Isotretinoin, a synthetic vitamin A derivative, is primarily used in themanagement of severe nodulocystic acne. Since its introduction, isotretinoin hasbeen linked with various psychiatric side effects. In particular, depression andsuicidality have been extensively reported as side effects. This case reportfeatures a young male who developed a first psychotic episode within 3 months ofstarting isotretinoin therapy. The patient was hospitalized, and organicpathologies and use of psychoactive substances that could explain hispresentation were ruled out. After stopping isotretinoin and starting olanzapine10 mg, the psychotic symptoms remitted completely within 2 weeks. This casehighlights the need for increased vigilance toward psychiatric manifestations ofisotretinoin. In addition, it suggests that secondary psychosis should beconsidered as a differential diagnosis by clinicians, especially in patientswith no past psychiatric history or family history of mental illness.
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