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Additionally, these cytokine aberrations in severe IMDD could elicit depressive symptoms

Department of Agriculture (USDA) says

The AAD's 2016 guidelines on isotretinoin describe dietary modification and lipid-lowering agents as appropriate interventions when triglycerides rise, without restricting specific agents [9]

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The most common side effects include nausea (50-60% of users, most common during dose escalation but usually resolves within 2-4 weeks at each dose level), vomiting (25-30%, often transient and manageable), diarrhea (25-30%, usually mild and self-limiting), constipation (15-20%, manageable with dietary adjustments), and decreased appetite (20-30%, which is a desired effect but can be intense first)