Much has been said about the suicide link with antidepressant use. I think we should accept that antidepressants can induce suicide given that the manufacturers and regulators have now admitted this one small fact that they previously [conveniently] omitted.
If a person can kill themselves due to an adverse reaction to a drug then could they also harm others?
In cases of homicide the antidepressant defence has been used many times, "My client was under the influence of an antidepressant and had homicidal thoughts your Honour".
Those that use such a defence are ridiculed because those that manufacture these types of drugs refuse to admit that their products can induce acts of homicide in those who take them.
Three high profile cases involve three SSRi type drugs, namely, Citalopram [known as Celexa in the US] and Seroxat [known as Paxil in the US] and Prozac.
Shane Clancy (22) drove to the quiet residential area of Cuala Grove in Bray where he unleashed an attack of psychotic proportions on his ex-girlfriend and her new boyfriend. Sebastian Creane. Creane's brother, Dylan, was stabbed nine times when he came to his aid.
The following afternoon, August 16, 2009, Shane Clancy's body was found in the back garden at Cuala Grove. He had stabbed himself 19 times.
The inquest into Shane's death returned an open verdict. The jury wasn't satisfied that he had intended to take his own life. Shane had toxic levels of citalopram, in his system. [More here]
David Carmichael, a Canadian, took his 11-year-old son, Ian, to a hotel room in London, Ont., and strangled him to death.
Charged with first-degree murder, Carmichael was found not criminally responsible because of a mental disorder and transferred to the Brockville Mental Health Centre. In 2009 he received an absolute discharge from the Ontario Review Board.
The makers of Paxil, GlaxoSmithKline, have said they “do not believe Paxil played any part in this situation.” [More here]
David Crespi was alone with his twin daughters when he stabbed them to death, then called 911 to report the murder. The cocktail of drugs that his wife said pushed him over the edge was Prozac, Ambien, Trazadone and Lunesta. He'd been taking them for one to three weeks.
David Crespi entered guilty plea came to avoid the death penalty, but it led to a life sentence with no chance of parole. [More here]
There are those that refuse to accept that the antidepressants in the above cases played any part in the decisions of those who carried out these violent acts, opting instead to blame the 'mental illness'.
What if evidence could be provided, would it ease the pain of those left behind to pick up the pieces?
Exactly who are the victims here?
Those who were killed, the loved ones of those who were killed or those who carried out the homicide?
Well, all of them.
A 2009 review of antidepressants in Japan has been flying under the radar for some time and it was only by chance that I happened to find it via the Japanese Medicine Regulatory website.
The Japanese Ministry of Health, Labour and Welfare [MHLW] reviewed reported adverse reactions of aggression, etc. including harmful behavior to others (including injury) associated with SSRIs or SNRIs.
MHLW issued an alert to patients and their families to pay due attention to changes in patient condition during the course of treatment. On May 8, 2009, MHLW required marketing authorization holders [MAHs] to revise precautions in package inserts.
Here's what they found...
"After a careful review of the 39 cases of harmful behavior to others including injury (including 4 potential episodes associated with milnacipran hydrochloride that could have resulted in harmful behavior) identified from the clinical course, causality between the drug and harmful behavior to others could not be denied in 2 cases of reported adverse reactions associated with fluvoxamine maleate and 2 cases of reported adverse reactions associated with paroxetine hydrochloride hydrate. For the remaining 35 cases of adverse reactions, causality between the drug and adverse reactions was considered unknown.
"In light of the above findings and discussions amongst specialists, it is considered necessary to add the following precautionary statements to the “Important Precautions” section of package inserts: 1) Episodes of anxiety, irritation, excitement, panic attack, irritability, hostility, aggression, and impulsivity have been reported; 2) In patients with these symptoms or behavior, exacerbation of underlying disease, harmful behavior to others, etc. have been reported, though causality with the drugs is not clear; 3) Patients should be carefully monitored for changes in their clinical condition; 4) Patients’ families should be given full information on risks associated with changes in behavior such as excitement, aggression, irritability, etc., and an exacerbation of underlying disease, and be instructed to keep in close contact with the physician."
I wrote to the British drug regulator, the MHRA and asked them the following...
I would like to know if the MHRA have any information, be it by study or review, regarding SSRi adverse reactions of aggression including harmful behavior to others (including injury).
Please state if any alerts to patients and their families have ever been sent out regarding this issue.
Please state if any revision to package inserts have been made regarding this issue.
The MHRA have deemed that my query falls under the Freedom of Information Act and that I should receive a reply within 20 working days.
I'll keep you updated of any reply they send me.
Next time you read about a gun slaying in an American school it may be worth taking this Japanese review into account.
Next time you read of a murder carried out by someone who, just like the above three cases, were your normal, average, hard working male... then take the Japanese review into account.
Here's a recent one that raises all the red flags, for me at least.
The review by the Japanese Ministry of Health, Labour and Welfare can be downloaded here.