I'm 28 and have been on Accutane twice....once in early high school and again right before I graduated.
My biggest side effect was dry lips.....they gave me some special balm to try and it did absolutely nothing. No matter how much chapstick I put on, they were incredibly dry.
The other big issue that drove me crazy was that it dried my poop out. I know it's really gross, but it was soooo painful to take a dump. Honestly, I've had some stomach problems ever since and that was when things went sour....I don't really BLAME Accutane for this, but it does seem awfully ironic.
I haven't eaten red meat since the 5th grade and have always had incredibly low blood pressure and cholesterol. I had my cholesterol taken on Accutane and it was something like 350, which is unbelievably high. I had it taken back in college and it was back down to 170 after I went off the Accutane, but that's another thing to keep your eye on.
Honestly, with all these horrible side effects it really doesn't seem worth it. That being said, it completely cleared my skin up back then and gave me my self confidence back, so it sure felt worth it at the time! It's a personal choice.....I never had any hair loss or depression, FYI.