If drug companies didn't spend so much money on advertising, I suspect we'd hear even more about...

[AP]

...how all the school shooters from the last 15 years stopped taking their meds just before going on their rampages.

Shortly after Columbine, I remember reading a long article in the Saturday magazine section of (IIRC) The Independent (UK) about how that's the case. Haven't seen anything like that kind of coverage in the US press. But I did hear the N. Ill. shooters ex-girlfriend say in an interview today that he stopped taking Prozac two weeks ago.

[emilyg]

1. Drugs are beneficial.

He stopped taking his meds on his own.

[AP]

2. The interesting part is the correlation.

According to that article I read, just about every one of the school shooters in the last 15 years went off a drug like Prozac shortly before going on his rampage.

People wonder why these shootings happen so often these days. Well, we've never so heavily medicated young people with drugs like Prozac until recently.

And I concede that these drugs have advantages, but if they're causing people to shoot up classrooms and schools, then we should probably look into that. And not having a media blackout on that part of the story might be a good start.

[seriousstan]

4. Fine, don't give them drugs. Then you can post about how we ignored the call for help.

FUCK THAT!!! The crazy bastard killed someone. That is easy enough to believe.

With or without the drug of choice that you need to defend/condemn, The person was on their way.

[fed-up]

10. the problem is there is little to no monitoring for adverse reactions-when I went manic

after being prescribed an antidepressant for what was not yet diagnosed bipolar the psychologist at the clinic just told me to wait until my body adjusted to the meds.

I finally did reading on my own and found that I probably was bipolar due to my reaction. I was not violent, but was pacing and irritable, I felt like I had drank a few pots of coffee. With my bad neck it was really frustrating as all of a sudden I had energy to do things, but physical limitations stopped me.

I was assured by the psychologist's advise that "I just needed more time for the meds to work", clearly they were NOT working for me. Luckily the physican's assistant looked up the meds and figured out the problem.

My sis took an anticonvulsant for her MS spasms and went into a manic state-clearly triggered by the meds

My neice saw spiders after taking something-



The medical profession needs to make sure family members are aware that a select few people can have very adverse and deadly reactions to their meds and they need to find a way to educate families and monitor patients better and make sure they get help if they are having any adverse reactions.

[sandnsea]

3. It's true of most of them

I know it was true of Kip Kinkle. Pretty sure the kid from Padukah had been on some meds. Several others. It's a serious problem. I don't know that we're making sure these kids understand the risk of stopping medication abruptly.

In addition, women and teen girls must stop medication too. How is it presenting with females. Is anybody studying that?

[Tandalayo_Scheisskopf]

5. Prozac is just not indicated...

In whatever was wrong with that guy. Prozac is for depression, sure, but the vastest majority of people who take that class of medications(Selective Seratonin Reuptake Inhibitors) do not have such behavior in their past.

Now, depression is not a malady that generally makes you act out like that. Were he to go medication non-compliant and he indeed had a depressive illness, he would generally not have the energy or motivation to walk out the door, much less shoot up a University.

What you could and should be concerned about is the very real possibility that he was mis-diagnosed. There is a lot of that out there, because people get diagnosed the relatively benign SSRI's by their family physician, when they report psychiatric symptoms. The physicians, instead of referring them to a psychiatric evaluation team, instead simply prescribes SSRI's, which are grossly inappropriate for the apparently real underlying psychiatric condition.

Finding the right medication or combination of meds for those with psychiatric conditions is a delicate art, one enhanced by much experience in that specialized endeavor. Also, the mental health consumer should be closely monitored and supported by caregivers, advocates, family and friends, especially during the period of the first 2-6 weeks of any psychiatric medication, as the consumer titrates up to effective levels of the medication in their bodies.

So the short version is: No, this was not Prozac at fault. This was a mis-diagnosis or a consumer who was deftly concealing his symptoms and ideations. And perhaps a family physician who had no business not referring to specialists.

I will bet you that there is more to this story than his girlfriend knows. After all, a lot cannot be revealed by the medical people, due to HIPAA law confidentiality requirements and you can bet the kid did not tell her everything.

The last thing to consider, here in The Paradise that is America, is that this kid could just not afford effective care, so he got none. After all, this is such an enlightened society that we live in. For the 11th Century.

[SoCalDem]

6. I wonder how many of these guys were on the ADD-HDD merry-go-round

as little kids..

Could it be that in SOME boys, these drugs may have affected the way their growing brains were completed?

We've always had boys and we've always had guns..but it's a fairly recent occurence, where these teen/20-ish guys go on shooting sprees..

If I recall, the start-up of all the medicating of "rowdy boys" would have started when these kids were in grade school..

just wondering.

[Tandalayo_Scheisskopf]

7. Entirely possible.

There were some stories, ones that died rather quickly on the vine, about structural changes in the brains of children who were on long term medication care for ADHD and all of the other acronyms.

I am sure the drug companies buried those stories in rapid fashion.

[wtmusic]

8. Handguns were banned in the UK after the 1996 Dunblane massacre

Since then:

Number of students killed in school massacres in America:

159

Number of students killed in school massacres in the UK:

0

The problem is guns.

