I do not use Accutane in my practice and instead choose to refer all recalcitrant acne cases to dermatologists in our area. I have little first hand experience with this particular medication because I choose not to write it often.
Quoting the package insert:
"Pediatric patients and their caregivers should be informed that approximately 29% (104/358) of pediatric patients treated with Accutane devleoped back pain. Back pain was severe in 13.5% (14/104) of the cases and occurred at a higher frequency in female than male patients.
Arthalgias were experienced in 22% (79/358) of pediatric patients.
Arthralgias were severe in 7.6% (6/79) of patients. Appropriate evaluation of the musculoskeletal system should be done in patients who present with these symptoms during or after a course of Accutane. Consideration should be given to discontinuation of Accutane if any significant abnormality is found.
I can appreciate that doctor who is not a dermatologist would want to let a specialist be responsible for prescribing accutane. What bothers me is the attitude that bureaucrats in Washington DC, or trial lawyers should want to keep it away from everyone just because there are some really stupid and irresponsible women out there who get pregnant while taking accutane. I was very much aware of accutane before it was approved. I was also aware of the potential side effects before I went on a five month cours of therapy. I can't imagine anyone would want to put up with its side effects if any other therapy worked.