I took accutane during my sophmore year of college when I was 19 - I'm now 22. I went into the experience with extreme reservations because of the claims that accutane can effect your mood (ie. make you suicidal), and may only accomplish temporary results (ie. acne comes back a within months after stopping treatment). However, about 2 and half years later I have to say I'm very happy I chose to go through with it.
Before continuing, though, I should make note of two things. Firstly, since I'm a guy, I didn't face the issues girls do when considering taking accutane (if you're a girl you CAN NOT get pregnant while on accutane or you baby will have serious birth defects). Secondly, while I considered my acne to be horrible, my dermotogist thought it was only moderate since it was only on my face and not really widespread, so I had to convince him to I wanted to try it. I would assume most people on or considering acne probably had worse skin.
Anyway, I was on accutane for about 6 months and it was not always an enjoyable experience. Most of the time I was on accutane, my skin was incredibly dry. When you wake up in the morning on accuatane, your skin is so dry it looks cracked and may even peel, so regularly applying mosturizer became a must - not an easy adjustment for a young guy. Also, your lips become ridiculously dry, so always carrying a good, medicated chapstick becomes neccessary.
Now, I'll talk about how accutane affected my mood. Accutane never once made me consider suicide - not even close. Still, I can distinctly recall a few times - probably about once or twice every month - where I would notice I was "down" about something in my life moreso than I normally would be. I wouldn't quite say accutane made me depressed at these moments, but that it made it more difficult at these times to get over/not care about some issue in my life which normally wouldn't effect as much without accutane. However, I learned to recognize when accutane was causing these moments to occur, and that made it easier to move on to being myself again.
Finally, after completing my 6 months on accutane my skin was completely clear, and it still is to this day. Now, to help my skin stay clear, every day I try to remember to wash my skin while in the shower, then after getting out of the shower I eventually apply the '2nd step' Proactive benzoyl peroxide-base solution (it's the only Proactive product worth crap IMO), before finally applying some oil-free moisturizer with some sort of SPF something in it.
So, in conclusion, I would recommend Accutane to anyone who, like me, feels like you have unsuccessfully tried all other acne medications and simply can't bear dealing with acne anymore, because from my experience, it does work and the side effects are not nearly as bad as some claim.