I second the poster who called it a wonder drug.
In fact my dermatologist called it a wonder drug herself.
Like others I'd tried everything and NOTHING WORKED - Roaccutane not only worked, it worked brilliantly.
I used it twice, about 8 years apart, for about 6 months each time.
Since the second time I used it, 12 years ago, I had literally not a single spot UNTIL I started getting hormonal ones on my chin about a year ago. I'm 42 and think it's peri-menoapusal, my mum's skin went dreadful at this point in her life. So I'm all geared up to go back to Roaccutane once more if the huge hormonal spots keep appearing (getting two huge painful ones, even if only once a month, means that I spend 2-3 weeks of each month with the problem as they take ages to go away and then redness won't fade). More than happy to take it again and have every confidence it would work if I needed it.
It's brilliant stuff, I'm no expert and can only speak for my own experience but having suffered from anxiety and depression prior to taking the drug, I can say that Roaccutane had ZERO impact on that part of my life.
Dryness of skin wasn't even that big an issue for me. I wear contact lenses and my eyes were fine. I did use lip balm but not excessively so.
Like with any drug (even aspirin) the side effects have to be pointed out, and yes there have been individuals who've suffered severe mental health problems but I think there was a level of hysterical reporting around a few of those incidents with scant information about other triggers the individuals may have experienced and with no reporting of the millions of people whose lives and mental health have been drastically improved by the drug.
Your derm will monitor you, I'm sure, and honestly don't worry about the side effects (dryness etc) as they may not even happen, and are likely to be manageable if they do.
I'm excited for you, I think you'll see HUGE benefits and if you've struggled for a long time, it will be marvellous to see the results.