February 20, 2008

Northern Illinois Shooting: Off-Meds In The News

It's ironic that today marks my seven month anniversary of going off-meds because the phenomenon of going off-meds--well, anti-depressants at any rate--is very much in the media these days due to the NIU shooting. More on that in a second.

I am doing fine, for those of you who are interested. And given the rigorous life stresses I've been under, I am pleased to be able to say that. For those of you who are new to this site, I'd stress that this was not my own idea, but was the idea of a very experienced psychiatrist whom I've seen for four years. It's a well planned experiment. And I say that in as non-delusional and subclinical a manner as possible. Even though I bet there are people who suspect I am full of BS.

Anyway, in recent days, there's been a rush to judgment on both sides of the meds issue--on or off-meds--in the wake of the Northern Illinois University massacre. I think that it's just not clear yet if going off Prozac made him do it, as some critics of SSRIs claim, but what's intriguing to me in a forensic sense is that he was going off Prozac for roughly three weeks leading up to the shooting and during that period began doing all manner of things that were sort of out of character for him: buying guns, ammo and clips; reaching out to his long lost godfather (why not earlier when he was on Prozac? and why didn't he call his father?); writing what was in essence a suicide note to his ex-girlfriend; covering his tracks from investigators by removing his computer hard drive and the SIM card from his cellphone. All of that would be out of the ordinary for someone who's described as not being a monster, according to those who knew him. And all of those behaviors would be well within the window of withdrawal from Prozac, or the after-effects of withdrawal which are a poorly understood phenomenon.

In other words, there are things that point to an off-meds reaction driving this and there are things that point away from it. For example, numerous medical authorities are quoted as saying Prozac doesn't have the "withdrawal crazies," for lack of a better term, attached to it, that do other anti-depressants, especially Paxil and Zoloft. I doubt that they are lying but are speaking from their own experiences as clinicians. That said, one doctor is quoted as saying something a bit different: "his history of psychological problems leads her to believe that a lack of Prozac could cause such violent actions." That statement was made by Sherry Falsetti, Director of Behavioral Science for the U of I College of Medicine at Rockford.

For its part, the AP weighs in with its official salute to meds article.

What confuses me is that journalists are supposed to be skeptical and look at all sides of an issues. In this case, they are only talking to people--fed to them by advocacy groups apparently--who went off meds and had problems. They are having problems finding someone who went off-meds properly and has done well? What's more, the AP article talks about a woman who went off an anti-depressant but had what sounds like possible rebound symptoms to me and went right back on the drug, when in actuality the symptoms she was experiencing were likely part of the withdrawal process. In Prozac Backlash, Joseph Glenmullen describes this problem at length.

Seriously, though, if as many people go off anti-depressants as some press accounts claim--anywhere from one-third to one-half--then they shouldn't have problems understanding that it must've worked out well for some of the people, or there would be human wreckage all over the place. No mention of that anywhere in the media or coming from the mouths of doctors whom I'm sure know of numerous patients who've gone off anti-depressants and done alright.

The fact is that the research base on these questions is appalling limited. You'd think after 20 years of new generation anti-depressants and 20 years of people going off the meds that someone would've done a big long-term study of how people fare who go off-meds. Then again, who would fund it? Then again, why wouldn't they fund it? Whether anyone is for or against people being on meds forever is beside the point. There is a very real phenomenon going on in America around meds and it's time for someone to take a hard, scientific look at the issue and do the kind of study that will actually tell us something useful.

I'd say the media has some more work to here as well. This is a very serious issue that deserves a serious gander.

Let me make sure that readers understand my views here before I get slammed too much. I'm not an advocate for anyone being on or off-meds. I am an advocate for people being responsible adults and doing things properly, no matter what choice they make. And nothing I've said in this post relates to schizophrenia or other psychotic disorders. They are their own special universe when it comes to these questions. There is something very powerful about anti-depressants and coming off of them that other classes of psych meds can't come close to claiming. I'm unaware of withdrawal crazies being attached to people who go off a mood stabilizer or ADHD meds, for example. I know there are individual cases that speak to problems there, but I've never seen it to be on the scale of anti-depressant withdrawal. And I don't know of too many people who are taking an anti-psychotic for a non-psychotic disorder who go off the handle as they come off the drug. In fact, I don't know of any cases of anyone losing it as a result of going on either of those meds classes, whereas with anti-depressants there are well known problems attached to a minority of patients who start an anti-depressant or undergo a dosage increase.

