These Legal Drugs Linked to Violence

Psychiatric Drugs and Violence: A Review of FDA Data Finds A Link
By Robert Whitaker, Psychology Today

There has been an enduring controversy over whether psychiatric medications can trigger violent actions toward others. A review of the FDA's Adverse Event Reporting System by Thomas Moore, Joseph Glenmullen and Curt Furberg, which was published by PLoS One, found that such "adverse events" are indeed associated with antidepressants and several other types of psychotropic medications. To do their study, Moore and his collaborators extracted all serious events reports from the FDA's database from 2004 through September 2009, and then identified 484 drugs that had triggered at least 200 case reports of serious adverse events (of any type) during that 69-month period. They then investigated to see if any of these 484 drugs had a "disproportionate" association with violence. They identified 31 such drugs, out of the 484, that met this criteria.

The 31 "suspect" drugs accounted for 1527 of the 1937 case reports of violence toward others in the FDA database for that 69-month period. The drugs in that list of 31 included varenicline (an aid to smoking cessation), 11 antidepressants, 6 hypnotic/sedatives, and 3 drugs for attention deficit hyperactivity disorder. Antidepressants were responsible for 572 case reports of violence toward others; the three ADHD drugs for 108; and the hypnotic/sedatives for 97. Of the 1937 total case reports of violence toward others, there were 387 cases of homicide, 404 physical assaults, 27 cases of physical abuse, 896 reports of homicidal ideation, and 223 cases of "violence related symptoms.

"The adverse events reported to the FDA are known to represent but a tiny fraction of all such adverse events. This study simply identified 31 drugs responsible for most of the FDA case reports of violence toward others, with antidepressants near the top of that list. In light of this finding, the many past shootings at school campuses and other public venues should perhaps be investigated anew by government officials, with an eye toward ascertaining whether psychotropic use may have, in the manner of an adverse event, triggered that violence.Moore and his collaborators concluded: "These data provide new evidence that acts of violence towards others are a genuine and serious adverse drug event that is associated with a relatively small group of drugs. Varenicline, which increases the availability of dopamine, and serotonin reuptake inhibitors were the most strongly and consistently implicated drugs."

Top Ten Legal Drugs Linked to Violence
By Maia Szalavitz, Time Magazine

10. Desvenlafaxine (Pristiq) An antidepressant which affects both serotonin and noradrenaline, this drug is 7.9 times more likely to be associated with violence than other drugs.

9. Venlafaxine (Effexor) A drug related to Pristiq in the same class of antidepressants, both are also used to treat anxiety disorders. Effexor is 8.3 times more likely than other drugs to be related to violent behavior.

8. Fluvoxamine (Luvox) An antidepressant that affects serotonin (SSRI), Luvox is 8.4 times more likely than other medications to be linked with violence

7. Triazolam (Halcion) A benzodiazepine which can be addictive, used to treat insomnia. Halcion is 8.7 times more likely to be linked with violence than other drugs, according to the study.

6. Atomoxetine (Strattera) Used to treat attention-deficit hyperactivity disorder (ADHD), Strattera affects the neurotransmitter noradrenaline and is 9 times more likely to be linked with violence compared to the average medication.

5. Mefoquine (Lariam) A treatment for malaria, Lariam has long been linked with reports of bizarre behavior. It is 9.5 times more likely to be linked with violence than other drugs.

4. Amphetamines: (Various) Amphetamines are used to treat ADHD and affect the brain's dopamine and noradrenaline systems. They are 9.6 times more likely to be linked to violence, compared to other drugs.

3. Paroxetine (Paxil) An SSRI antidepressant, Paxil is also linked with more severe withdrawal symptoms and a greater risk of birth defects compared to other medications in that class. It is 10.3 times more likely to be linked with violence compared to other drugs.

2. Fluoxetine (Prozac) The first well-known SSRI antidepressant, Prozac is 10.9 times more likely to be linked with violence in comparison with other medications.

1. Varenicline (Chantix) The anti-smoking medication Chantix affects the nicotinic acetylcholine receptor, which helps reduce craving for smoking. Unfortunately, it's 18 times more likely to be linked with violence compared to other drugs — by comparison, that number for Xyban is 3.9 and just 1.9 for nicotine replacement. Because Chantix is slightly superior in terms of quit rates in comparison to other drugs, it shouldn't necessarily be ruled out as an option for those trying to quit, however.