Right, this is definitely hearsay and also, let's be clear, if he was "activated" by Zoloft, it was on top of the history of excess steroid use. It's always important to look at these drug reactions, if that's what they are, in context. It certainly fits a disturbing pattern though, I have to say, and Benoit's doctor was known for prescribing drugs and then more drugs -- taper or transition between drugs -- these guys have never heard of it.

I am pretty sure there is a large amount of factors that led to this. One thing that isn't often mentioned is that one of Chris Benoit's signature moves was a diving headbut. Basically, he jumped off the top rope and smashed his head into the other wrestler's upper torso. When you watch this, you notice that he hits his head HARD often. I'm pretty sure the guy hit his head so many times (thousands!) that he had some serious damage up there.

I've worked with people who were had closed head injuries over the years. These people as a group are much less likely than the general population to murder their wives and children. On the same note, people with psychiatric diagnoses are much less likely to commit violent crimes than people without them. This can be proven by considering the fact that most people convicted of committing violent crimes do not have psychiatric diagnoses.

However, people on zoloft are more likely to commit violent crimes than people not on zoloft. I don't know much about steriods or steriods combined with zoloft but it sounds like a bad combination. Furthermore, most domestic abuse is committed by people who do not have psychiatric diagnoses.

Sally, I am pretty sure head injuries have generally been found to show increases in violent behavior post head-injury. Estimates of traumatic brain injury in the incarcerated population range from about 3-10x the general pop.

http://www.ncbi.nlm.nih.gov/sites/entrez?cmd=Retrieve&db=PubMed&list_uids=9783082&dopt=Abstract

http://www.cdc.gov/ncipc/tbi/FactSheets/Prisoner_Crim_Justice_Prof.pdf

http://ajp.psychiatryonline.org/cgi/content/abstract/143/7/838

http://www-rcf.usc.edu/~raine/SelectiveReductoinPrefrontal.pdf

My daughter was on 150mg a day of Zoloft at age 13 and at no other time did she have full blown rages that lasted 6 hours or behave suicidally and speak of suicide except on that drug. Other drugs that activated similar erratic behavior/moods was an inhaler of prednisone for childhood asthma. I've also heard anecdotal stories about steroid shots given to patients with MS become manic, and I also witnessed 'roid rage' in an ex boyfriend who was a body builder. That shit made him lose his mind, become enraged for simple shit like elevators taking too long in college--and he beat the shit out of someone on campus as a result. I walked away from that scene at a fast pace and never looked back. I think there is much to be learned about how medications affect individual people, it sure is not one size fits all, and when someone acts strangely or violent on medications, I feel it should not be quickly dismissed. The rage I saw in the person on steroids was so bad, that I seriously would not be shocked to find out that person killed someone while on 'roids. It's scary shit, especially in big men with a lot of muscle power.

I agree with Philip that it's probably premature to say that 'the Zoloft did it', particularly if it was recently prescribed. However, steroid-SSRI interactions may be a factor. But I have to say that after a while on a large dose of Zoloft I found myself becoming more and more irritable, and what actually prompted me to withdraw from the drug was an incident where I came very close to actually punching a woman who was behaving badly at a function I had organised.

Mark, none of the links you provide indicate that people with head injuries have a greater propensity for violence than the general population. It's certainly true that people with head injuries suffer economic discrimination which makes it difficult for them to afford lawyers and its also true that people caught commiting violent acts will grasp at any excuse possible to avoid responsibility, but the proposition that head injury = violence is not supported by any data whatsoever. It's even true that violent people are more likely to suffer head injuries, but it's also true that following a head injury people with a previous history of violence become less violent.

Actually if the Zoloft was recently prescribed that could make a violent reaction more likely, not less. One of the most dangerous periods for violent suicidality is within the first three weeks and some people can get it after even one dose, particularly if they are poor metabolizers or have a compromised liver because of other drugs. It's like pouring gasoline on a pile of embers. At one time regulators wanted to insist on prescribing a concomitant sedative in the early weeks of treatment with an SSRI because of this risk but the drug companies quashed it because it would have hurt sales.

Perhaps with a high profile case as this, the FDA, judges and juries will be convinced that these SSRI's can have side effects for "Harm to Others". The black box warnings contain the statement regarding suicides, but I believe "Harm to Others" needs to be a part of the black box warning too. We have kids sentenced as adults serving 30 plus years in adult prisons who I believe suffered involuntary drug intoxication and committed crimes as a result. Look at Christopher Pittman in South Carolina, Kurt Danysh in Pennsylvania, just to name two. Sending kids to adult prison for doing what they were told and taking the medicine just doesn't seem right to me. They needed help, not adult prison. go to Prescription Suicide site, hear the stories. www.juvenilejusticefoundation.com

Mark has a good point about head trauma. There have been several published cases of ex football players who have experienced severe mood changes due to numerous concussions. What I've read has involved significant depression and suicide, but finding a violent link would not suprise me at all.

Of course, there are those that would love nothing more than to find a psych med had something to do with this. Talk about playing right into an agenda!

As a person who suffers from bipolar disorder it should be no surprise that when on Zoloft I suffered significant mania. Was it the drug's fault? Absolutely not, it was due to a mis-diagnosis.

Sally, I'm pretty sure the data supports what I am saying:
"According to jail and prison studies, 25-87% of inmates report having experienced a head injury or TBI17-19 as compared to 8.5% in a general population reporting a history of TBI."

About 2/3 of the prisoners in America are in state/federal prisons. To be put in one of these, you usually need a fairly length criminal history. I work in a minimum-security prison setting where the average number of arrests is about 15, and most people have combinations of drug, property, and violent crime. This number and the likelihood that you have been involved in a violent crime increases as the security level increases. People with just property or drug crimes generally don't get prison or even jail time because of the costs and capacity problems. Taking a lower estimate of 40% of prison inmates with TBI, and a roughly 40% of the people are imprisoned for violent crimes at any given time now (note - their current prison offense at the time was for a violent crime; if you included prisoners who have ever been convicted of a violnt crime, that number easily doubles), 16% of the volent offenders would have TBI. That's about double the risk of the gen pop. I think this is an understimate too, as I don't know of any theoretical or empirical link to property offenders and TBI.

Another study:
"Head injury in partner-abusive men," Alan Rosenbaum, Steven K. Hoge, Steven A. Adelman, William J. Warnken, Kenneth E. Fletcher, and Robert L. Kane, Journal of Consulting and Clinical Psychology, Vol. 62, No. 6, 1994.

The researchers compared the incidence of head injuries in three groups: 53 men who beat their wives, 45 happily married non-violent men, and 32 unhappily married non-violent men. (Assessments were performed by a physician unaware of the history of the participants.) They found that more than 50% of the batterers had suffered a significant head injury, compared with only 25% of the unhappily married non-violent men and 16% of the happily married non-violent men.

In almost all cases, Rosenbaum et al. note, the head injuries suffered by the wife-beaters occurred before they began abusing their spouses. "Furthermore," the researchers say, "in the 13 head- injured subjects with a history of arrest for assault and battery, the head injury preceded the assault and battery in every case." Most of the head injuries had occurred in childhood, and the most common causes were accidents, falls, and sports injuries.

Their data show, the researchers say, that "a history of significant head injury increased the chances of marital aggression almost six-fold." By comparing batterers to unhappily married non- violent men, they note, they were able to demonstrate that "the association between head injury and being a batterer was not attributable to the marital discord that is characteristic of abusive relationships." Also the incidence of alcohol use-which has been associated with both head injury and marital abuse-did not vary significantly between batterers and controls.

In 2001 when I called the on-call psychiatrist about the 6 hour long wild/violent rage my [at the time age 13, about the same year and age of Pittman]he said this: "She could be reacting to the Zoloft, I have had 2 other patients react the same way." I don't think we can dismiss psychiatrict side effects. This is what the problem is about: psychiatrists, and patients alike will fully accept diarrhea, vomiting, dizziness, headache, etc as a side effect and even remove the medication for those reasons. WHEN there are psychiatric side effects [listed on the package inserts folks]--consumers, doctors, etc. will assume and do assume it is the illness needing a different medication. I have opened Pandora's box to this discussion at many a boardroom meeting, and psychiatrist's do not want to discuss, or possibly believe in those psychiatric side effects. Aggression, agitatation, schizophrenic reaction, are just a few that are listed in most fine print of Depakote,Zoloft,Zyprexa,Abilify, etc. It really is time for patients, consumers and the public to be honest about these medications. I swear pot and mushrooms get more interest than this stuff. Until we start talking about snorting Seroquel in prison[oh wait that hasn't been on CNN has it?] --and the steroid hostility is not news.The news is because someone famous is in the news and the drugs are in their story.

Sara, you wrote:

"Actually if the Zoloft was recently prescribed that could make a violent reaction more likely, not less. One of the most dangerous periods for violent suicidality is within the first three weeks and some people can get it after even one dose."

Do you know whether the risk of violent suicidality during the early stages of Zoloft treatment is related to the initial dosage? Do people typically react in this way during the first couple of weeks if they're on only 25mg a day to start with (to avert nausea, for example), or only if they've started on a standard dose, like 100-150mg?

(Sorry Philip for going slightly off-topic.)

Mark,

I recommend that you check the accuracy of your second sentence, "About 2/3 of the prisoners in America are in state/federal prisons. To be put in one of these, you usually need a fairly length criminal history. " The head injury data you sighted is misleading, assuming there were no problems with the underlying "studies." People, and particularly men, who are violent are more likely to get head injuries partly because being hit in the head is a pretty common way to get a head injury. In addition, assuming, as I do, that violent behavior is learned behavior, men who beat their wives are usually men who were physically abused as children, and most phycally abused children have head injuries, defining the term as losely as you seem to.

Real head injuries affect different people differently. Frontal lobe damage usually causes a loss of some degree of impulse control but this is not correlated with an increase in violence. A head injury can and often does cause a lack of physical coordination that makes a person less effective physically, i.e. less able to be violent even if they want to be. And it's pretty well documented that someone with true frontal lobe damage should not be given ssri's or antipsychotics because these drugs affect the head injured differently from how they affect non brain injured.

It's a shame that the American FDA is not as concerned as the Canadian FDA. Why has Pfizer Canada issued a warning regarding harm to oneself and harm to others on Paxil and Zoloft in Canada, but Pfizer America states there is no accepted evidence that Zoloft causes such thoughts or behavior and there is not current avaiable data linking SSRI's to increased aggression or violence? Wouldn't the clinical trials' evidence apply to both countries? It is my understanding that Luvox, Xanax, and Effexor have added warnings of homicidal ideation as a rare side effect. It is also my understanding that all SSRI's carry the same warnings on their labels, so what is the FDA waiting for?

With more and more children/teens suffering from depression and being placed on these powerful medications I believe the parents need to know all the possible side effects. Shouldn't a simple DNA test be performed to see how the body metabolizes the medication prior to be placed on the medication?

There are blood tests now available to show how the body metabolizes medication. My daughter had it done. If all patients had this done before any medication was taken; then 1. It would/could streamline medicating a person without trial and error 2. It would save insurance companies money 3. It would save consumers money 4. Pharma could/would lose money.
Therefore, though this is a logical way of finding out if a person is a poor metabolizer of medications such as Zoloft,Paxil,Zyprexa etc.; American FDA and Big Pharma will surely make sure this never happens as protocol. Until the United States FDA gets enough pressure placed on them by consumers, advocates etc. we will continue to have a corrupt system. It now lacks integrity, honesty and merit in my opinion.

Also, regarding head trauma and TBI. I have a relative who was hit by a car. Suffered severe head injuries, as a result for a year this person was highly combative and aggressive, and over time the head injury healed and the behaviors stopped. The nursing staff told the family the aggression was a common after effect of TBI. Any form of injury to the brain, whether it is injury, concussion,stroke or medications, it is clear the brain is affected and can be affected by many things.

Stephany, agression is not violence. One of the false negative stereotypes about head injuries is the myth that people who have head injuries become violent. This myth is so pervasive that Mark could actually blame a trained fighter's violence on a head injury. I would imagine that trained fighters, whether, wrestlers, boxers, or soldiers, as a group are more violent. Head injuries don't cause violence or agression, though they can cause a change in impulse control. Violence and agression can be side effects of the situations people who are head injured are in. Not causes for them.

Sally,
Respectfully speaking here, I do not recall saying that aggression is violence. I suppose everyone may have an opinion about what violence level counts as aggression though. There is no solid evidence backing any one of our opinions here.

Go to the package insert page 26 for Zoloft and find
all the fun possible side effects under Psychiatrict
Disorder. Amnesia, Abnormal Dreams, Paranoid Reaction, hallucinations, aggressive reaction, suicidal ideation and somnambulism (sleepwalking) and tell me that Chris Benoit could have killed his loved ones just from taking Zoloft.
http://www.fda.gov/medwatch/SAFETY/2002/Zoloft_USPI_rev4.pdf

Let's not forget Bryne Hartman killed her husband Phil after only taking Zoloft for two days. The surviving family sued Phizer and Phizer settled out of court.

Other possible SSRI murder/suicide
http://www.ssristories.com/index.php
Scroll to the bottom for Zoloft cases.
http://www.ssristories.com/index.php?sort=drug

According to jail and prison studies, 25-87% of inmates report having experienced a head injury or TBI 2-4 as compared to 8.5% in a general population reporting a history of TBI.

An autopsy has proven Chris Benoit had TBI

http://www.cdc.gov/ncipc/tbi/FactSheets/Prisoner_TBI_Prof.pdf

The majority of school massacres have one thing in common.
SSRIs & SNRIs such as Zoloft.

http://www.ssristories.com/index.php

Hormonal changes can cause rage. Anabolic steroids alter Hormonal levels. Roid rage is well known to the under ground culture that takes this dangerous drug.

Given all these factors, it was only a matter of when, This normally loving family man went bizerk.

You have to be twisted to enjoy seeing men repeatedly injured.