Antidepressants and Violence: Problems at the Interface of Medicine and Law

www.ncbi.nlm.nih.gov...

This is a discussion of this paper from pubmed. Here is the summery from the page linked above.

Summary

Recent regulatory warnings about adverse behavioural effects of antidepressants in susceptible individuals have raised the profile of these issues with clinicians, patients, and the public. We review available clinical trial data on paroxetine and sertraline and pharmacovigilance studies of paroxetine and fluoxetine, and outline a series of medico-legal cases involving antidepressants and violence.

Both clinical trial and pharmacovigilance data point to possible links between these drugs and violent behaviours. The legal cases outlined returned a variety of verdicts that may in part have stemmed from different judicial processes. Many jurisdictions appear not to have considered the possibility that a prescription drug may induce violence.

The association of antidepressant treatment with aggression and violence reported here calls for more clinical trial and epidemiological data to be made available and for good clinical descriptions of the adverse outcomes of treatment. Legal systems are likely to continue to be faced with cases of violence associated with the use of psychotropic drugs, and it may fall to the courts to demand access to currently unavailable data. The problem is international and calls for an international response.

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To illustrate the point of the thread I will also include the first paragraph of the introduction since it has such cogent relevance to the point of this thread..

Introduction

In 1989, Joseph Wesbecker shot dead eight people and injured 12 others before killing himself at his place of work in Kentucky. Wesbecker had been taking the selective serotonin reuptake inhibitor (SSRI) antidepressant fluoxetine for four weeks before these homicides, and this led to a legal action against the makers of fluoxetine, Eli Lilly [1]. The case was tried and settled in 1994, and as part of the settlement a number of pharmaceutical company documents about drug-induced activation were released into the public domain. Subsequent legal cases, some of which are outlined below, have further raised the possibility of a link between antidepressant use and violence

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The recent spate of shootings is the obvious reason for this thread and the discussion of this paper from 2006 on this class of drug which clearly have an impact on this discussion. This is the variable that I feel is most of concern to the recent shootings. It is clear to this observer that these so called medications are over prescribed. They are debilitating to many individuals who take them in good faith that they will relieve fairly mild problems compared to suicide or mass shootings.I think we must examine the use of these drugs, their effects on society and the profit motives of those pushing such drugs. There might be another problem or 2 I have not thought of. Please lets have this conversation on this important issue and for the love of Mike lets keep it respectful and unemotional.

By the grace of God go many of us had we been put on these drugs. Respect.

As a former user of Sertraline all I can say is that I was far less prone to violent outbursts when on them as I was before I took them. So I of course would disagree that using them makes you more violent.

I feel they are an important piece of the puzzle. And may be the driving force

reply to post by michael1983l


A non violent robot I take it. Good for you and all of us I am sure. Just a dig based on your tag line chap. No offense intended. It does fit. Serotonin does make you feel real non violent almost robotic so long as your levels are constantly fairly high. It is when the subjects are taken off suddenly that this effect is most commonly noted by clinicians.

reply to post by exitusstatuquo


Yes I agree but that is the whole point that you are not supposed to withdraw suddenly. The physitians are well aware of the issues caused by sudden withdrawal, even heart attacks leading to death can happen.

reply to post by michael1983l


Non compliance to the protocol is the cause of much failure in clinical settings as far as drug effects and or interactions. These can not be known by the clinician all the time but good communications between clinician and patient can bridge this problem area. That in the case of most of these shootings was not the case for what ever reason.

reply to post by michael1983l
I have read some of your other threads now and all I have to say is that we all need to take a closer look at this issue given the treatment you have reported. If you were given these drugs and then the state neglected your follow up treatment to that point you illustrate this is why the government can not in its given huge sluggish nature be expected to respond to a crisis produced by a drug of the nature you were put on. The government does not have the ability to police the treatment they are giving the people with these drugs plain and simple.