Can Antidepressants Induce Suicide, Violence & Bizarre Behavior?
The widely acknowledged fact is that a single antidepressant drug holds the potential to incite suicide and violence. In today's article, I will specifically outline some of the evidence pertaining to antidepressants and their links with suicide and violence. If regulatory agencies across the globe have issued warnings about the hazards posed by these drugs, one might question why this information isn't more widely disseminated. Is there a connection between these drugs and incidents of mass shootings, homicides, suicides, or other violent behaviors? What happens when multiple mood and mind altering drugs are prescribed ?
I'll leave that determination up to you.
Your honor… if it pleases the court of public opinion may I enter into the public record the following evidence:
Exhibit A: Black Box Warning
The United States Food and Drug Administration issued a Black Box warning in October 2004 after placebo-controlled trials of antidepressant medications found an increased risk of suicidal thoughts and behaviors among children, adolescents and young adults taking antidepressant medications relative to placebo.
Exhibit B: Systematic Reviews Linking SSRI’s w/ Violence Toward Self and Others
A 2016 review of over 70 trials found an increase in self-harm and aggression in children and adolescents taking SSRIs. Another 2016 review of over 5,000 publications found that use of SSRIs in adults might increase the chance of self-harm or violence toward others.
Exhibit C: Eli Lilly Internal Documents
CNN, Monday, January 3, 2005 Read here
An internal document purportedly from Eli Lilly and Co. made public Monday appears to show that the drug maker had data more than 15 years ago showing that patients on its antidepressant Prozac were far more likely to attempt suicide and show hostility than were patients on other antidepressants and that the company attempted to minimize public awareness of the side effects.
The 1988 document indicated that 3.7 percent of patients attempted suicide while on the blockbuster drug, a rate more than 12 times that cited for any of four other commonly used antidepressants.
In addition, the paper said that 1.6 percent of patients reported incidents of hostility -- more than double the rate reported by patients on any of four other commonly used antidepressants.
Exhibit D: Animal Studies
On October 1, 2012 Science Daily reported on a study published in Behavioral Neuroscience by Prof.Richard Melloni of Northeastern University Read here
Repeated administration of a low dose of fluoxetine to adolescent hamsters dramatically increased offensive aggression and altered the development of brain areas directly associated with controlling the aggressive response.
“These data show clearly that repeated exposure to fluoxetine during adolescence directly stimulates aggressive responding and alters the normal development of two important brain systems, i.e., the serotonin and vasopressin neural systems, in a fashion consistent with the expression of the highly aggressive behavioral characteristics."
Exhibit E: Legal Precedents
In June 2001, a Wyoming jury awarded $8 million to the relatives of a non-violent family man and doting grandfather who had gone on a shooting rampage after taking an antidepressant, prescribed for anxiety. Two days later, the father put three bullets each through the heads of his wife, his daughter, and his nine-month-old granddaughter before killing himself. The jury determined that paroxetine "can cause some people to become homicidal and/or suicidal" and that the drug was 80 percent responsible for the ensuing acts
The Guardian, May 25, 2001 Read here
On May 25, 2001, an Australian judge blamed the antidepressant sertraline for turning a peaceful, law-abiding husband into a violent killer. The man had no history of violence or suicidality and had remained gainfully employed throughout his life. Judge Barry O'Keefe said that had the defendant not taken the antidepressant, "it is overwhelmingly probable that [his wife] would not have been killed..." He was sentenced to three years in prison.
Exhibit F: Examples of Violence after Prescription
January 24, 2020 – Newcastle, South Dublin, Ireland: Deirdre Morley, 44, smothered and killed her two sons Conor, 9, and Darragh, 7, and her three-year-old daughter Carla McGinley in their family home. She had been taking antidepressants since October 2018 and was admitted to St. Patrick’s Mental Health Services on July 6, 2019, but was discharged after a short period, but was put on a combination of two antidepressants and a sedative
May 11, 2018 – Osmington, Western Australia: Peter Miles, 61, shot his 35-year-old daughter and four grandchildren, aged 8 through 13, while they slept in their beds, in a shed that had been converted to a second house on the property. He then turned the gun on his 58-year-old wife in the living room of their house, before placing a call to police alerting them to his crimes. When they arrived, Miles was also found dead from a gunshot wound. Miles had started taking antidepressant medication just weeks before.