So what's so special about these serotonin enhancing drugs? Remember it's not just their interaction with people with depression that's at work. These same kinds of issues have been seen in people with anxiety, back pain, OCD and so on. What should the special case of anti-depressants be telling us? I ask this in as philosophical a manner as possible.

And just so I am clear on another point: I don't think the NIU case will ever be Exhibit A for the reported dangers of SSRI withdrawal. There are too many unknowns and imponderables in the shooter's life story and behavior. I think there are other, better examples of the phenomenon than the tragedy in DeKalb. This one sure makes you ask questions, however--and I think the families of the victims deserve answers, as do all of us.

I know this is emotional stuff, regardless of what side of the issue you are on and since this is the Net I expect a fair amount of flaming and Lord of the Rings style clashes. I just ask that people continue to keep things respectful.

Posted by Philip Dawdy at February 20, 2008 12:05 AM
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Comments

My first thought was "sociopath" when I heard people talk about how nice & charming he was. He clearly had a very dark side that his girlfriend didn't know about.

Did withdrawal from Prozac send this guy over the edge? I don't know. I'm willing to entertain that idea. I also think it may just be a copy cat scenario like someone else mentioned. Maybe he was just a huge narcissist who wanted to be remembered. If so, he got his wish.

Posted by: Lisa at February 20, 2008 04:48 AM

I think you've done a great job commenting on this whole episode, Philip. You are refusing to provide easy answers, but you are also raising all the right questions. I tend to agree with Lisa that whatever the role of Prozac here, it is difficult to see this tragedy playing out the way it did unless the shooter had a serious dark side to begin with.

It surprises me that ONLY 1/3 to 1/2 of people on antidepressants eventually go off them. Considering how badly the side effects can suck, I would expect the proportion to be much higher - unless 1/2 to 2/3 of them actually have severe recurrent depressive disorders, which I doubt. Any thoughts about this?

Posted by: Garth at February 20, 2008 08:21 AM

Philip,
I just tuned in because I found this appallingly slanted article on Yahoo news on my way to checking my e-mail:
http://news.yahoo.com/s/ap/20080220/ap_on_he_me/off_their_meds

As you can imagine, I'm just allover thrilled at the picture of mental illness being portrayed in the media at present. My only consolation is that I know this news fad will go out of style, although probably not soon enough to suit me.

I keep wondering why no one asks the obvious question: If these meds are so bloody wonderful, why do we have so many people who can't wait to get off them???

Best wishes,
Sherry (who's been functioning better off meds for 8 years now)

Posted by: Sherry at February 20, 2008 08:30 AM

So a "lack of Prozac" made him do it according to Falsetti. This is kind of a weird, warped way of putting it isn't it? As if Prozac is something we can be deficient in and have to take like a vitamin or supplement and of course this is exactly how it was originally marketed -- correcting "deficiencies" in serotonin -- and exactly how many people continue to think of it and it's a highly dangerous way to think of an antidepressant in my opinion.

Posted by: Sara at February 20, 2008 09:02 AM

thanks to those who keep passing along the yahoo news story. it's the same as the ap story i link to in the post. i too am kinda disturbed at the pic of the mentally ill that the ap is providing and if i get mad enough i may take it up with them.

Posted by: Philip Dawdy at February 20, 2008 09:02 AM

All SSRI related discussion aside, what I've been thinking,and pondering is what is the difference between this murder(s)and the one of the NY therapist? both men appear to have planned the murder(s)being that one packed a suitcase full of knives, scoped the basement for an exit route earlier[as reported]and the shooter in this case appears to have made several things well thought out in his plan, and those are listed above in this article.

I'm not trying to make a point or choose sides, or am I trying to start a debate of this.

I am thinking out loud, based on what looks like pre-planned murders and the only thing different appears to be that Prozac came out into the discussion so it is a theme now.

I bring back my provocative question from the other thread, not directed at any person here or their story, or their opinion:

Is this pre-meditated murder? meds or no meds?

Again these are my personal thoughts and opinion, and am not engaging in debate or rebuttal, just thinking like everyone else.

I also successfully removed Prozac without incidence.

