There has been tremendous confusion and controversy about whether some medications can increase the risk for suicidal thoughts. For years drug companies and health professionals resisted such a concept. Far more controversial is the question this reader poses:
Are Antidepressants Linked to Violence?
Q. I read your column spotlighting the danger of suicide due to antidepressants. Just as insidious, but far less publicized, is an apparent increase in the risk of homicidal behavior by those using or withdrawing from SSRIs. Please write about this as well.
A. Researchers in Sweden reported that people between 15 and 24 who were taking SSRI-type antidepressant drugs appeared more likely to resort to violence (PLOS Medicine, Sept. 15, 2015). After reviewing police records they found an association between SSRI prescriptions and convictions for assault, homicide, rape or arson.
This is epidemiological research and not a double-blind, placebo-controlled trial. Such a study would be expensive and take many years to complete. It is unlikely that any drug company would fund such a study.
Without such data, we are left with large population-based analyses. The Swedish study involved 856,493 people who were prescribed SSRIs. Their conclusion seems to be that for young people between the ages of 15 and 24 there may be an association and that the question: are antidepressants linked to violence? requires further study.
Stories from Readers:
We do have anecdotal reports from our website. Although they are not scientific, they do give you a more personal understanding of what some people experience:
Joe in Washington was taking two drugs that might pose violence issues:
“I got a felony for pointing a gun at a relative some years ago while on sertraline (Zoloft).
“I also became dangerously crazy the other night while on the stop-smoking drug Chantix. This is the second occurrence while on Chantix so I’m throwing it in the trash. I may be an intense person normally but never violent. This behavior scares me and has cost me unbelievably. Has it ruined my life? In ways I can’t even begin to describe.”
Jhon wrote:
“I have been on paroxetine for a quite a while now. I started feeling better and haven’t had any OCD thoughts so that’s a big plus! But I don’t know if this medication is actually making me worse or getting me better.
“Just the other day I attacked a random person just for finding him to be annoying, but I mean it was out of impulse like if I didn’t hesitate to put him on a choke hold. If it wasn’t for him reversing it and us falling on the sidewalk, I still think to myself when was I gonna let go? Or how far I was going to go with it?
“This still haunts me. What if I try to do something more dangerous? Should I check myself in to a mental hospital?”
L in Libertyville shared this story about her son:
“My son took sertraline with good results for approximately 3 months. Then he began having anger issues and became increasingly impulsive verbally. The final straw at about 5 months was hallucinatory type paranoia.
“The doctor did not seem to feel this could be due to meds, but his therapist encouraged him to discontinue it. He was spot on and now my son is feeling worlds better and using talk therapy for his depression and anxiety along with high potency fish oil for good measure. I do know people that got benefit from SSRI’s but the other reaction should not be dismissed.”
Captain in Florida:
“I was on Effexor for a while and needed to switch to something else for insurance reasons. My doctor forgot to tell me I had to titrate it down before starting the new drug.
“I switched cold-turkey and had a violent altercation (fortunately only verbal) with my wife. It was really scary. And it was also an out-of-body experience: I watched it happen, as if from afar, and was powerless to stop or alter it.”
M reports:
“At first I thought antidepressants were God sent. The difference in my mood was remarkable!
“After several years of using several different ones, I am in fear of losing my mind. Violent outbursts and aggressive with no warnings are the norm. HELP!”
Ben shares a scary experience:
“My outbreaks of impulsive aggressive behavior sometimes cause serious problems for me in social and work related situations. I’ve had three situations of strong impulsive aggressiveness that caused me serious trouble. Two were at work, and one was on a train I take a lot.
“My impulsive aggressiveness on the train had me (against my better judgment) confront three extremely obnoxious and muscular men. These men got on the train at a stop close to a medium security prison in Newark New Jersey. They seemed like three tough parollees. To them I must have seemed like a clown punching bag. I was shaking in anger while storming up to them. I knew I was taking a dangerous and pointless risk, but I couldn’t stop myself.
“For a moment I felt like I was in a surreal dream. They threatened me. I went back to my seat. I was shaken by my loss of self-control and foolish risk I was taking. I need to work this out with my therapist.”
Take Home Message:
There is no definitive answer to the question: are antidepressants linked to violence? The relationship between these medications and violence remains highly controversial. Nonetheless, the FDA does warn that people taking antidepressants should be monitored for unusual behavior, which might include hostility, aggressiveness and impulsivity.
Please share your own experience with antidepressants in the comment section below.
