After the FDA put the more strict iPLEDGE program in place for the companies marketing the drug in the US, in 2011, 155 pregnancies occurred among 129,544 women of childbearing potential taking isotrentinoin (0.12%).People taking isotretinoin are not permitted to donate blood during and for at least one month after discontinuation of therapy due to its teratogenicity. Psychological effects
Rare psychological side effects may include depression, worsening of pre-existing depression, aggressive tendencies, irritable mood and anxiety. Very rare effects include abnormal behaviour, psychosis, suicidal ideation, suicide attempts and suicide. In a total of 5577 adverse reactions reported to the UKs MHRA up to 31 March 2017, the plurality (1207, or 22%) concerned psychiatric effects. There were 85 reports of suicidal ideation, 56 of suicide and 43 of suicide attempts.The association between isotretinoin use and psychopathology has been controversial. Beginning in 1983, isolated case reports emerged suggesting mood change, particularly depression, occurring during or soon after isotretinoin use. A number of studies have been conducted since then of the drugs effect on depression, psychosis, suicidal thoughts and other psychological effects. Depression and suicidality
Isotretinoin is the only non-psychiatric drug on the FDAs top 10 list of drugs associated with depression and is also within the top 10 for suicide attempts. A black box warning for suicide, depression and psychosis has been present on isotretinoins packaging in the United States since 2005.
Chronic fatigue may refer to:

Fatigue (medical)#Chronic, a long-term state of physical or mental exhaustion, a symptom of many chronic illnesses
Chronic fatigue syndrome, a medical condition characterized by long-term fatigue and other long term symptoms that limit a persons ability to carry out ordinary daily activities.