Posted by: Stephany at February 20, 2008 09:04 AM

There is absolutely no doubt that Prozac is the easiest antidepressant to withdraw from. I don't think anyone is going to deny that. But just because that is the case that does not mean that there cannot be trouble in someone who either is on a large dose and goes off too fast (or worse cold turkey), who can't metabolize it (because they are a poor metabolizer or very skinny -- yes, that makes a difference) or has been on repeated courses of antidepressants and is highly sensitized to them. There are lots of different scenarios that are being somewhat ignored in this discussion. Also I think we need to wrap our heads around the fact an antidepressant induced act of violence is often the result of obsessive rumination and an inability to let go of violent thoughts that might otherwise be transient. Martin Teicher described this antidepressant activated phenomenon 17(!!) years ago. This obsessive rumination combined with reduced impulse control can lead to disaster. Of course it is very rare that it would lead to a rampage shooting -- there really has to be some "perfect" combination of circumstances to lead to that tragic and very sad outcome. I do think unfortunately that there is a "copy cat" phenomenon that could be at work too because these incidents (and video game images too for that matter) float to the surface of people besieged with violent fantasies as a result of their drug use. But I guess this is all speculation on some level. Still these phenomena have been recorded in medical journals and they do fit the profile of this incident too, they really do.

Posted by: Sara at February 20, 2008 09:38 AM

For those of you who missed my previous post on this:

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."

To read the rest, go to:

http://tinyurl.com/2a3g7l

Again, no will know exactly what happened. But if you still feel there is no possibility that meds had anything to do with this, then I don't know what to say.

AA


Posted by: AA at February 20, 2008 09:42 AM

aa: i don't think anyone missed what you said before....although making comment threads refer to one another is tough. as i've said, i don't think this case is every going to resolve this issue one way or another but if it gets serious attention focused on these issues then so be it.

Posted by: Philip Dawdy at February 20, 2008 10:14 AM

Stephany,

I hope I am not doing something you don't want done. You're asking some good questions such as what is the difference between the Illinois Shooter and the murdererer of the NY psychologist as they both planned it. It sounds like the inference in your question is that if Prozac is such an influence, how can someone still be able to plan out this shooting?

Laurie Yorke, the nurse who runs Paxil Progress Boards, said her son, who is fine now that he is off Paxil, was planning all sorts of homocidal activities when tapering off of Paxil. She feels lucky no one was killed.

Now granted, we're talking about Paxil and not Prozac. But it still shows that someone who normally is quite normal is quite capable of planning bad behavior while under the influence of an SSRI.

Also, the fact that the shooter's friend said that drugs had a negative effect on him and was causing rages leads me to believe the meds are an issue.

But you ask some great questions.

AA


Posted by: AA at February 20, 2008 10:17 AM

Hi Phillip, I think you're being a bit, well, lazy here: "What confuses me is that journalists are supposed to be skeptical..."

I think you've made a good start at understanding and describing the AP/Yahoo report but please, take the next step: No skepticism = no journalism. It's that simple. Journalists have, for the most part, been replaced by PR flacks and color commentary.

You should not be surprised, and you should not feign confusion where unwarranted. These dogs do not hunt. Anymore. And yes, arguing with them, and pushing back with facts, is probably fruitless but we will continue to do so as energy and enthusiasm allow.

Carry on,

--
-------^.^--

Posted by: Matthew Platte at February 20, 2008 11:06 AM

Philip,

With all the comments being posted, it is easy to miss stuff unintentionally.

You're right, none of us know exactly what happened. But when the guy's best friend is saying that the drugs made him worse at a young age, I think that is quite relevant.

AA

Posted by: AA at February 20, 2008 11:13 AM

He was a mass killer and a psychopath. I blogged on it-- and his girlfriend the perfect dupe for such a creature.

Posted by: holy water salt at February 20, 2008 11:37 AM

Girlfriend: Shooter was taking cocktail of 3 drugs

Jessica Baty said Tuesday that her boyfriend of two years had been taking Xanax, used to treat anxiety, and Ambien, a sleep agent, as well as the antidepressant Prozac.

To read the rest, go to

http://tinyurl.com/26e62t

Posted by: AA at February 20, 2008 12:36 PM

I agree with the poster named AA who said, "Since he did poorly on the drugs when he was younger, the meds are more of a factor here."

