Still At Large: Are Psychiatric Drugs The Hidden Culprit In Mass Shootings?

On the morning of May 21, 1988, I stood before my class of 25 traumatized fifth graders and began a necessary discussion about one of the first school shootings, which had occurred the previous morning at a nearby elementary school in Winnetka, Illinois. It was also one of the first shootings in which the side effects of psychiatric drugs were considered. I don’t remember all of what I told them, but I remember exactly what I said when a student asked me, “What would you have done, Ms. Hayford?”

“I would have jumped on top of her and done whatever I could to get the gun away,” I said. “I love each of you as if you were my own child, and I would do anything to protect you.”

It is in this same spirit that I share the following information about the dangerous side effects associated with psychiatric drugs and school shootings. It is my way of metaphorically jumping on the next potential shooter before they get a gun in their hands.

In the past few months, following the school massacre in Newtown, Connecticut, there has been much talk about gun control, a smattering of discussion about mental illness, an occasional mention of violent video games and television. But once again, as has been the case with other school and multiple-victim shootings over the years, there has been no talk about what could be the most significant contributing factor: psychiatric drugs.

There are, of course, multiple issues, often complex and interwoven, that can lead to violent shootings. The adverse side effects associated with mind-altering medications is just one of them.

As of July 2012, in the United States there is, on average, a mass shooting every 2.5 weeks, and a multiplevictim shooting every 5.9 days. Because there are many things to talk about and the time between mass shootings has gotten shorter and shorter, we can no longer afford to dismiss this all-important, yet littleknown and frequently misunderstood information. Children’s lives may, in fact, depend on it.

Following is a brief overview of the three most important initial factors to increase awareness and clarity around this issue, which obviously requires much more thorough investigation and discussion— investigation and discussion that will never happen if people are not clear about the facts, or worse, not aware of it at all.

Fact #1: Over 90 percent of school shootings have been linked to psychiatric medications with dangerous side effects that include violent behavior and suicidal and homicidal thoughts.

This is a well-documented pattern, and these side effects are a possible contributor to, if not cause of, the perpetrators’ violent behavior. However, it’s not being addressed by politicians or the mainstream media, and consequently most people are not even aware of it as a possibility. Selective serotonin reuptake inhibitors (SSRIs), a class of antidepressants, have been identified by doctors like Peter R. Breggin, a Harvard-trained psychiatrist and former full-time consultant at the National Institute of Mental Health, as the primary culprits.

Writing in 2003 in Ethical Human Sciences and Services, a peer-reviewed scholarly journal, Breggin concluded SSRI drugs could be a factor in suicide, violence and other forms of extreme abnormal behavior, as evidenced in case reports, controlled clinical trials, and epidemiological studies in children and adults.

A peer-reviewed study drawn from reports to the Food and Drug Administration’s (FDA) Adverse Event Reporting System (AERS) concluded that acts of violence toward others are a genuine and serious adverse drug event. The violent cases reviewed in the study were reported between 2004 and 2009. They included 387 reports of homicide, 404 physical assaults, 896 homicidal ideation reports and 223 cases described as violence-related symptoms. Antidepressants were the drugs most strongly and consistently implicated.

In addition, there are others who have established these patterns. For example SSRIStories.com has a listing of more than 4,800 news stories, mainly criminal in nature, that have appeared in the media or as part of FDA testimony, in which antidepressants are mentioned. It includes a subcategory listing of school shootings linked to psychiatric drug use.

SSRIStories.com and its sister site, RxISK.org (an independent website for researching and reporting on prescription drugs), are the work of Dr. David Healy, an internationally respected psychiatrist and author of several books on psychopharmacology, including The Anti-Depressant Era and his latest book, Pharmageddon.

According to Dr. Healy, there are probably between 1,000–1,500 extra suicides in the U.S. each year triggered by antidepressants, and another 1,000– 1,500 extra episodes of violence that would not have happened without antidepressant input. Some of these include school or other mass shootings, which were unheard of 25 years ago, before the introduction of SSRIs.

Fact #2: The FDA has issued public health warnings about the volatile side effects associated with psychiatric drugs, and they are clearly disclosed by the pharmaceutical companies that manufacture them.

Dangerous, mind-altering side effects are listed in the product inserts provided by the pharmaceutical companies, and even television commercials for individual drugs. (Case in point, in the midst of preparing this article I heard a commercial for Cymbalta that said, “…please talk to your doctor if you experience changes in behavior or suicidal thoughts, which may be intensified in teens and young adults.”)

