Isotretinoin can cause birth defects, and its packaging is printed with labelled with ideograms against pregnancy.
Suicide may be genetically predisposed. It's obvious that parental suicide harms a child's life, and that pregnancy ought to be delayed for patients with any disorder or medication that may cause suicide.
It's not an altogether irrational thought, either. Tragic examples of suicide running in families abound. Researchers in the 1940s wrote of a Spanish family in which the male descendants across five successive generations each killed themselves at the age of 45. And in 2009, 46 years after his mother, the poet Sylvia Plath, stuck her head in the oven after sealing the windows and doors to keep the gas from seeping into the children's rooms, her son Nicholas Hughes, a fisheries biologist, hanged himself in Alaska.
This past week, I was a shade dismayed that a female patient with treatment-resistant depression and suicidal ideations disclosed that she was thinking of pregnancy. But her antidepressants didn't contain this ideogram against pregnancy.
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