Remember that the Boston Globe in the year 2000 wrote an article about the "new" Prozac that was going to be launched by Sepacor [sp]. It's advantage over the old Prozac, according to the patent, was that it wouldn't cause suicidal ideation and self-mutilation [cutting]like the original Prozac did. The new Prozac was never launched but that is beside the point. The point here is that Steve K. started to cut himself AFTER he started on his meds according to news articles.

What we have to realize here is how rare homicide is when withdrawing from an SSRI. SSRI Stories has 136 cases listed for 'withdrawal' and 55 of these involve a completed murder. Now, assuming that SSRI Stories is only reaching the tip of the iceberg and is catching about one out of two hundred cases [you will have to bear with me here] and there are 40 million people who have taken an SSRI and half have discontinued, then you have 20 million people who experienced discontinuation.

If you multiply the 55 cases by that 200 [to try and catch the true figure of cases], you have 11,000 cases [scattered over almost 20 years].
You then divide the 20 million people by 11,000 cases and you reach the number 1,818.

The number 1,818 is the odds of a person going off an antidepressant and committing a homicide.

So the chances of committing a homicide are one in one thousand eight hundred and eighteen. This is considered rare adverse reaction according to the experts. The likelihood of an adverse reaction happening between one and one hundred times is considered 'Frequent'. Between one hundred and one thousand times it is considere "Infrequent" and anything after one in a thousand is considered rare.

If I am way off base and SSRI Stories is catching, say, one in a hundred cases instead of one in two hundred, then you would have to double this figure and say the chances of committing a murder during withdrawal are 1 in 3,636.

There is an SSRI called Sarafem which has the exact same ingriedients as Prozac. Not one molecule has been changed. It is prescribed for women with PMS. They take it for half the month and then discontinue for half the month - every month.

I only know of one case of a woman committing a murder while following this procedure and she was not using Sarafem - she was using Celexa for PMS and was in a 7 day withdrawal. She was an award winning school teacher in a suburb of Dallas, Texas and she killed her two little boys and attempted suicide. She was given 45 years in prison.

Her story can be viewed at SSRI Stories by going to the Index: www.ssristories.com/php.html
and either using your word finder or clicking on the red column at the top for the "Date". Find 1999-05-14 This is the date.

As for why the SSRIs cause more homicides than the antipsychotics or mood stabilizers, I will leave that to the scientists, if we can find any who are interested in studying this phenomena. Since scientists aren't even away of the phenomena, I doubt the studies will get done.

Posted by: Rosie at February 20, 2008 01:03 PM

There is no doubt in my mind that numerous of the current murders-homicides are drug-induced and that the news is seldom told clearly by even our best mainstream media. This needs to stop, as a public safety measure. But there is other work to be done as well, that is about mental illness, number one in the stigma parade.

Having experienced in my immediate family such catastrophes as lithium toxicity (4, as opposed to 1)and near death, major suicidality/homicidality from Lexapro, months of suicidality from Lamictal, it is my fervent hope that the person who has had to live through all of this gets off the whole schmear. Except lithium. And that the mainstream media really starts to do their job. And that the doctors start to spell out the truth and do THEIR job instead of p laying candy man.

Posted by: Ellen at February 20, 2008 01:09 PM

Barring induced psychosis, murders are not "drug-induced." He thought of killing people (not a crime) - and you might successfully argue that such thoughts could be drug-induced. And then he bought guns, and ammunition. Not drug-induced. And THEN he killed people.

The problem here is not that the man had a hard life, or that he was diagnosed with a mental illness, or that he took antidepressants, or that he stopped taking antidepressants. The problem is that he chose to kill people.

When we make it all about his psych history, or his medication history, we dishonor the hundreds of thousands of people with similar (though obviously not identical) histories who do NOT choose to kill people.

And, I must add, all those thousands of people's choices to stay on or go off meds, or go back and forth, is nobody's business but theirs. THEY aren't hurting anyone (except perhaps themselves - also not a crime).

Posted by: Rose at February 20, 2008 01:28 PM

I am really saddened by fellow brothers and sisters in the cause bashing me for believing in Prozac. I only wrote about my experience. We all have stories and we none have all the answers. My mom listened to people who said Prozac was bad and crumbled her script up and placed in the trash can before every taking one pill. Now, no longer with us, my family and I will always wonder would the outcome have been different if she would have atleast tried medication.

While enjoying the discussion, being attacked is irresponsible. Even more it is irresponsible to allow the attacks to continue. You don't know me. I will no longer be a reader of this site.

