to my

attention. Besides me, there

> are millions of other doctors in the world who may have fielded

similar reports from their

> patients. Furthermore, I think that many people just suffer in

silence if they have a sexual

> problem since it can be very difficult to discuss your sex life

with someone even if he is

> a physician. The patient discussed above waited eight years before

he mustered the courage

> to discuss his problem, and he's probably not the only one who is

reluctant to discuss sexual

> dysfunction.

>

June 2, 2002

Was this on standard dose Accutane course, or the low dose (10mg

daily or every other day) reccommended for cea treatment?

> Here is just one of the many reasons it should not.

>

> Accutane® (isotretinoin) can permanently affect your sex life,

reducing libido and sexual sensation.

> In some cases it may also induce sexual dysesthesias in which

sexual sensations feel like

> " pins and needles " instead of being normally pleasant. If you or

someone you know has been

> affected by any of these problems, please continue reading.

>

> While there are many drugs that interfere with one or more aspects

of sexuality while the user

> is taking them, with one exception all of these problems resolve

once the drug is discontinued.

> The only drug that can permanently affect libido and sexual

pleasure in some people is Accutane®

> (isotretinoin), used in the treatment of severe recalcitrant

nodular acne. Roche Laboratories,

> the manufacturer of Accutane, claims to be unaware of any such

adverse effects. However, I

> have firsthand knowledge that their ignorance of this matter is,

well, fishy. I called Roche

> in January of 1991 to discuss this problem which had been reported

by a patient. Perhaps not

> surprisingly they claimed to have never heard of any link between

Accutane and long-term sexual

> dysfunction. When I called again in March of 1999 I was told the

same thing, which caused me

> to question their credibility. They'd never heard of it? Bull. I've

heard of several cases,

> and I'm not exactly the clearinghouse for the adverse effects of

Accutane. Roche states that

> the " exact mechanism of action of Accutane is unknown. " Well, if

they don't even know how it

> suppresses acne, perhaps they are equally unaware of how it affects

the body in other ways.

>

> The case that I presented to Roche in 1991 was one that should have

caused them to seriously

> consider that Accutane's sexual effects were a cause for concern.

In this case, the patient

> took several courses of Accutane over a period of years. With each

course of treatment the

> patient experienced reduced libido and altered sexual sensation.

Instead of being pleasant,

> his sexual sensation was markedly unpleasant and felt similar to

the sensation that people

> perceive when they strike their " funny bone " (ulnar nerve at the

elbow). These symptoms would

> decrease somewhat when the patient stopped taking Accutane, but

they never totally resolved.

> The patient concluded that the problems would abate entirely once

he had been off Accutane

> for a longer time. The patient took additional courses of Accutane

over the following years

> to control his acne, each time experiencing an exacerbation of the

symptoms while on the Accutane

> and a reduction in the symptoms after discontinuing Accutane. After

the final course of Accutane,

> the patient was alarmed that the symptoms persisted for more than a

decade.

>

> Whenever a scientist is presented with a case in which

reintroduction of a drug induces problems

> that had abated once the drug was discontinued, and this

concordance between symptoms and drug

> use continues over a number of cycles, it is virtually impossible

to conclude that there is

> no connection between the drug and the problem. Therefore, Roche

should not have dismissed

> or ignored the case I reported to them.

>

> While I have heard of several cases linking Accutane and long-term

sexual dysfunction, I am

> certain that there are many cases which have not yet come to my

attention. Besides me, there

> are millions of other doctors in the world who may have fielded

similar reports from their

> patients. Furthermore, I think that many people just suffer in

silence if they have a sexual

> problem since it can be very difficult to discuss your sex life

with someone even if he is

> a physician. The patient discussed above waited eight years before

he mustered the courage

> to discuss his problem, and he's probably not the only one who is

reluctant to discuss sexual

> dysfunction.

>

June 2, 2002

Was this on standard dose Accutane course, or the low dose (10mg

daily or every other day) reccommended for cea treatment?

> Here is just one of the many reasons it should not.

