One course, which is typically five months, results in prolonged remission of acne in up to 85 percent of patients. A member of a class of drugs known as retinoids, Accutane is highly effective. But it doesn't work for everyone, and some patients need more than one course of treatment. Dr. Harper took a second course of Accutane one year after the first and has been free of severe acne ever since, now only occasionally using a topical medication. No other acne medicine works as well for severe acne.
Patients generally have to keep using other medications because they only suppress acne temporarily.
But as powerful as Accutane can be in improving patients' lives, its adverse effects can be just as powerful. The drug is known to cause miscarriage and severe birth defects. Patients taking Accutane may develop potentially serious problems affecting a number of organs, including the liver, intestines, eyes, ears, and skeletal system. And some patients taking Accutane have developed serious psychiatric problems, including depression. More rarely, patients have developed suicidal behavior and killed themselves.