Posted by: Lizzie at February 20, 2008 01:39 PM

Sara, you know what i was thinking about that "lack of Prozac" thing, was maybe it's like the brain becoming addicted and adjusted to "needing" the med [like a meth addict].

Because as you know with all of the research we all have [most here anyhow,in combined efforts]done, it appears that even antipsychotics are hard to remove and can end up being a lifelong "need"--brain damage in essence, where the brain cannot function w/out these drugs, and therefore the violent reaction in a person's mind when "drug free" too fast, especially.

Also, I've always firmly believed in the 18 month rebound effect, where transcient shifts of withdrawal side effects can occur once off of antidepresants, and antipychotics.

I also believe there is only data surrounding the SSRI violence because they are so predominantly rx'ed now, and in my opinion we will see much attention toward anti psychotic removal in the next decade, due to the SSRI's being replaced with broad base use of antipsychotics such as Abilify.

Again, these are only my opinions.

Posted by: Stephany at February 20, 2008 01:42 PM

"""So what's so special about these serotonin enhancing drugs? Remember it's not just their interaction with people with depression that's at work. These same kinds of issues have been seen in people with anxiety, back pain, OCD and so on. What should the special case of anti-depressants be telling us? I ask this in as philosophical a manner as possible."""

Philosophy aside here is some interesting info I learned from my previous psych doc (and some stuff I've learned through my own research and self education):

SSRI's and SNRI's aren't all as "selective" as we would like to believe. AND for anyone who doesn't already know this many HALLUCINOGENIC (psychedelic) drugs work by creating a massive increase in the release of, or by blocking the reuptake of SERITONIN, OR by acting as an "agonist" at the (to be specific) 5HT2 seritonin receptor subtype (or by all mechanisms together). But mostly hallucinogens work by over stimulating the 5HT2 receptor subtypes. (Ibogaine and Salvia are the only two psychedelic hallucinogens that don't work exclusively by messing with Seritonin)

There are more than a dozen "subtypes" of Seritonin receptors, ONE of these receptors is involved in making a person hallucinate when it is over stimulated... and it just so happens that since SSRI's/SNRI's aren't so selective as to not cause an increase of seritonin to effect that receptor subtype as well, that it's not a far stretch to say that SSRI's and SNRI's can cause someone to have a "bad trip" or even end up deaing with full blown psychosis.

In the 5HT2 receptor subtype there are three further "subtypes" 5HT2A, 5HT2B and 5HT2C. The 5HT2A receptor subtype is the one that hallucinogens like LSD and Psylocibin exert thier effects thru.

Now comes some more interesting info:
Most of the newer (and I am assuming some of the older) Antipsychotics work not only by being antagonists ("blockers") of Dopamine receptors (D2 receptors in most cases of the newer APs) BUT ALSO by being antagonists (blocker) at the 5HT2 seritonin receptor subtype(s).

Some of the antipsychotics say in thier "CLINICAL PHARMACOLOGY"/"Pharmacodynamics" section that they are antagonists (blockers) of one 5HT2 receptor subtype, others say they are antagonists of all the 5HT2 receptors, others say they are an agonist (stimulator) of one subtype(s) and an antagonist of another subtype(s). But what they all have in common is that they generaly block at least one of the 5HT2 subtypes, AND if they do "stimulate" one of the other 5HT2 subtypes they do it by being an AGONIST at seritonin receptors, not by blocking "reuptake" of seritonin which is a completely different mechanism of action.(agonists work by attaching to the recptor and mimicking the action of seritonin EXCEPT that they do not "stimulate" the receptors thay are attached to/are agonists of, at the same LEVEL as actual serotinin does when it attaches to the receptors).
So though they may be stimulating even the 5HT2A receptor subtype (the one that hullicinogens stimulate) thier "stimulating effects" are often much less than what your natural seritonin would have, and definately much less than what a hallucinogen would do. So even though they are an "agonist" they are not OVER stimulating the receptor (unless you have an "adverse reaction" to one and it doesn't work the way it should for you).

