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Do SSRI Antidepressants Cause Violence? Not So Fast...

Website "SSRI Stories" Presents Distorted Information

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Updated June 27, 2014

Written or reviewed by a board-certified physician. See About.com's Medical Review Board.

Do psychiatric drugs cause violence? Many people and groups say they do. A reader referred me to a website called "SSRI Stories" purporting to list more than 4,800 cases of criminal behavior by people who were taking antidepressants, mostly SSRIs (selective serotonin reuptake inhibitors). The focus is on blaming the antidepressants for violent, hypersexual, bizarre or suicidal behavior.

I reviewed a number of these stories at random and found distorted information in some and questionable conclusions in others.

Some examples of supposed SSRI-induced violence from "SSRI Stories"

1. From article "Man Accused of Gunning Down Boss Faces Competency Hearing"1:
...Ludlam, the valedictorian of his high school class and a former Navy combat pilot, became a troubled man who is taking many medications, including Prozac and lithium. Ludlam was diagnosed previously with bipolar disorder..."
"SSRI Stories" comments, "It is the opinion of SSRI Stories advocates that the majority of these 'bipolar' cases are caused by the massive use of antidepressant in this country. Many of these 'bipolar' patients began taking an antidepressant, become manic/psychotic, and then are diagnosed as 'bipolar'."

Besides being only an opinion, this statement belies medical and historical facts. Bipolar disorder was first described in antiquity, and the symptoms have been recorded down through the centuries. Manic depression, as it was called until the very late 1900s, existed millennia before antidepressant drugs -- let alone SSRI antidepressants in particular -- were developed. The above comment appears to suggest that "bipolar" doesn't exist, or that it is almost all "caused" by antidepressant drugs, which is patently untrue.

In addition, there is no evidence whatever in the story that Mr. Ludlam was prescribed Prozac before lithium.

2. Here's another, from a case where a 70-year-old man shot a co-worker2:

Juanita Watts, Tysor's sister who lives near him on Roseberry Circle, said her brother didn't have a violent nature, but had been battling depression for some time.

"His mind goes out on him sometimes," Watts said.

Watts said Tysor had been admitted to the hospital several times in recent years to deal with depression. When Tysor was being arraigned in Kanawha Magistrate Court on Tuesday, he told authorities he was on Prozac, a potent antidepressant, WSAZ NewsChannel 3 reported.

It is possible that Prozac contributed to this incident, but it's impossible to confirm this in a man who had a serious mental illness already.

3. In another story, after her husband was involved in a serious road rage incident, his wife said he "had not taken his anger medication the night of the fight."3 "SSRI Stories" comments that in a personal interview, the wife said those medications were Prozac and Vicodin.

I can't even find the connection here. This is a man who obviously had serious anger issues. He was taking an antidepressant and a strong painkiller -- for anger? And he missed a dose. In addition, Prozac has a very long half-life, so missing one dose would have little effect.

"SSRI Stories" on Suicidal Behavior

1. The article on the suicide of author Danielle Steel's son, Nick Traina, who died of an overdose of heroin or morphine4, says that Traina's blood levels of Prozac were within normal ranges, but it appeared he had not been taking the correct dose of lithium (the levels were far too low). To blame the suicide of a young man with bipolar disorder on Prozac in this situation is irresponsible in the extreme. Traina had attempted suicide several times before. Since lithium acts to stabilize both mania and depression, the low blood levels of this drug could have made his depression worse. There is absolutely no evidence that Prozac "caused" his suicide. (See His Bright Light: The Story of Nick Traina.)

2. "SSRI Stories" blames actor Corey Haim's death on psychiatric drugs even though the coroner's ruling was death by natural causes, with the specific statement that the levels of prescription and over-the-counter drugs in Haim's system were all too low to have had any effect.5 Haim died of pneumonia.

"SSRI Stories" on the Subject of "Women Teacher Molestations"

1. In Ex-Aide Gets Jail For Sexual Abuse, "SSRI Stories" highlights this line as follows6:

"Expert witnesses said Prozac and mental illness diminished Draper's capacity to reason when she began a sexual relationship with her former student. The relationship did not involve intercourse."

I find it significant that "and mental illness" was carefully not highlighted. What criteria the expert witnesses used to place specific blame on Prozac we have no way of knowing.

2. In several other stories7, the fact that women teachers were taking antidepressants was specifically used by their defense attorneys. I reported on one of these stories earlier this year: Saskatchewan Teacher Not Guilty by Reason of Bipolar Disorder. That one is clearly a case where Effexor uncovered latent or unrecognized bipolar disorder. Yes, this happens, but very frequently the person has exhibited some manic or hypomanic symptoms in the past that weren't recognized -- a fact news reports aren't going to mention, and that, based on the opinion mentioned earlier, "SSRI Stories" appears not to believe.

So, do SSRI antidepressants cause violent behavior?

It is true that sometimes taking SSRIs -- as well as other drugs -- may contribute to violent, hypersexual or suicidal behavior. Though the anti-smoking drug Chantix (varenicline) tops the list of drugs that are associated with incidents of violence, the SSRIs are also prominent on the list. Still, I have to take issue with groups and sites like "SSRI Stories" that distort information to make their points.

No objective discussion on the subject of psychiatric drugs and violence can be complete without considering how many people are helped by these medications and never exhibit any behavior dangerous to themselves or others. No such figures are available, of course, but common sense tells us that only a fraction of those who commit violent acts are taking SSRI antidepressants, and only a fraction of those taking these drugs ever commit violent acts.

References:
1Man Accused of Gunning Down Boss Faces Competency Hearing
2Suspect was hospitalized for depression
3Angry Pima man attacks officers after traffic stop
4Danielle Steel's Son Overdosed, Tests Say
5Coroner: Corey Haim died of natural causes
6Ex-Aide Gets Jail For Sexual Abuse
7Women Teacher Molestations

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