April 6, 2018 – Wadsworth, Ohio: Gavon Ramsay, 17, strangled his neighbor, 98-year-old Margaret Douglas in her own home. His parents blame his actions on his having been misprescribed Zoloft. After a report by his school principal that the teen was depressed and might harm himself, he “returned to therapy,” and after a recommendation by a psychologist, the family’s pediatrician prescribed the antidepressant Zoloft. From January through March leading up to the incident, the dosages were increased. During this time, his mother said she observed her son’s behavior change—becoming increasingly irritable and hostile and saying bizarre things.
October 21, 2013 – Sparks, Nevada: 12-year-old Jose Reyes opened fire at Sparks Middle School, killing a teacher and wounding two classmates before committing suicide. The investigation revealed that he had been seeing a psychotherapist 3 days before the shooting and was prescribed an antidepressant. He had a generic form of the antidepressant Prozac (fluoxetine) in his system at the time of death, police said
October 24, 2011 – Snohomish County, Washington: A unnamed 15-year-old girl went to Snohomish High School where police alleged that she stabbed a girl as many as 25 times just before the start of school, and then stabbed another girl who tried to help her injured friend. Prior to the attack, the girl had been taking “medication” and seeing a psychiatrist. Court documents said the girl was being treated for depression.
December 13, 2010 – Planoise, France: An unnamed 17-year-old youth held twenty preschool children and their teacher hostage with two swords for hours at Charles Fourier preschool. The teen was reported to be on “medication for depression.” Eventually, all the children and the teacher were released safely.
In 2011, a paper was published in Pharmacogenomics and Personalized Medicine examining the relationship of antidepressants and akathisia side effects in those with genetic mutations in the metabolizing genes of the CYP450 family. In the study, eight of the subjects had committed homicide and many more became extremely violent while on antidepressants. Read here
In episode 42 of the Radically Genuine Podcast we brought on one of the co-authors of this study and interviewed David Carmichael, from Toronto, Canada, says he had a severe reaction to the antidepressant paroxetine (Paxil), which caused him to kill his “loving” 11-year-old son, Ian.
You can listen to the entire episode here
Mr. Carmichael’s story can also be viewed here. Warning: Details of violence & homicide
Exhibit G: International Drug Regulatory Warnings
United States, November 10, 2021: The FDA updated the safety label for Effexor XR (venlafaxine) to include postmarketing reports of serious discontinuation symptoms including completed suicide, suicidal thoughts, aggression, and violent behavior while reducing dosage or discontinuing the drug.
United States, November 10, 2021: The FDA updated the safety label for Pristiq (desvenlafaxine) to note that there have been postmarketing reports of serious discontinuation symptoms including completed suicide, suicidal thoughts, and aggression (including hostility, rage, and homicidal ideation) while reducing dosage or discontinuing the drug.
United States, November 13, 2020: The FDA updated the safety label for Trintellix (vortioxetine) to include aggression, agitation, anger, hostility, and irritability under Postmarketing Experience in the Adverse Reactions section.
Italy, May 18, 2017: The Italian Medicines Agency sent out a reminder to healthcare professionals about the use of antidepressants, particularly regarding risks in children and adolescents. The reminder warned against the use of Paxil (paroxetine) in those under 18, because of a lack of data on efficacy, in addition to the increased risk of suicidal and hostile behavior.
United States, May 4, 2017: The FDA updated the safety label of Zyban (bupropion) to that while Zyban is not indicated for depression, it has the same active ingredient as antidepressants Wellbutrin, Wellbutrin SR, and Wellbutrin XL. Antidepressants increase the risk of suicidal thoughts and behavior in children, adolescents, and young adults in short-term drug trials. Neuropsychiatric adverse events (e.g., mania, depression, psychosis, hallucinations, paranoia, delusions, homicidal ideation, hostility, agitation, anxiety, panic, suicidal ideation, suicide attempt, and completed suicide) have occurred in those with and without pre-existing mental illness. Some patients experienced worsening mental illness. In a clinical trial of patients with or without a history of mental illness, the adverse events reported in over 10% of subjects taking Zyban were nausea, insomnia, and anxiety.
United States, May 4, 2017: The FDA updated the safety labels of Wellbutrin and Wellbutrin SR(bupropion) to include aggression, hostility, panic, suicidal ideation, suicide attempt, and completed suicide as reported in post-market reports for bupropion as a smoking cessation treatment. Neuropsychiatric adverse events (e.g., mania, depression, psychosis, hallucinations, paranoia, delusions, homicidal ideation, agitation, and anxiety) have occurred in those with and without pre-existing mental illness. Some patients experienced worsening mental illness.