The thing with agonists and antagonists is that wether or not they have a real and dependable effect depends upon thier "binding affinity". So in order for an agonist or an antagonist to work in a dependable way they must have a higher binding affinity for the receptor (whatever neurtransmitter type it may be) than the neurotransmitter itself.
That means that when you are taking a drug that is an agonist or antagonist that has a higher "binding affinity" for receptors than the neurotransmitter that would usually bind to those receptors, your natural neurotransmitters that would usually attach to those receptors can not do so anymore - they can't "kick off" the drug from the neurotransmitter binding site and take it's place (at least not in most of the available "binding sites")

Whereas an antagonist will completely "turn off" the effects of a receptor (subtype if the drug is very specific in it's action) and trick the brain into thinking "I am not getting any dopamine or seritonin at this receptor subtype" (which has "down the line" effects on many other neurotransmitter production and release, not just on the receptor that is being antagonized), an "agonist" will trick the brain into thinking "oh I getting such and such a level of this (lets say seritonin) neurotransmitter."

So in comparison to a drug that has agonist and antagonist effects at different neurotransmitter binding sites, which is a very specific mode of action, an drug that blocks the reuptake of any type of neurotransmitter(s) has a very unspecific effect.
Reputake inhibitors basicaly "flood the brain" with an excess of whatever neurotransmitter(s) it is blocking the reuptake of... and after it has done that it has no effect upon how that excess of said neurotransmitter is used. So if you are on an SSRI and it effectively raises your amount of available seritonin, it all depends on your specific make-up as to how that extra available Seritonin is going to be used/where it will end up/which seritonin receptor subtypes the excess seritonin will end up attaching to.
... Obviously for some people that excess seritonin ends up going to the 5HT2A receptor subtype and over stimulating it. Maybe not to the extent that it actually makes them hallucinate, though this can happen, but definately for a not so tiny minority of patients to the extent of making them feel in thier emotional and immaginitive realms, like they are "having a bad trip".

For anyone who doesn't understand hallucinogens or has never had a decent amount of experience with them I feel I should explain: Not all hallucinogens actually make you hallucinate. For some people they can take "shrooms" and not see or hear anything that can be regarded as a hallucination, BUT they will still "feel" a little, or a lot, "off".... having extreem moodswings, having thoughts that are bizarr, getting a "body high" and not feeling comfortable in their own skin, and of course possibly having an panic or anxiety type reaction...but without actually seeing or hearing things that "aren't there". So a person who is having a bad reaction to an SSRI/SNRI could actually be having a "bad trip".

I know that's a lot ot digest and I probably didn't write it out as clearly as someone else with an actual medical degree could, but I hope that helps you understand what is going on with these SSRI drugs and why they are so "special" in regards to making some people completely "loopy".

As a side note I'd like to add that if you are taking an antipsychotic you can't "trip" and hallucinogens will not work for you. So maybe for these people that have bad reactions to SSRI/SNRI drugs, the best treatment may be to put them on a newer atypical antipsychotic for a few weeks to a coupel months to "bring them down" from thier bad trip. For me I always had VERY bad reactions to antidepressants and it has turned out that antipsychotics are what has brought me back from the horrid state of mental illness that ADs sent me into. It makes sense if you think about it the way I explained, that a person who has bad reactions to ADs would get a positive effect from an AP. So that's something to think about.


Posted by: katielou82 at February 20, 2008 01:43 PM

Going off the meds...makes it seem like the meds are not the cause of Kazmierczxaks problem. Note too that the original cause of his mental problems that led to his being on antidepressants is obscure.

Why do people assume he had a dark side that the meds kept in check? Because its too difficult for amny people to conclude that modern medical science is driving people to mania and to committing murder and suicide. That would make modern medicine a public menace.

Posted by: brian at February 20, 2008 01:46 PM

'I think that it's just not clear yet if going off Prozac made him do it, as some critics of SSRIs claim'

Guilt by association..just about every murder/suicide case, esp mass shootings shows SSRI/SNRI antidepressants in the background. Think of Andrea Yates a mother of 5 who kills all her children: initially no mention of meds.But finally we were belatedly told she had been on Effexor:
http://www.ssristories.com/show.php?item=525
The onlyt thing in her background that would make her do such an extraordinary thing is Effexor!
Like DUH!

When will the penny drop for the regulators?

Posted by: brian at February 20, 2008 01:58 PM

'For me I always had VERY bad reactions to antidepressants and it has turned out that antipsychotics are what has brought me back from the horrid state of mental illness that ADs sent me into'

So this would mean that antidepressants make a person psychotic!