>

> Accutane® (isotretinoin) can permanently affect your sex life,

reducing libido and sexual sensation.

> In some cases it may also induce sexual dysesthesias in which

sexual sensations feel like

> " pins and needles " instead of being normally pleasant. If you or

someone you know has been

> affected by any of these problems, please continue reading.

>

> While there are many drugs that interfere with one or more aspects

of sexuality while the user

> is taking them, with one exception all of these problems resolve

once the drug is discontinued.

> The only drug that can permanently affect libido and sexual

pleasure in some people is Accutane®

> (isotretinoin), used in the treatment of severe recalcitrant

nodular acne. Roche Laboratories,

> the manufacturer of Accutane, claims to be unaware of any such

adverse effects. However, I

> have firsthand knowledge that their ignorance of this matter is,

well, fishy. I called Roche

> in January of 1991 to discuss this problem which had been reported

by a patient. Perhaps not

> surprisingly they claimed to have never heard of any link between

Accutane and long-term sexual

> dysfunction. When I called again in March of 1999 I was told the

same thing, which caused me

> to question their credibility. They'd never heard of it? Bull. I've

heard of several cases,

> and I'm not exactly the clearinghouse for the adverse effects of

Accutane. Roche states that

> the " exact mechanism of action of Accutane is unknown. " Well, if

they don't even know how it

> suppresses acne, perhaps they are equally unaware of how it affects

the body in other ways.

>

> The case that I presented to Roche in 1991 was one that should have

caused them to seriously

> consider that Accutane's sexual effects were a cause for concern.

In this case, the patient

> took several courses of Accutane over a period of years. With each

course of treatment the

> patient experienced reduced libido and altered sexual sensation.

Instead of being pleasant,

> his sexual sensation was markedly unpleasant and felt similar to

the sensation that people

> perceive when they strike their " funny bone " (ulnar nerve at the

elbow). These symptoms would

> decrease somewhat when the patient stopped taking Accutane, but

they never totally resolved.

> The patient concluded that the problems would abate entirely once

he had been off Accutane

> for a longer time. The patient took additional courses of Accutane

over the following years

> to control his acne, each time experiencing an exacerbation of the

symptoms while on the Accutane

> and a reduction in the symptoms after discontinuing Accutane. After

the final course of Accutane,

> the patient was alarmed that the symptoms persisted for more than a

decade.

>

> Whenever a scientist is presented with a case in which

reintroduction of a drug induces problems

> that had abated once the drug was discontinued, and this

concordance between symptoms and drug

> use continues over a number of cycles, it is virtually impossible

to conclude that there is

> no connection between the drug and the problem. Therefore, Roche

should not have dismissed

> or ignored the case I reported to them.

>

> While I have heard of several cases linking Accutane and long-term

sexual dysfunction, I am

> certain that there are many cases which have not yet come to my

attention. Besides me, there

> are millions of other doctors in the world who may have fielded

similar reports from their

> patients. Furthermore, I think that many people just suffer in

silence if they have a sexual

> problem since it can be very difficult to discuss your sex life

with someone even if he is

> a physician. The patient discussed above waited eight years before

he mustered the courage

> to discuss his problem, and he's probably not the only one who is

reluctant to discuss sexual

> dysfunction.

>

June 2, 2002

The debate continues. Has anyone considered that people who need

Accutane and do not take it -- their sex life will be reduced or non

existent or by taking Accutane they will actually enhance their sex

life by becoming more attractive.

The increased attractiveness leading to better sex life vs. possible

sexual dysfunction must be considered in the final balance.

> > Here is just one of the many reasons it should not.

> >

> > Accutane® (isotretinoin) can permanently affect your sex life,

> reducing libido and sexual sensation.

> > In some cases it may also induce sexual dysesthesias in which

> sexual sensations feel like

> > " pins and needles " instead of being normally pleasant. If you or

> someone you know has been

> > affected by any of these problems, please continue reading.

> >

> > While there are many drugs that interfere with one or more

aspects

> of sexuality while the user

> > is taking them, with one exception all of these problems resolve

> once the drug is discontinued.

