Nightmares caused by isotretinoin in treating hidradenitis suppurativa: a case report and clinical insights
Fawaz Aljehani, Shumukh Alqahtani, Sara Alharbi, Seham Alsulami
Dermatology Reports December 6, 2024 DOI: 10.4081/dr.2024.10171 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Case study Case report Peer reviewed |
|---|---|
| Sample size | 1 |
| Population | 24-year-old male with hidradenitis suppurativa |
| Interventions | Isotretinoin Adalimumab |
| Measures | Naranjo algorithm |
| Topics | Dreaming |
| Citations | 1 |
| Key findings | In a 24-year-old man with hidradenitis suppurativa, increasing the off-label isotretinoin dose was followed by severe, sleep-disrupting nightmares that resolved after the drug was stopped; the Naranjo algorithm indicated a probable association. The authors argue for psychiatric monitoring during isotretinoin therapy and consideration of alternatives such as adalimumab when side effects are intolerable. |
Abstract
Isotretinoin, widely used for treating severe acne, has also been prescribed off-label for hidradenitis suppurativa (HS). While effective in some cases, isotretinoin is known to cause psychiatric side effects. This case report discusses a 24-year-old male with HS who developed severe nightmares after the isotretinoin dosage was increased. Initially prescribed to manage his HS symptoms, the drug led to vivid, distressing nightmares that significantly disrupted his sleep, resulting in the discontinuation of treatment. The symptoms resolved upon cessation of isotretinoin, and a probable association was confirmed using the Naranjo algorithm. The patient was later transitioned to adalimumab, a biologic therapy for HS. This case highlights the need for careful psychiatric monitoring during isotretinoin therapy and emphasizes the importance of considering alternative treatments in cases of intolerable side effects. Further research is necessary to better understand the psychiatric implications of isotretinoin, including sleep disturbances like nightmares.
Comparable studies
Other case reports and case series on dreaming, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Lucid Dreaming as a Learnable Skill: A Case Study The author | 1980 | Case study | n = 1 |
| Lucid Dreaming as a Treatment for Recurrent Nightmares People with recurrent nightmares | 2010 | Case study | n = 5 |
| Treating Chronic Nightmares of Sexual Assault Survivors with an Intellectual Disability – Two Descriptive Case Studies Adults with learning disabilities suffering from post-traumatic nightmares | 2006 | Case study | n = 2 |
| Lucid dreaming: Correspondence between dreamed and actual events in one subject during rem sleep A lucid dreamer | 1984 | Case study | n = 1 |
| Lucid dreaming treatment for nightmares: A series of cases. Participants with nightmares | 2003 | Case series | n = 8 |