[acb-hsp] Violence and SSRIS?

[peter altschul]

Shootings: A Caution About Violence and SSRIS
  SRI's rank high in the top ten drugs that cause violence
  Published on December 20, 2012 by Lennard J.  Davis in 
Obsessively Yours
  As the debate moves forward about how to keep events like the 
shooting in Newtown from happening, the inevitable topic that 
comes up is how to best detect and treat young people with mental 
illness.  Many of our politicians have opined on this subject, 
sometimes as a way of deflecting from the issue of gun control.  
While it is obvious that better screening and treatment of 
troubled adolescents can be of enormous benefit, we also have to 
exercise caution.
  The reason for the note of caution is that when a typical young 
person is diagnosed with depression and/or a host of anti-social 
conditions, the standard treatment offered is SSRI's [Selective 
Serotonin Uptake Inhibitors] also known as Prozac-like drugs.  
There has recently been a great deal of debate about the 
effectiveness of such medications.
  But more relevant to the discussion, is that these very drugs 
we hope can treat mental illness are at the same time drugs that 
cause violent behavior including suicide and aggression toward 
others.  In fact, SSRI's are the leading drugs in a recent list 
compiled of the Top Ten Drugs that cause violent behavior.
  It's been well known that adolescents and young people have an 
increased risk of suicide when they begin to take SSRI's.  But 
what we may forget is that suicide is an impulsive behavior that 
is turned against oneself.  But impulses, particularly violent 
ones, can be turned against others.
  An accompanying effect of SSRI's is the dulling of feelings 
that cause depression-and one of the main feelings in this line 
is empathy.  If empathy is dulled and violent impulses increase 
when young people are on SSRI's, then certainly that is a recipe 
for causing harm to others.
  It's not that SSRI's are not an important part of a 
mental-health practitioner's arsenal against mental illness-they 
are.  But it is important to understand that they are not 
panaceas and may even contribute to more violence.
  It is possible that the SSRI's were not properly prescribed and 
therefore were not working.  But we also have to entertain the 
idea that those drugs may have directly or indirectly contributed 
to the violence that resulted.
  After all, drugs are drugsbwith effects and side effects.  We 
need to know more about how these drugs work before we decide 
that the best policy is to get as many trouble adolescents on 
them as possible.  The physician's motto: "Do no harm" is more 
relevant than ever in this scenario.