> > The only drug that can permanently affect libido and sexual

> pleasure in some people is Accutane®

> > (isotretinoin), used in the treatment of severe recalcitrant

> nodular acne. Roche Laboratories,

> > the manufacturer of Accutane, claims to be unaware of any such

> adverse effects. However, I

> > have firsthand knowledge that their ignorance of this matter is,

> well, fishy. I called Roche

> > in January of 1991 to discuss this problem which had been

reported

> by a patient. Perhaps not

> > surprisingly they claimed to have never heard of any link between

> Accutane and long-term sexual

> > dysfunction. When I called again in March of 1999 I was told the

> same thing, which caused me

> > to question their credibility. They'd never heard of it? Bull.

I've

> heard of several cases,

> > and I'm not exactly the clearinghouse for the adverse effects of

> Accutane. Roche states that

> > the " exact mechanism of action of Accutane is unknown. " Well, if

> they don't even know how it

> > suppresses acne, perhaps they are equally unaware of how it

affects

> the body in other ways.

> >

> > The case that I presented to Roche in 1991 was one that should

have

> caused them to seriously

> > consider that Accutane's sexual effects were a cause for concern.

> In this case, the patient

> > took several courses of Accutane over a period of years. With

each

> course of treatment the

> > patient experienced reduced libido and altered sexual sensation.

> Instead of being pleasant,

> > his sexual sensation was markedly unpleasant and felt similar to

> the sensation that people

> > perceive when they strike their " funny bone " (ulnar nerve at the

> elbow). These symptoms would

> > decrease somewhat when the patient stopped taking Accutane, but

> they never totally resolved.

> > The patient concluded that the problems would abate entirely once

> he had been off Accutane

> > for a longer time. The patient took additional courses of

Accutane

> over the following years

> > to control his acne, each time experiencing an exacerbation of

the

> symptoms while on the Accutane

> > and a reduction in the symptoms after discontinuing Accutane.

After

> the final course of Accutane,

> > the patient was alarmed that the symptoms persisted for more than

a

> decade.

> >

> > Whenever a scientist is presented with a case in which

> reintroduction of a drug induces problems

> > that had abated once the drug was discontinued, and this

> concordance between symptoms and drug

> > use continues over a number of cycles, it is virtually impossible

> to conclude that there is

> > no connection between the drug and the problem. Therefore, Roche

> should not have dismissed

> > or ignored the case I reported to them.

> >

> > While I have heard of several cases linking Accutane and long-

term

> sexual dysfunction, I am

> > certain that there are many cases which have not yet come to my

> attention. Besides me, there

> > are millions of other doctors in the world who may have fielded

> similar reports from their

> > patients. Furthermore, I think that many people just suffer in

> silence if they have a sexual

> > problem since it can be very difficult to discuss your sex life

> with someone even if he is

> > a physician. The patient discussed above waited eight years

before

> he mustered the courage

> > to discuss his problem, and he's probably not the only one who is

> reluctant to discuss sexual

> > dysfunction.

> >

June 2, 2002

I guess the rug or hair piece to cover the balding from Accutane

should also be added into the attractiveness equation.

> > > Here is just one of the many reasons it should not.

> > >

> > > Accutane® (isotretinoin) can permanently affect your sex

life,

> > reducing libido and sexual sensation.

> > > In some cases it may also induce sexual dysesthesias in which

> > sexual sensations feel like

> > > " pins and needles " instead of being normally pleasant. If you

or

> > someone you know has been

> > > affected by any of these problems, please continue reading.

> > >

> > > While there are many drugs that interfere with one or more

> aspects

> > of sexuality while the user

> > > is taking them, with one exception all of these problems

resolve

> > once the drug is discontinued.

