Evidence Based or Theoretical Concern? The Alleged Acitretin Side Effects of Pseudotumor Cerebri and Depression
November 2005 | Volume 4 | Issue 6 | Original Article | 690 | Copyright © November 2005
John Starling III BA, John Koo MD
Oral retinoids are among the first line agents for treatment of pustular and erythrodermic psoriasis, and they are effective
in combination with phototherapy and other topical and systemic agents for the treatment of plaque psoriasis.
Acitretin is the leading oral retinoid used today for the treatment of psoriasis. Recently, possible side effects such as
pseudotumor cerebri and depression have gained a warning and precaution respectively on the acitretin package insert.
This paper presents a review of the scientific literature and attempts to clarify whether warnings of these side effects
have arisen from a scientific evidence base or from theoretical concern/class labeling. A paucity of scientific evidence
was found in this review for acitretin-associated pseudotumor cerebri and depression. The authors conclude that these
2 acitretin side effects must be further investigated to assess whether these associations are scientifically certain or if
class labeling has led to inclusion in the package insert