Posted by: brian at February 20, 2008 02:49 PM

I just wanted to apologize to Lizzie although she may no longer be here to listen. I really didn't mean to slander the claim that Prozac saved her life; simply wanted to point out that OTHERS who make that claim also assume that therefore no one else can be harmed. This is the point I was trying to make and I realize I did not make it very delicately and I should have asked Philip if I could change that sentence before he posted it as a main blog posting. Really, although I do think down the line anyone who believes Prozac is saving their life MAY be in for some problems, I honestly do wish Lizzie well and I do believe it is making her and others like her feel better for the time being, I really do. I just ask all you Prozac believers to be responsible consumers and understand withdrawal and side effects so that if you do want to come off you are prepared for the ride and don't think it is your "underlying illness" coming back.

Posted by: Sara at February 20, 2008 03:33 PM

When are we going to demand the medical community to take responsibility in these tragedies and begin educating the public at large about abruptly stopping these medications. It does not work to blame the patients behavior on an underlining condition. For many people, they actually felt better before starting the medications, so stopping them actually seems like a plausible solution to their problems. It is not their mental illness, they want to at least feel the way they did before starting medications. If someone is not homicidal prior to taking a medication it is beyond their comprehension they would progress to the point to where they would all the sudden kill someone. It is time the media and the medical community begin to make it prefectly clear the medications can cause this behavior. We have enough information to know these medications have some pretty severe withdrawl symptoms. Patients need to be told in no uncertain terms they may not have any control over their actions should they just stop these medications. Withdrawing from these medications needs to be publized in every media outlet. Patients need to be told in no uncertain terms they may not have any control over their actions should they just stop these medications. For the past twenty years we have educated the public on how to fear mental illness and have said nothing about fearing the medications used to treat it. IMO, that is where the real danager is.

Posted by: Jane at February 20, 2008 03:41 PM

So this guy is a "killer" but not a quote "sane enough" killer to join/stay in the army? Why/how does one volunteer for a job where you may have have to kill people and be sane? Oh that's right it's because they're bad guys. And who gets to decide who bad guys are again? Lets no forget he wanted to be in the army and got rejected. There may have been harbored/hidden feelings of anger/resentment over this.

The fact he was on drugs as child proves nothing. The shrink could have decided he "needed" them. Being an average teenage with different opinions than your parents and previous generations conservative/older values is justification for a disorder. His parents thinking "Oh my god something is wrong with my baby" "Do what ever you have to do" may have just as much damaged/deranged him then any disorder. Children today have less rights and have more social behavior crap forced on to them than ever before. We have more violence than every before in schools.We have you will go to school or we will force you to go. How many of the shooters kids wouldn't have had anger at their school if they weren't forced to go there? Yes, kids don't want to go to school but there comes a point when you forced somebody too far. What's the logic.... If we just force it long enough, they'll realize this is the righteous way. If not we're lock them up and drug them


The kids have more invasion into their life than ever before. Parents snooping into and watching your child online, tracking them by their cellphones. How many time did your parents pick up the phone and easedrop in your conversations with friends? Go through your room? Read your private journals? Violating sense of privacy and self. Being treated as lesser class citizens and having no rights over self and body. Kids are treated like criminals. "Oh its about safety" " if it saves one life" How many times do kids have to be searched before they start to feel less than human? People are shock by this violence, I'm shocked there's not more. You treat someone as animal and its no surprise when they act like an animal. Its not just about video games and tv. Fairy tales have been for more grim than what's on the screen.

When these events happen everyone is "monster this" & "monster that". He most likely wasn't a monster to himself, family and friends until this unfortunate event. Every person who has done bad things to another considers themselves to be a good person. Just ask what any law enforcement officer who enforced the jim crow laws? Any person who served in the military? What about prison guards? What about those prison guards on p.o.w's? All claim they are good and "just" and most do these things because of the "bad" people. What about the people who work the Japanese internment camps? They were all good people. Somebody has to protect the sheep. The only monster is the fanatic who decides they are the judge of what is right and what is wrong.

Sadly debate on this issue for the past decade hasn't brought change. Maybe some good will come out of it and force the issue. As history shows violence is often necessary for change. Personally I wish ego and pride were such people would admit they are wrong and fix the problem instead of firing up the stakes for heresy.


Posted by: bob at February 20, 2008 04:21 PM

I wanted to add a congratulations and continued success off of meds to Philip.