When it comes to violent and suicidal side effects, SSRI antidepressants dominate the list. The fatal five include Pristiq, Effexor, Luvox, Paxil and Prozac, the last of which came in at number two, causing violent reactions in those ingesting it at a frequency almost 11 times greater than the average pharmaceutical drug.

In March 2004, the FDA published a Public Health Advisory that reiterates several of the above-mentioned side effects and states, in part, “Anxiety, agitation, panic attacks, insomnia, irritability, hostility, impulsivity, severe 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 non-psychiatric.”

It’s important to note that adverse reactions are most likely to occur when starting or discontinuing a drug, increasing or lowering the dose, or when switching from one drug to another. Adverse reactions are often misdiagnosed as bipolar disorder, when the symptoms may be entirely iatrogenic (treatmentinduced). Withdrawal, especially abrupt withdrawal, from any of these medications can cause severe symptoms. It’s important to withdraw extremely slowly from these drugs, under the supervision of a qualified specialist. Withdrawal is sometimes more severe than the original symptoms or problems.

Fact #3: There is an FDA-issued black-box warning indicating these dangerous side effects may be intensified in those under the age of 25.

When a prescription drug is known to be effective for some patients, but may cause serious side effects in others, the FDA requires a warning about those adverse effects. That warning, surrounded by a printed black box, is known as a black-box warning.

A black-box warning is the strongest form of warning issued by the FDA about a drug; it’s the step taken just short of taking the drug off the market. It’s an acknowledgement of how harmful the drug can be if given to patients who are at risk of developing the possible adverse side effects.

In September 2004, the FDA issued a black-box warning for nine antidepressants (Celexa, Luvox, Paxil, Prozac, Zoloft, Effexor, Remeron, Serzone and Wellbutrin) indicating that when used to treat major depressive disorder (MDD) in children and adolescents, they may increase the risk of suicidal ideations and behaviors. In 2006, the FDA expanded this warning to include 36 antidepressants, and raised the age of potentially vulnerable patients from 18 to 25.

For patients younger than 25, pharmacies must provide their parents or guardians with the FDA’s Antidepressant Patient Medication Guide. It reads, in part: “Contact your child’s healthcare provider right away if your child exhibits any of the following signs…[including] acting aggressive, being angry, or violent, [and] acting on dangerous impulses….” It also states, “Never stop an antidepressant medicine without first talking to a healthcare provider. Stopping an antidepressant medicine suddenly can cause other symptoms.”

In keeping with these warnings, another common denominator that experts researching these cases have discovered is that most attackers followed a discernible pattern of behavior for weeks or even months before the attack. They call it “the pathway to violence.” In almost all cases, the shooter communicated the intent to commit the attack.

Moving Forward

Public health warnings are clearly not enough, but they are a start. If you, a loved one or someone under your supervision is taking one of these medications, please take these warnings seriously. Take note of changes in mood and behavior, including suicidal or other dangerous thoughts, and do what the commercial says—talk to your doctor or trained professional and get help!

Please educate yourself further on this critical topic so you can make wise, informed choices for yourself and your loved ones, and for whatever public policies or laws that may be proposed in the future. There will be much discussion about mental illness in the days to come, and many people are already calling for even more of these high-risk drugs to be administered as treatment.

In light of the above factors, we must demand that policymakers start answering the tough, but obvious, questions. For example, why has there never been a federal investigation on the link between psychiatric drugs and acts of senseless violence, including school shootings, given the evidence and the FDA warnings? Why are people who are already mentally unstable prescribed drugs that have the potential to exacerbate their symptoms or develop new ones, including suicidal thoughts and violent aggression toward others, in some cases 11 times more frequently than the average pharmaceutical drug?

Or better yet, why are drugs with such dangerous side effects allowed on the market? When bunches of spinach or certain models of cars have been linked to sickness or death, the whole lot of them have been recalled or removed from store shelves for public safety purposes—even those that aren’t contaminated or defective. Why? Because there is a strong possibility that they could cause further harm. Why aren’t pharmaceutical companies held to a similar standard of safety, especially when it comes to our children?

Speaking out about this topic inevitably draws criticism, as it is both unpopular and controversial. But if even one life is saved because one person read this article, I’m willing to take those shots. Although it’s been 25 years—25 years in which the frequency and intensity of school shootings have increased dramatically—I still remember exactly what I said to the students that day when they cried, “But Ms. Hayford, you might have gotten shot if you jumped on her!”

“Yes,” I told them, “but at least I would have tried.”