{"doi":"10.1111/ijd.17232","title":"Isotretinoin‐associated vivid dreams during acne therapy","abstract":"Isotretinoin-associated vivid dreams during acne therapy While a highly effective treatment for acne, isotretinoin has been associated with a variety of potential neuropsychiatric adverse effects, including mood changes. 1,2Here, we present three cases of patients experiencing disturbing, vivid dreams while on isotretinoin (Table 1). Case 1A female patient in her 20s started isotretinoin 40 mg/day (0.45 mg/kg/day) for severe acne.After 2 weeks, she began to experience progressively worsening episodes of nighttime restlessness and vivid nightmares occurring 1-2 times per night.Her partner observed she would wake up in a state of panic, requiring extensive reassurance to fall back asleep.She otherwise experienced no mood changes.Laboratory values found that her vitamin A levels were in the lower half of normal at 43.4 mcg/dl (ref: 32.5-78.0mcg/dl).A trial of low-dose vitamin A supplementation (5,000 IU/day) was started, and the patient reported resolution of her symptoms after 2 weeks.A subsequent recurrence of vivid dreams occurred 2 days after she ran out of vitamin A; however, her symptoms continued after she restarted vitamin A until the completion of her treatment course. Case 2A 15-year-old girl started isotretinoin 20 mg/day for severe acne.The dose was subsequently increased to 40 mg/day after 1 month.Three weeks later, she began to experience nearly daily episodes of disturbing, vivid, and lucid dreams.After decreasing her dose to 40 mg every other day, symptom resolution was noted without recurrence throughout the rest of her isotretinoin course.","journal":"International Journal of Dermatology","year":2024,"id":471149,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":2,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9581,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2024-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1305732,"name":"Jason Mathis","orcid":"0000-0002-6789-8172","position":1,"is_corresponding":false},{"id":1306082,"name":"A. Heinze","orcid":null,"position":2,"is_corresponding":false},{"id":267741,"name":"John S. Barbieri","orcid":"0000-0002-5467-4102","position":3,"is_corresponding":false},{"id":1257319,"name":"James Choe","orcid":"0000-0003-3539-3513","position":0,"is_corresponding":true}],"reference_count":6,"raw_metadata":null,"created_at":"2026-07-19T02:05:44.736405Z","pmid":"38825758","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}