Also, I have a question re: the pdoc advising/prompting the Lamictal removal, can you share his idea, and/or why he told you to remove the meds?

Posted by: Stephany at February 20, 2008 04:53 PM

Stephany, I'm not sure anyone ever addressed your question about what the differences (or similarities) might be between the NY murder and the NIU rampage. I know I am so incredibly biased and I just can't help myself but to me both incidents demonstrate that medication can make someone worse over the long term rather than better. I think the fellow in NY was much more mentally disabled than the student and the trigger for him seems to have been his mother being put into care. Whether that then caused him not to take medication the way he might have been taking it before is a possibility. It appears he was pretty dependent on his mother if he was planning to kidnap and run away with her. In both cases I think the perps sound like they had some pretty obsessive violent ruminations that were weird and warped in the weeks just before the murders because they did things that were preparatory to the acts. Were these medication/withdrawal induced or exacerbated ruminations? From my observations and study I certainly think they could have been but I guess others could argue they were all "illness" based. In both cases innocent lives were lost and if different mental health treatment with much more cautious use of medication could have avoided that outcome then I think we need to understand what that might look like -- a pipe dream I'm afraid.

Posted by: Sara at February 20, 2008 10:00 PM

From my own experiences of the SSRI Paxil , I can easily see how any individual could become homicidal while in withdrawal from an SSRI. I was very volatile and hostile coming off Paxil. The drug companies should be paying out compensation to the victims families. Although i am aware that innocent lives were lost from this guys murdering rampage, people have to remember that he was a victim too and was probably not in control of his behavior dur to the drugs he was prescribed. Psych meds are powerful drugs and can change personalities completely. My heart goes out to all the victims in this case, the shooter included. It is very sad and psychiatry and the drug companies have a lot to answer for...

Posted by: truthman30 at February 21, 2008 09:32 AM

What a shame about Lizzie being attacked for having an positive experience with Prozac. I'll bet there are many people here who are afraid to post anything positive about psych drugs helping them.

Prozac was the first AD I was prescribed in the late 1990s. I am not bipolar. I suffer from major depressive disorder and dysthmia.

Prozac was a miracle drug for me. For 4 years, I rose out of the muck that was always dragging me down. I took no other drugs. It is the only time in my life that I felt "normal." I was not manic, I was happy. I functioned.

After 4 years, it stopped working, and I started on the merry-go-round of trying pretty much every drug out there. I have never returned to the "normal" state that Prozac gave me.

As far as I recall, I did not murder anybody during those 4 years.

Describing a positive experience with a drug does not negate the suffering of others who have had bad reactions. It is simply a different experience.

I hope Lizzie comes back.

Posted by: rocketdog at February 22, 2008 09:42 PM

Rocket dog,

You say you love Paxil, but even now you must admit it was not a lifelong solution for you.

It should be pointed out that Lizzie's posting was just as much an "attack" on people who deal with life without meds, as is the position of those who revile meds, the other way round. How is it that she is able to blame her loved one's death on "no meds" but others are not allowed to make a similar causal connection between meds/side effects/withdrawal and their own loved one's demise? There is a lot more evidence for the latter position.

To appreciate this, it would help to have a fact-based graphic which shows the statistics that many of us have percolating in our mind - the bar chart that shows number of rampages by year along with another set of bars for ssri use, going back 10 decades. Has anyone done something like this? I imagine it would show a strong correlation. The only other factor that I can think of that might co-correlate is video display (computer) use.

Posted by: Susan at February 23, 2008 05:17 AM

Prozac. I said Prozac. Not Paxil.

It was not a lifelong solution, but it was a drug that [i]helped[/i] me. It did not [i]harm[/i] me. Many other drugs have not helped me, but have harmed me.

I am different from the people posting here. I had a positive experience with Prozac and simply wanted to add my voice on that fact because Lizzie was being attacked for expressing her positive experiences with Prozac.

Posted by: rocketdog at February 23, 2008 01:27 PM

rocketdog, you're not different from people posting positive things about meds you're just a brave one beating down the negative comments by speaking up.

Once again, someone who says Prozac helped gets attacked.

Honestly, this is ridiculous.

I'm glad for those who are helped by meds--- and they don't need to show proof or charts or graphs as to the whys and hows.

They have a life and good for them!

Posted by: Stephany at February 23, 2008 04:48 PM
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