A Texas teenager convicted of fatally shooting a friend in 2023 argued in court that his actions were influenced by the acne medication isotretinoin, a claim rejected by the judge during sentencing. Connor Hilton, then 17, was sentenced to 50 years in prison in September 2025 after pleading guilty to murder and aggravated assault, according to reporting by the New York Post on February 9, 2026.
Hilton shot Ethan Riley, who died, and Benjamin Blick, who was seriously injured, at Hilton’s home in Friendswood, Texas, in December 2023. Following the shooting, Hilton reportedly told investigators, “What I did was wrong. I need to be punished. But I need help too,” and revealed a history of suicidal thoughts and impulses to harm others.
The defense centered on the potential side effects of isotretinoin, commonly known as Accutane, which carries a warning from the U.S. Food and Drug Administration regarding potential links to depression, suicidal ideation, hallucinations, aggression, and psychosis. Hilton reportedly told police the day before the shooting he had skipped his medication, then doubled his dose on the day of the incident. He likewise allegedly confessed to his mother that he intended to either shoot himself or someone else whereas attempting to persuade her to purchase the firearm.
Despite the defense’s arguments, the court did not consider the drug’s potential impact as a mitigating factor in Hilton’s sentencing. A similar case involving Accutane and violent behavior prompted four U.S. Representatives, including Bart Stupak whose son died by suicide while taking the medication, to threaten action against the FDA in November 2025 if the agency failed to improve safety oversight of the drug.
The drug’s controversial history includes its withdrawal from the U.S. Market by Roche in 2009 due to the financial burden of numerous lawsuits, with some settlements reaching $25 million. Despite these concerns and legal challenges in the United States, isotretinoin remains available and frequently prescribed in South Korea, where it has been administered to approximately 170,000 children under the age of 12 since 2010, raising concerns about potential adverse effects and inappropriate prescribing practices.
