Antidepressant Use and Violence: We Need to Talk About It

Humor is the great thing, the saving thing. The minute it crops up, all our
irritations and resentments slip away and a sunny spirit takes their place.

                                                                                                                  -Mark Twain

     An ongoing rash of violent crimes in schools is causing many physicians to rethink current strategies of prescription drug use for depression and anxiety and their potential side effects. Certainly we are all shocked to hear of it when someone enters a classroom or auditorium and opens fire on groups of innocent people, only to then turn the gun on him self. We are also left to wonder why the majority of such horrific crimes are committed by people taking psychiatric medications.

     Over the years, the antidepressant Prozac, its cousins Paxil and Zoloft, and the newer generation Celexa and Cymbalta have been linked to suicide and violence in many people. They represent the most popular class of antidepressant drugs, known as Selective Serotonin Reuptake Inhibitors, or SSRI’s. Tens of millions of people have taken them, and doctors say it is almost impossible to tell whether the streams of violence stem in part from their side effects or from the very illnesses they attempt to treat.

     Some of the most reliable statistics dating back to 2002 show that more than one in three doctor's office visits by women involved a prescription for an antidepressant drug. Today approximately one in ten American women take an SSRI, and the use of such drugs by all adults has nearly tripled in the last decade. Also in 2002, about six percent of all boys and girls were taking antidepressants, triple the rate during the period of 1994-96. About 14 percent of boys - nearly one in seven - were on stimulant drugs (to treat ADD and ADHD). That’s double the number in 1994-96.  

     It is not uncommon to see antidepressant use in pre-school age children as well, as parents are increasingly concerned about controlling their children’s behavior before they even begin school. Even more shocking, many physicians will often write prescriptions based on school nurse recommendations rather than properly evaluating the child themselves.

     SSRI’s target a central brain chemical called serotonin, which directly influences whether we are happy or sad, animated or withdrawn, high or low. An interesting tidbit to note is that though it acts in the brain, 95% of our serotonin is made in our intestinal tract. Ever had a gut feeling about something and found out it was true? Now you know why.

Just before the holidays I wrote an Inspiration showing how exercise is a natural way to boost serotonin and how to use it to better manage the holiday blues.

     Do I mean to suggest to you that by altering your lifestyle habits you might be able to treat your depression or anxiety naturally? You bet I am. Rather than focusing on altering brain chemistry and risk upsetting an already delicate balance with mood altering drugs, wouldn’t we be better off just improving the way we live? I should think so.

     Now I do believe that in certain extreme circumstances drugs like SSRI’s do have their place – in the short-term. But the concern I have with the industry in general is that patients are rarely ever given an exit strategy for their drug regimens - and this can be a problem. Often times a doctor won’t hear back from a patient until it is time for their next refill in one year - as you can tell from the above statistics, this is often way too late. Doctors are often also much too quick to pull the trigger on prescribing such drugs rather than taking time to refer patients for counseling, therapy, or an appropriate support group.

     Doctors aren’t all to blame. They’re stretched to the max when it comes to high patient loads, increasing malpractice costs, and frankly, pressure from patients to get them their quick fixes. Do we want to perpetuate this situation or is it time for another approach?  I’m for change and my gift is to bring situations like this to light.  And I hope you’ll join me in the effort.                                                          

Healthiest regards,