United States, December 23, 2016: The FDA updated the safety label for Zoloft (sertraline) to include a warning for suicidal thoughts or actions in patients aged 24 and younger. Pediatric patients are to be monitored for suicidal thoughts, clinical worsening, or unusual behavior, especially when starting the drug or changing the dosage. Patients and their caregivers are advised to look for the emergence of mania/hypomania.
United States, February 2013: The FDA added the following side effects updates to the “Adverse Reactions” in Pristiq’s (desvenlafaxine) drug label which included Suicidal Thoughts and Behaviors in Adolescents and Young Adults and Activation of Mania/Hypomania.
Japan, May 2009: The Japanese Ministry of Health, Labor and Welfare investigated news reports of antidepressant users “who developed increased feelings of hostility or anxiety, and have even committed sudden acts of violence against others.” After its investigation, the Ministry decided to revise the label warnings on newer antidepressants stating, “There are cases where we cannot rule out a causal relationship [of hostility, anxiety, and sudden acts of violence] with the medication.”
United States, November 2005: The FDA’s Safety Information and Adverse Event Reporting Program reported safety label changes for Effexor XR (extended-release). This included the following Adverse Reactions: adverse events associated with discontinuation of treatment, panic disorder, and homicidal ideation.
European Union, August 19, 2005: The Commission of the European Communities, representing 25 European countries, endorsed and issued the strongest warning yet against child antidepressant use as recommended by Europe’s Committee for Medicinal Products for Human Use (CHMP). Clinical trials had shown that the drugs caused suicidal behavior including suicide attempts and suicidal ideation, hostility (predominantly aggression, oppositional behavior, and anger), and/or related behavior.
Australia, December 2004:The Australian Adverse Drug Reactions Advisory Committee reviewed data on the safety and efficacy of using SSRI antidepressants in children for the treatment of depression. Their assessment of published and unpublished data available for SSRI use in children and adolescents indicated that there is evidence of an increased risk of suicidality, including suicidal ideation, suicide attempts, and self-harm events, associated with each of the SSRIs. Further, in a recent study involving fluoxetine (Prozac), there was an increase in some adverse psychiatric events (acts and ideation of suicide, self-harm, aggression and violence).
United Kingdom, September 21, 2004: The British Healthcare Products Regulatory Authority advised that it had issued guidelines that children should not be given most SSRI antidepressants because of clinical trial data showing an increased rate of harmful outcomes, including hostility.
Canada, June 03, 2004:Health Canada issued an advisory to the public stating that stronger warnings have been placed on antidepressants. These warnings indicate that people taking these drugs at any age are at greater risk of behavioral or emotional changes including self-harm or harm to others. The advisory said, “[A] small number of patients taking drugs of this type may feel worse instead of better…. For example, they may experience unusual feelings of agitation, hostility or anxiety, or have impulsive or disturbing thoughts that could involve self-harm or harm to others.”
United States, March 22, 2004:The FDA asked drug companies to add new warnings on 10 widely used antidepressants. It said patients given these drugs should be closely monitored for worsening depression or suicidality, especially when the patient first begins taking the drugs or changes doses. At the time the FDA had not concluded whether the worsening of symptoms was due to the underlying disorder or the drug. It also said, “Anxiety, agitation, panic attacks, insomnia, irritability, hostility, impulsivity, akathisia [severe restlessness], hypomania [abnormal excitement, mild mania] and mania, have been reported in adult and pediatric patients being treated with antidepressants….”
Canada, August 22, 2003:Health Canada posted a letter sent out to healthcare professionals about updates to Effexor’s prescribing information. The letter explained that in clinical studies in pediatric patients (aged 6 to 17), efficacy was not established for major depressive disorder or generalized anxiety disorder. Also, there were increased reports among those patients on Effexor XR (vs. placebo) of hostility and suicide-related adverse events, such as suicidal ideation and self-harm.
In light of this compelling evidence, can anyone reasonably dismiss the connection between antidepressants, suicide, and violence? It seems unlikely, unless one stands to gain financially from the prescription of these drugs.
I rest my case.
Credit for research:
Thank you for providing solid evidence of the link between violence and anti-depressants. This conversation needs to be taking place in Congress where they believe legislating more gun control will stop the violence. Your article proves that means to act out violence doesn't always involve a gun. Will our law makers want to take on the big pharmaceutical companies? Lobbyist? I pray they will prioritize people over personal profit.
Great article. Thanks for compiling all this evidence into one read.