Dermatological Severe acne due to<unk>  was first reported in 1988 by various authors—Grupper, Thioly-Bensoussan, Vexiau, Fiet, Puissant, Gourmel, Teillac, Levigne, to name a few—simultaneously in the same issue of Annales de dermatologie et de vénéréologie and in the 12 March 1988 issue of The Lancet. A year later, Dr Martin-Ortega and colleagues in Barcelona, Spain reported a case of "acneiform eruption" in a 54-year-old woman whose intake of<unk>  was described as "excessive." One year after that, Vexiau and colleagues reported six women, one of whom never admitted to using<unk> , getting severe acne concentrated in the face, back and thorax, the severity of which varied with the dosage. Most of them were treated unsuccessfully with isotretinoin (Accutane) for about 18 months; two of the three that discontinued<unk>  experienced a reduction in cutaneous symptoms, with the least affected patient going into remission. Psychiatric Psychomotor excitation can very rarely occur with this drug. * Insomnia * Irritability * Nervousness * Suicidal ideation. Seen early in the treatment, by lifting of psychomotor inhibition. Abuse and dependence The risk of addiction is low, but exists nonetheless. Between 1978 and 1988, there were 186 cases of<unk>  addiction reported to the French Regional Centres of Pharmacovigilance; an analysis of 155 of those cases found that they were predominantly female, and that two-thirds of cases had known risk factors for addiction. However, a 1981 study of known opiate addicts and schizophrenia patients found no drug addiction in any of the subjects. In a 1990 study of eight<unk>  dependence cases, the gradual withdrawal of<unk>  could be achieved without problems in six people; in two others, anxiety, psychomotor agitation, and/or bulimia appeared. Withdrawal Pharmacodependence is very common with<unk>  compared to other antidepressants. A variety of psychological symptoms can occur during withdrawal from<unk> , such as anxiety and agitation. Cardiovascular Very rarely: * Arterial hypotension * Palpitations * Vasomotor episode Hepatic<unk>  can rarely cause hepatitis, of the cytolytic, cholestatic varieties.<unk> -induced hepatitis, which is sometimes preceded by a rash, is believed to be due to an immunoallergic reaction. It resolves upon discontinuation of the offending drug. The risk of getting this may or may not be genetically determined. Additionally,<unk>  is known to rarely elevate transaminases, alkaline phosphatase, and bilirubin. Mixed hepatitis, which is very rare, generally occurs between the 15th and 30th day of treatment. Often preceded by sometimes intense abdominal pains, nausea, vomiting or a rash, the jaundice is variable. Hepatitis is either of mixed type or with cholestatic prevalence. The evolution was, in all the cases, favorable to the discontinuation of the drug. The mechanism is discussed (immunoallergic and/or toxic). In circa 1994 Spain, there was a case associating acute pancreatitis and mixed hepatitis, after three weeks of treatment. Lazaros and colleagues at the Western Attica General Hospital in Athens, Greece reported two cases of drug induced hepatitis 18 and 15 days of treatment. One case of cytolytic hepatitis occurred after ingestion of only one tablet. Gastrointestinal * Acute pancreatitis (very rare) A case associating acute pancreatitis and mixed hepatitis after three weeks of treatment. Immunological In 1989, Sgro and colleagues at the Centre de Pharmacovigilance in Dijon reported a case of anaphylactic shock in a woman who had been taking<unk> .
Amineptine
Fluorodopa
Butriptyline
Galantamine
Protriptyline
Tianeptine
Amantadine
Bisantrene