A Drug That Makes You Fly

"This child was a happy, well-balanced, forward-thinking child who had a great deal to live for," said Julie Bishop. "This was psychotic, and the only conclusion we have been able to draw is the Accutane poisoned him."

Bishop was talking about her 15-year-old son, Charles, who stole a plane and crashed it into a Tampa high-rise on January 5, leaving behind a note expressing support for Osama bin Laden and the September 11 attacks. Bishop, who this week filed a lawsuit against Hoffman-La Roche, the company that makes Accutane, claims the drug put those ideas into her son's head.

Bishop's bewilderment is understandable, but her effort to blame Accutane is almost as bizarre as her son's suicidal flight. Millions of Americans have used Accutane since it was introduced in 1983. Inevitably, some of them have committed self-destructive acts, but there's no evidence that suicide is more common among Accutane users than it is among adolescents and young adults generally. Nor is there a plausible biochemical explanation for a link between Accutane and suicide.

A close reading of the material on the Web site run by Accutane Suicide Legal Help, a network of trial lawyers that includes Bishop's attorneys, indicates the weakness of the evidence against the drug, which is almost entirely anecdotal. The lawyers say "severe depression and suicide" are "well-documented side effects" of Accutane. But they also quote the Food and Drug Administration's medication guide, which notes that, while some Accutane users have reported depression and suicidal thoughts, "No one knows if Accutane caused these behaviors or if they would have happened even if the person did not take Accutane."

Too often ignored in the controversy over Accutane are the patients whose lives have been dramatically improved by the drug, the only available cure for cystic acne. A dermatologist who testified before Congress a couple of years ago acknowledged hearing "anecdotes from colleagues who have had patients who responded negatively to the drug, and whose mood recovered after therapy was stopped." But he added, "I am also aware of cases of suicide in patients with severe acne who have not been prescribed Accutane, young men for whom the burden of the taunting of their peers grew too heavy to bear."