The acne pills stopped. The side effects did not.
- Side effects that last for years, from an acne drug.
- Thousands of people. Most were teenagers when they took it.
- The label warns of the risk. It does not say it can last for years.
Mental health risks are on the label. How long they last is not.FDA label
2,146 reports of suicidal thoughts, 531 suicide attempts, 264 deaths by suicide.FDA FAERS, retrieved Aug 2026
It is given for acne. Nobody dies of acne.Indication
PAS has no diagnostic code. So no health system counts these patients.ICD
What is PAS?
PAS is when side effects from isotretinoin do not go away after you stop. Isotretinoin is a strong acne drug, sold as Accutane and Roaccutane.
Most people are teenagers or young adults when they take it.
- The drug changes how genes work all over the body.
- Studies point to androgen receptors, the switches that sex hormones use.
- It also disrupts neurosteroids, the hormones the brain makes for itself.
- Some epigenetic changes (changes in how genes are read) may not reverse.
- The drug is built to keep working after the course ends. For some people, so do the side effects.
Symptoms people still have after stopping
PAS can affect sex, mood and the body. Many took the drug as teenagers and still have symptoms decades later.
Sexual
2- Sexual dysfunction (sex does not work as before)
- Low or no sex drive
Brain and mood
4- Depression
- Brain fog and trouble thinking
- Emotional blunting (feelings go flat)
- Suicidal thoughts
Body
5- Joint pain that does not stop
- Dry eyes (meibomian gland dysfunction)
- Gut problems, including IBS
- Fatigue that does not lift
- Fragile skin
This list is not complete. It shows what patients report most often.
PAS by the numbers
34 years of silence
The FDA approves Accutane
The FDA approves isotretinoin for severe cystic acne. Roche sells it in the US as Accutane.
First report of sexual dysfunction
Someone reports sexual dysfunction after isotretinoin. That is one year after approval.
Roche pulls Accutane from the US market
Roche withdraws the brand by choice. It follows more than 7,000 lawsuits and evidence of serious harm to mind and body. Generic isotretinoin is still prescribed widely.
Sexual side effects reach the FDA label
The US label finally names sexual dysfunction, 34 years after the first report. By then millions had been given the drug with no warning.
Still no MedDRA code. No drug company research.
PAS still has no MedDRA code, the standard list of side effect names. There is no agreed way to diagnose it. No drug company has publicly paid for a study.
The least researched condition
PAS is studied far less than PFS and PSSD. Patients and independent academics have paid for every study.
Very little research exists
Most of it is case reports and counts of side effect reports. Almost nobody has studied how the harm happens.
Drug companies have funded none of it, after decades of reports.
Shared causes with PFS and PSSD
Early evidence links all three conditions to the same two paths.
Epigenetic change means the way genes are read is altered. Neurosteroid disruption means the hormones the brain makes are thrown off.
Research across all three may speed up answers and treatments.
I think I have PAS. What now?
If this sounds like you, here are 5 steps you can take now.
You are not imagining this
PAS is recognised less than PFS or PSSD. It shares the same epigenetic and neurosteroid paths as both. Your symptoms are real, and thousands of people share them.
Connect with others
Join a WhatsApp support group. Talk to people who know what this is like.
Report your side effects
Report to your country's health regulator. Every report makes these conditions harder to ignore.
Read about managing symptoms
Our Support Library has guides on coping, talking to your doctor, and daily life.
Join the registry
Register your experience anonymously. Your data helps research and shows the real scale.
Help build the evidence
Add your case to the SIDEfxHUB registry. Your data stays anonymous, and it helps PAS research.