Wysowski and Beitz point out several limitations of our study on isotretinoin and the risk of depression, psychotic symptoms, and attempted suicide.1 Indeed, we have addressed some of these in our manuscript. Other concerns are perhaps not of relevance in this instance. Whereas it is likely that we missed some cases of depression, psychotic behaviors, or suicidal behaviors, it is unlikely that there would be any differential underascertainment between the patients treated with isotretinoin and those treated with antibiotic, and thus it is unlikely to have an effect on our results. Case-control studies often fail to capture all cases.
Jick SS, Vasilakis-Scaramozza C. Methodological Limitations of the Study "Isotretinoin Use and Risk of Depression, Psychotic Symptoms, Suicide, and Attempted Suicide". Arch Dermatol. 2001;137(8):1102-1103. doi: