One more coincidence that we won't be taking seriously via --

http://shakespearessister.blogspot.com/2008/02/
things-that-are-not-coincidences.html

He bought his gun from the same online dealer who sold gun accessories to Seung-Hui Cho.

Eric Thompson said his Web site, [ugh, redacted] sold two empty 9 mm Glock magazines and a Glock holster to Steven Kazmierczak on Feb. 4, just 10 days before the 27-year-old opened fire in a classroom and killed five before committing suicide.

Another Web site run by Thompson's company, [redacted] also sold a Walther .22-caliber handgun to Seung-Hui Cho, who killed 32 people in April on the Virginia Tech campus before killing himself.

"I'm still blown away by the coincidences," Thompson said Friday. "I'm shaking. I can't believe somebody would order from us again and do this."

Yeah right, but still manages to include both his website addresses into the story.

Philip,

Before I get to my point, all your readers, no matter what viewpoints they have on meds, owe you a huge amount of thanks for the way you have covered these issues. I thank you profusely.

I am very concerned about the psychiatrist in the NY Times article who claims that Prozac can be used to withdraw from other antidepressants safely. I don't want to go into detail but I have suffered severe adverse effects from cold turkeying this drug, which included suicidal behavior. That is one main reason why I think it is very possible that cold turkeying off this drug by the shooter was a big factor.

AA

Philip,

It is a comfort knowing that you are there with your Website and that people can have their views aired and have a decent discussion of all the issues.

I am glad that you post everyone's comments [unless that person becomes abusive, of course].

I love your quote [What planet is he on] on Dr. Stone's figures of "only a few cases of violence on antidepressants".

As for the coumnist in Dallas - that is what she is,-- a columnist in Dallas.

Thanks for this great post.

This article is fair and balanced, and hopefully it will open up the debate on SSRI induced violence. The connection has been made, and the mainstream media is starting to join the dots. And that is good thing.

Wellbutrin, soft antidepressant? Ha. Granted, its not an SSRI, so there aren't those problems. It also didn't make me nauseous for the first two weeks I was taking it like celxa did. On the other hand, it took me almost a month to learn to sleep properly on the stuff because it made me so wired at first. All that said, it doesn't make me numb like celxa, and I consider gaining the ability to not sleep through all my classes every day to be worth a little edginess every now and then, so why am I complaining?

But aside from my little personal rant, I'd like to second AA's thanks for how you've covered all of this.

Thanks for the kudos and I guess it's a pretty big moment to be in the NYTimes especially as a counter jab to one of those big KOL shrinks at Columbia. I just would like to reiterate how off base those shrinks are who were being quoted on Prozac withdrawal. Yes, Prozac has a long half life and is often used as a cross-over drug when someone is having trouble tapering off another shorter half-life antidepressant, but that CERTAINLY does not mean that it is not necessary to taper slowly off Prozac itself or one risks withdrawal mayhem. I am just astonished that these doctors are not more clued in about the withdrawal process off any SSRI (or any other psych drug for that matter) and how very long it takes -- Jane Garland, especially. She's said some intelligent things about antidepressants in the past.

I participate in the Washington Post Forum where there are some very bright people. They simply don't believe theimpact of these drugs, but rather just discuss gun laws instead. The mainstream media may be beginning to wake up, but IMO they have a long way to go. Having gotten to know spouses and parents whose loved ones hung themselves or shot themselves, I feel great kinship with this group even though my child was killed by Zyprexa. There can't be enough coverage on the impact of SSRIs for my taste, and I, too, am glad there is SSRIStories.com.

P.S. I just read the article in the Tribune on withdrawal saying that "experts" claim Prozac withdrawal is rarely linked to violence. I say the only reason the experts don't know this is because they haven't been looking. I can tell you from my experience it absolutely can be related to intense violence and anyone who doesn't know this has their head in the sand.

I also agree the extensive and round the clock coverage is unbelievable, great work Philip.

And Sara and SSRI stories and crew, your diligence is amazing and good work as well.

Even though the Chicago Tributne said today that Prozac withdrawal probably doesn't cause violence, they gave an example of a woman withdrawing from Prozac who became psychotic during the withdrawal and kept saying, "I am Jesus".

So the whole Chicago Tribune article wasn't a complete waste of time.

Philip,

I saw this article which hasn't been part of the discussion. I found these exerts intereresting:

Kazmierczak was, by all accounts, a normal child who grew up in the Chicago suburbs with his parents - his mother died of cancer almost two years ago - and older sister. When he became rebellious in high school, his parents had him medicated.

His best friend, Peter Rachowsky, began noticing a difference in Kazmierczak, whose weight was fluctuating as much as his mood.

"He started to identify more with hatred-type stuff," Rachowsky told reporters.

"It seemed like the medicine made the whole situation worse."

Kazmierczak also started cutting himself, which led to prolonged stays at a psychiatric clinic after he completed high school. But he seemed to recover, becoming a well-regarded university student who won the Dean's award.

Of course, we still don't know the whole story. But in my opinion, this is more proof of the possibility that alot of this guy's problems were caused by medication. I would even guess the cutting was related to the side effects of the meds.

Here is a direct link to the article:

http://tinyurl.com/2a3g7l

of all of the SSRI compounds currently on the market, Paxil is the most dangerous to stop abrubtly, largely because it has the shortest pharmacuetical half-life ( 10-15 hours - 5 half-lifes and the drug is essentially undetectable in blood)it also has no active metabolites, considered to be significantly active as a 5-HT reuptake inhibitor. Two missed doses of Paxil is all it takes for someone to become suicidal. Fluoxetine (Prozac) is at the other end of the scale (half-life 3-5 days, and also with very active first metabolite norfluoxetine. It is thought that this combination of long half-life with very active metabolite provides somewhat of a natural taper if abrubtly discontinued. Prozac in this regard is really just the better of two evils. If this guy had abrubtly stopped Paxil thiese shootings would probably have occured several weeks before. In any case, it is difficult to make broad conclusions because no one yet really understands the longer term after effects that these drugs cause the brains biochemical system. One thing is for certain, is that these SSRI drugs are definately associated with a higher number of suicide & homicidal effects. A recent paper Fazel et al. J Clin Psychomarmocol - Oct 2007 showed that %61 of women 15-24 completed violent suicide while under SSRI drug therapy. One would think that if the drugs work as they are marketed that this number would be zero.
neil

My question is, isn't committing suicide or violence against others while on antidepressants a completely different and separate issue than committing suicide or violence against others while not on antidepressants? Someone who hasn't been on antidepressant for weeks, as this guy apparently wasn't, no longer has any antidepressant in him. So why is this even being discussed as an issue?

I see all of the mainstream articles confusing this issue too, and wonder about that. Talking about the published studies (not databases) that connect dots between antidepressants and violence/suicide is one thing. But there are no dots that connect violence/suicide to coming off of antidepressants in the published literature.

anon: from what's known he'd been off prozac about three weeks and did so cold turkey. not knowing what dosage he was on makes things a bit tricky, but it's likely he still had some of the anti-depressant in his system, perhaps trace amounts, perhaps more. everyone metabolizes things a bit differently. some people argue that there's evidence that your brain is effected by ssri withdrawal for many months and years afterwards.

the reality is that as someone withdraws from any drug that they've become dependent upon, then their body is crying out for it as they withdraw and for a period of time after.

Philip, you are absolutely correct - these are very complex drugs acting upon very complex neurobiological syatem. No two people are exactly the same in how they process these chemicals, or how these substances act. Just to make something clear, our bodies eliminate all toxins by processing molecules through the liver. It is an amazing organ, the liver creates metabolites through processes that I won't get into here, with the eventual hope that the resultant metabolites have been reduced to a size that the body can easily eliminate, through urine and feces. In this regard, there is no long term scientific data that shows conclusively how we are affected by these drugs. In this regard, the general population are all part of a long term study. And this includes many other pharmaceuticals - especially statins.
neil

But that's just gossip, that's not evidence. I think this point is getting lost and the two are being tossed together that it's like the murderer was actually on Prozac at the time of the murders. He wasn't. He wasn't for weeks. So what if he has some trace amounts in him? There's zero evidence linking violence and coming off of a medication 3 weeks later. Zero.

So it's just hearsay and conjecture and it drives me nuts, because it makes people scared of antidepressants as some sort of evil when it seems pretty clear they have nothing to do with this random event.

hey anonymous: how is any of what you are saying not gossip as well then? and what evidence do you have that there is no evidence of people having withdrawal related violence after three weeks off an anti-depressant? let's see it smart guy, peer-reviewed and published. i'm sure your soon to be new best friends at ssristories.com can help.

Mr. Anon - you sound like you work for a big pharma company, or you or anyone you dearly love, has never been severley injured by pharmaceuticals. I truly hope that this never happens to you. And I might say, what I have posted is not gossip, I can support everything I say with peer reviewed literature from scientific journals, unlike you, who has no idea what he talking about. If you wish to exchange bona-fide scientific information - contact Philip Dawdy - and I will supply you with whatever you need. In the mean time you should at least put your name to your comments and not be such a coward.
Neil

Most of the media are downplaying the Prozac connection, or claiming it was because he was off it he turned violent.Nor is there any explanation for the cause of his earlier mental state, for which SSRIS were prescribed.
So expect more SSRI driven massacres in the next year.

Brian, you are very astute in your thoughts, as long as these SSRI drugs continue to be prescibed, there will me many more related suicide/ homicides. What we need, is that the people who are charged with our public safety will awaken, from their phamra ($billions) induced sleep, and begin to protect the public.
Neil

Anonymous: The Prozac label - which is similar for all SSRIs - warns about a cluster of drug-induced withdrawal symptoms.

Here is what it says: "Discontinuation Treatment of Prozac": During marketing of Prozac there have been spontaneous reports of adverse events occurring upon discontinuation of these drugs: dysphoric mood, irritability, agitation, dizziness, sensory disturbances, anxiety, confusion, headache, lethargy, emotional lability, insomnia and hypomania.

These are the symptoms which were noted during the clinical trials for Prozac and which were noted for Prozac discontinuation. The FDA required these adverse events to be listed by the manufacturer in marketing the drug.

Rosie and others - here are comments straight out of the mouth of GSK regarding Paxil.

Paxil - GSK Canada product monograph - November 24, 2006 - Page 22

"Other Events Observed During the Clinical Development of Paroxetine…

Nervous System

Frequent: CNS stimulation, concentration impaired, depression, emotional lability,
Vertigo.

Infrequent: Akinesia, alcohol abuse, amnesia, ataxia, convulsion,
depersonalization, hallucinations, hyperkinesia, hypertonia, incoordination, lack of
emotion, manic reaction, paranoid reaction, thinking abnormal, hypesthesia.

Rare: Abnormal electroencephalogram, abnormal gait, antisocial reaction, brain edema,choreoathetosis, circumoral paraesthesia, confusion, delirium, delusions, diplopia, drugdependence, dysarthria, dyskinesia, dystonia, euphoria, fasciculations, grand malconvulsion, hostility, hyperalgesia, hypokinesia, hysteria, libido increased, manicdepressive reaction, meningitis, myelitis, neuralgia, neuropathy, nystagmus

Neil

Thank you writer of Furious Seasons for your intelligent and informed post.

It is clear that you, along with many other reporters, have elucidated an issue that clearly needs to be looked into further. Based on accounts made by yourself along with advocates such as the founder of ssristories.com, there clearly is a relationship between antidepressants and violence. But that correlation can not be considered a direct or causal relationship. The media's typically hysterical search for someone or something to blame, in the case of the NIU shooting, has lead to citing a rather weak correlation and not causation between antidepressants and violence (weak considering what behaviors or conditions one can more readily correlate with violence) that only sponsors fear of a good product.

SSRI's among other modern treatments for depression and anxiety provide a great deal of relief to the 15 million Americans that are treated by them, and it is not fair nor ethical to instill in them the lingering fear that their medication might incite in them a homicidal rampage. Years of clinical trials by pharmaceutical companies themselves, the FDA, NIMH, APA, and unbiased researchers have led to these drugs that clearly do more to alleviate debilitating psychological conditions than aggravate side effects. Your statement that improper use of antidepressants may be a "recipe for bad things" is entirely valid, and withdrawal from almost any drug can be dangerous, but to go from symptoms of agitation and unpredictability as quoted by Dr. Garland to linking the medications to murderous sprees seems irresponsible. I entirely agree that improper use and withdrawal from antidepressants needs more research, but pointing a condemning finger at the medication that was more likely keeping Kazmierczak's violent capabilities at bay, only creates unnecessary fear.

Furthermore, it is definitely not a "chicken-and-egg" relationship, as described in the New York Times article you cited; violence obviously preceded the advent of antidepressants. It is much more likely for an un-medicated individual with depression or anxiety to hurt themselves or others than a medicated one. As long as we are talking about correlation, studies have shown that as more antidepressants are prescribed, suicide rates go down. And that during the period between 1992 and 2006, in which SSRI prescriptions more than doubled, school-related violent crime has actually declined.

Yup. Don't see "murder" listed there as a discontinuation effect.

Look at it this way. If the guy ate a Hershey bar and had a Starbucks expresso a day before he committed the murders, would it make any sense to blame Hershey and Starbucks in his gruesome crime? After all, chocolate and caffeine have definite, proven effects on our biological states.

Yes, there was violence in our society before the advent of antidepressants but where is your evidence, RSS, that school related violence has actually declined since 1992? I am afraid I absolutely do not believe that for one minute. We certainly did not used to have a rampage shooting, especially at a school, every couple of months as we seem to now. And yesterday the NYTimes reported a 20% increase in suicides among 45-64 year olds where prescription drug use, especially psych drugs, has escalated exponentially at the same time. I'm afraid your data which you do not even cite appears to be seriously out of date. And Anonymous it's one thing to say an antidepressant is linked to a homicide when homicidal ideation is clearly listed in the PDR as a side effect (albeit rare) and another to say candy and coffee are when to my knowledge no such warnings for them have ever been issued.

the point about school violence over time is a valuable one sara. i can assure readers that school shootings like this simply didn't go on very much in the 60s and 70s. i'm pretty sure you didn't have kids in the 1930s walkign into their hs or college classroom and blasting away. and the weapons were essentially the same--semi auto pistols have been around for 100 years or more--and people owned guns. in some places where i grew up it was right of passage for daddy to give his son a rifle when he was deemed ready to handle the responsibility. and yet there were none of these rampage killings...or at least damn few. now it seems like we have several of these each year.

something has changed dramatically with male teens in this country over the last 50 years or so and with the 20somethings too. i haven't the faintest idea what. but i think we can all think of a few things that are in our culture now that weren't around then--namely meds and video games and tv. i'm not blaming those factors and i'm sure there are other factors, but i am saying those things weren't around back then, they are around now and look at what's going on.

and yet we refuse to rationally examine these issues and always turn this into a matter of veritable identity politics. not wise.

I withdrew from an SSRI over a three month period, after taking them correctly for nearly nine years. Incidentally, I feel they did me more harm than good.

I became acutely psychotic and manic. I was aggressive and violent at times - I was hospitalised three times. Extreme and protracted withdrawals from SSRIs are a real phenomena.

It is sad for me to see that people are still denying the tears and protestations of those who have experienced this or witnessed it happening to a loved one.

Whilst we can all debate these issues on the internet and quote to each other any number of studies... the reality is that most people popping into see their doctor have not spent time looking at clinical data and so on - they trust their doctor to do that for them. My issue is and always will be informed consent - saying there is no link between violence and anti-depressant useage is dangerous - it means that people don't know to look out for it.

I agree with Phillip we desperately need to acknowledge the connection between ssris and violence and find out what the hell is going on!!!!!!!!!

The elephant in the room is why is the precautionary principle not being invoked? These drugs are only used to treat depression (and also weight problems), and so are not worth the menace of 'homicide ideation and suicide ideation'.

One of the things that has changed so dramatically in recent decades is how people live - largely due to how hard it has become to make a living. Until about 30 years ago it was the norm for most adults to be able to earn enough money from one job to support a family. It didn't take two or more incomes, so families could have one parent who spent a lot of time with the children. Now, because of the ways the economy has changed, most families need both parents to work just to make ends meet - so the children don't get much personal attention. I think that makes a difference.

For some, I think psychiatric medications have become kind of like a babysitter to make the kids a little more manageable, because daycare programs, babysitters, and schools can't give as much personal attention to each and every child as a parent can. Of course there are other things that have changed as well - I just think this is one of the contributing factors that isn't often mentioned.

brian, i was prescribed effexor for nerve pain. antidpressants are routinely prescribed off label for nerve pain and fibromyalgia.

i can't get off the stupid stuff because i can't deal with vertigo that is so bad i can't even move my eyes. it helps my nerve pain, though.

where are the studies of withdrawal symptoms of people like me, who did not suffer from depression or any mental illness? have any of us become psychotic and hurt ourselves our someone else?

i need to go read the ssri stories...

I would like to point out that there is forensic scientific literature - dating back to the early 1990's that Prozac (fluoxetine)has a significantly increased association to violent suicide that the older tricyclic antidepressant drugs - which were extensively used before the development of Prozac & the other SSRI compounds.

"Violent methods were more often associated with fluoxetine suicides than with TCA suicides (65% v. 23%, P

Frankenfield et al. Fluoxetine & Violent Death in Maryland. Forensic Science International
64 (1994) 107-l 17

Anon Mom, you might want to get yourself a copy of The Antidepressant Solution by Joseph Glenmullen. He has a protocol in there for getting off antidepressants and refers specifically to Effexor which is notorious for problems. I wish you luck if you decide to come off.

To RSS: You certainly sound like a GSK or a big pharma employee - your rationale for increased SSRI drug prescription use seems to be - that the drugs help many millions and so what if there are a few thousand deaths here or there caused by their use. Although you deny any causal relationship you do not cite any scientific literature to support your view, although there is much bona-fide literature showing the opposite. You should put up or shut up.
neil

As a further response to RSS, and his comments regarding recent scientific literature, attempting to show a decline in suicide with increased prescriptions of SSRIs or an increase in suicide after the FDA black-box warnings.

Most of these ecological studies were conducted by Robert D. Gibbons PHD & J Mann MD et al.

Mann is the only MD in this group and he has strong ties to big pharma as disclosed as follows:

"Dr. Mann has received research support from GlaxoSmithKline and served as an adviser to Lilly and Lundbeck".

Gibbons RD, Mann J et al., The Relationship Between Antidepressant Prescription Rates and Rate of Early Adolescent Suicide;
Am J Psychiatry 2006; 163:1898–1904)

There have been at least two other recently published, peer reviwed papers which strongly refute Gibbons and Mann and their scientific techniques with comments as follows:

"Between 1990 and 1999, the suicide rate in
the USA steadily dropped from 12.5 to 10.7 per
100 000. But between 2000 and 2004, the suicide
rate in the USA rose to range between 10.7 and
11.0 per 100 000, and this increase occurred
while SSRI use was prominently increasing."

D.J. Safer et al., Public Health (2007) 121, 274–277

"These findings are important because they do not
suggest that reduced access to SSRIs in young people has had an adverse impact on suicidal behaviour among adolescents in the UK, as has been suggested."

Wheeler BW et al., BMJ:10.1136/bmj.39462.375613.BE
14 Feb 2008;

To address the responses to my previous comment, I certainly did not want to convey the belief that as long as SSRI's help so many that a few dozen murderous rampages are an acceptable sacrifice. My argument is that we should not stoke the fire that is our media culture of fear by simplifying trends in data, which are the summation of innumerable causes, to reach a dangerous and potentially slanderous conclusion.

I must apologize also for making statements without showing my data, the links did not translate. My statement about correlation was based on data here (http://www.cdc.gov/ncipc/sch-shooting.htm), and served partially to show that the media focus on school violence has exaggerated a rare event in our otherwise very safe schools, and partially to show that a correlation can be cited for and against almost any argument.

Finally I must concede that I did not focus on the main issue at hand, the one which it seems most involved in this blog community are concerned with. That issue is awareness. People blindly take pills to treat one ailment without enough knowledge or awareness about what consequences it may have on their physiological, psychological, and emotional well-being. The consumer is partly to blame for their lack of inquiry, but largely to blame IS big pharma, for obscuring, minimizing, or rationalizing the potential harms their products may cause. Furious Seasons is a stand-out in the movement towards the scrutiny of a giant by the little people.