[AP]

11. national health has probably never over-prescribed drugs like Prozac, which might (MIGHT) be why

there aren't terrible mass-killings in schools before or after gun laws were tightened as a result of Dunblane.

Guns might be part of the puzzle, but I have to say, if all these kids abruptly stopped taking their meds just before their rampages, there's probably another big part of the puzzle nobody is talking about.

[fed-up]

9. here are the studies linking meds to violence-it is termed an ADVERSE reaction to meds

http://medicine.plosjournals.org/perlserv/?request=get-document&doi=10.1371/journal.pmed.0030372&ct=1
Antidepressants and Violence: Problems at the Interface of Medicine and Law
David Healy*, Andrew Herxheimer, David B. Menkes

Funding: The authors received no specific funding for this article.

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.

The issue of treatment-related activation has since then been considered primarily in terms of possible increases in the risk of suicide among a subgroup of patients who react adversely to treatment. This possibility has led regulatory authorities to warn doctors about the risk of suicide in the early stages of treatment, at times of changing dosage, and during the withdrawal phase of treatment. Some regulators, such as the Canadian regulators, have also referred to risks of treatment-induced activation leading to both self-harm and harm to others <2>. The United States labels for all antidepressants as of August 2004 note that “anxiety, agitation, panic attacks, insomnia, irritability, hostility, aggressiveness, impulsivity, akathisia (psychomotor restlessness), hypomania, and mania have been reported in adult and pediatric patients being treated with antidepressants for major depressive disorder as well as for other indications, both psychiatric and nonpsychiatric” <3>. Despite these developments, few data are available on the links between antidepressant usage and violence. We here offer new data, review the implications of these data, and summarise a series of medico-legal cases.

This paper focuses on paroxetine primarily because we have access to more illustrative medico-legal case material for this drug than for other antidepressants. Secondly, the manufacturer, GlaxoSmithKline, submitted data on the rates of occurrence of “hostile” episodes on paroxetine for the recent review of antidepressant drugs undertaken by the British regulator <4,5>. It is not clear that the review team obtained comparable data for other antidepressants.

..snip

Discussion
Mechanisms of antidepressant-induced violence
A link between antidepressant use and violence needs a plausible clinical mechanism through which such effects might be realised. There are comparable data on increased rates of suicidal events on active treatment compared to placebo <16,17>. In the case of suicide, several explanations have been offered for the linkage. It is argued that alleviating the motor retardation of depression, the condition being treated, might enable suicides to happen, but this cannot explain the appearance of suicidality in healthy volunteers. Mechanisms linking antidepressant treatment, rather than the condition, to adverse behavioural outcomes include akathisia, emotional disinhibition, emotional blunting, and manic or psychotic reactions to treatment. There is good evidence that antidepressant treatment can induce problems such as these and a prima facie case that akathisia, emotional blunting, and manic or psychotic reactions might lead to violence.

..snip

Substantial evidence from SSRI clinical trials shows that these drugs can trigger agitation. Approximately five percent of patients on SSRIs in randomised trials drop out for agitation against 0.5% on placebo. The current data sheets for SSRI antidepressants specify that the drugs can cause akathisia and agitation, and warn about developing suicidality in the early phase of treatment, on treatment discontinuation, and in the wake of a dosage increase during the course of treatment. In the US, these warnings explicitly apply to not only depressed patients but also people being treated for anxiety, smoking cessation, or premenstrual dysphoric disorder. In Canada, warnings specify an increased risk of violence in addition to suicide.

..snip

Case 1
DS was a 60-year-old man with a history of five prior anxiety/depressive episodes. These did not involve suicidality, aggressive behaviour, or other serious disturbance. All prior episodes had resolved within several weeks. In 1990 DS had had an episode of depression, which his doctor treated with fluoxetine. He had a clear adverse reaction to fluoxetine involving agitation, restlessness and possible hallucinations, which worsened over a three-week period despite treatment with trazodone and propranolol that might have been expected to minimise the severity of such a reaction. After fluoxetine was discontinued DS responded rapidly to imipramine.

In 1998, a new family doctor, unaware of this adverse reaction to fluoxetine, prescribed paroxetine 20 mg to DS, for what was diagnosed as an anxiety disorder. Two days later having had, it is believed, two doses of medication, DS using a gun put three bullets each through the heads of his wife, his daughter who was visiting, and his nine-month-old granddaughter before killing himself.

At jury trial in Wyoming in June 2001, instigated by DS' surviving son-in-law, a jury found that paroxetine “can cause some people to become homicidal and/or suicidal” <39>. SmithKline Beecham was deemed 80 percent responsible for the ensuing events <1>. The documentary evidence included an unpublished company study of incidents of serious aggression in 80 patients, 25 of which involved homicide.

Experts for the plaintiff suggested that the mechanism through which paroxetine contributed to these events was probably akathisia or psychosis. A central problem with both akathisia and psychosis in such contexts is that the takers of medications often fail to recognise the fact that the state they are in is drug-induced and that discontinuing treatment can alleviate the symptoms.

..snip