Those familiar with isotretinoin, the drug formerly known under the brand name Accutane — a heavy-duty prescription acne medication — are probably also familiar with the drug’s potential side effects, which include some serious warnings. Now, lawyers for a teen accused of murder are suggesting that the drug may have contributed to his violent behavior.

The issue with the drug is that its side effects can be grave. In addition to severe skin irritation and birth defects, some studies cite a possible association between isotretinoin use and serious mental health issues. Studies of the drug performed over the last decade have suggested links between isotretinoin and anxiety, depression, bipolar disorder, and even psychosis.