> > > The only drug that can permanently affect libido and sexual

> > pleasure in some people is Accutane®

> > > (isotretinoin), used in the treatment of severe recalcitrant

> > nodular acne. Roche Laboratories,

> > > the manufacturer of Accutane, claims to be unaware of any such

> > adverse effects. However, I

> > > have firsthand knowledge that their ignorance of this matter

is,

> > well, fishy. I called Roche

> > > in January of 1991 to discuss this problem which had been

> reported

> > by a patient. Perhaps not

> > > surprisingly they claimed to have never heard of any link

between

> > Accutane and long-term sexual

> > > dysfunction. When I called again in March of 1999 I was told

the

> > same thing, which caused me

> > > to question their credibility. They'd never heard of it? Bull.

> I've

> > heard of several cases,

> > > and I'm not exactly the clearinghouse for the adverse effects

of

> > Accutane. Roche states that

> > > the " exact mechanism of action of Accutane is unknown. " Well,

if

> > they don't even know how it

> > > suppresses acne, perhaps they are equally unaware of how it

> affects

> > the body in other ways.

> > >

> > > The case that I presented to Roche in 1991 was one that should

> have

> > caused them to seriously

> > > consider that Accutane's sexual effects were a cause for

concern.

> > In this case, the patient

> > > took several courses of Accutane over a period of years. With

> each

> > course of treatment the

> > > patient experienced reduced libido and altered sexual

sensation.

> > Instead of being pleasant,

> > > his sexual sensation was markedly unpleasant and felt similar

to

> > the sensation that people

> > > perceive when they strike their " funny bone " (ulnar nerve at

the

> > elbow). These symptoms would

> > > decrease somewhat when the patient stopped taking Accutane, but

> > they never totally resolved.

> > > The patient concluded that the problems would abate entirely

once

> > he had been off Accutane

> > > for a longer time. The patient took additional courses of

> Accutane

> > over the following years

> > > to control his acne, each time experiencing an exacerbation of

> the

> > symptoms while on the Accutane

> > > and a reduction in the symptoms after discontinuing Accutane.

> After

> > the final course of Accutane,

> > > the patient was alarmed that the symptoms persisted for more

than

> a

> > decade.

> > >

> > > Whenever a scientist is presented with a case in which

> > reintroduction of a drug induces problems

> > > that had abated once the drug was discontinued, and this

> > concordance between symptoms and drug

> > > use continues over a number of cycles, it is virtually

impossible

> > to conclude that there is

> > > no connection between the drug and the problem. Therefore,

Roche

> > should not have dismissed

> > > or ignored the case I reported to them.

> > >

> > > While I have heard of several cases linking Accutane and long-

> term

> > sexual dysfunction, I am

> > > certain that there are many cases which have not yet come to my

> > attention. Besides me, there

> > > are millions of other doctors in the world who may have fielded

> > similar reports from their

> > > patients. Furthermore, I think that many people just suffer in

> > silence if they have a sexual

> > > problem since it can be very difficult to discuss your sex life

> > with someone even if he is

> > > a physician. The patient discussed above waited eight years

> before

> > he mustered the courage

> > > to discuss his problem, and he's probably not the only one who

is

> > reluctant to discuss sexual

> > > dysfunction.

> > >

June 5, 2002

>Has anyone considered that people who need Accutane

>and do not take it -- their sex life will be reduced or non

>existent or by taking Accutane they will actually enhance

>their sex life by becoming more attractive.

>The increased attractiveness leading to better sex life vs.

>possible sexual dysfunction must be considered in the final

>balance.

Dear 007,

(or are you a full-time Accutane agent now?)

Here is a comment that I simply have to make - the above is, - hmm, how do I

put it - a rather naive view of sexuality, sex appeal and attraction. If you

believe that you are losing on life because your potential partner doesn't

want to be with you because you have rosacea - that's fine, you are entitled

to that belief.

I, on the other hand, believe that you are better off without that person in

your life in the long run. There is a lot more to a human being than just a

pretty face. If I fall in love with a man, it's because I have already

fallen in love with his brain (and possibly with his hands), and face comes

only after that. So if I have a choice between a package where rosacea comes

bundled with intellect; versus a package where there is a pretty face but

the brain is on a permanent vacation, I'll take the rosacea.

But I guess our different choices and different preferences are a mechanism

that prevents us from fighting over the same person. ;-)

Alena

June 5, 2002