THREAD 1/7
Some thoughts on the association of SSRIs and violent behavior...
Without question, there is a literature on an *association* between SSRI prescriptions & aggressive/violent behavior including violent crimes (as well as suicidality).
Some thoughts on the association of SSRIs and violent behavior...
Without question, there is a literature on an *association* between SSRI prescriptions & aggressive/violent behavior including violent crimes (as well as suicidality).
2/7
The strongest evidence from RCTs indicates that the risk is limited to young people < 24 years old (see Sharma et al. 2016)
bmj.com/content/352/bm…
The strongest evidence from RCTs indicates that the risk is limited to young people < 24 years old (see Sharma et al. 2016)
bmj.com/content/352/bm…
3/7
I once saw a pt hospitalized for plans to commit a mass shooting. He had been treated with SSRIs in the past, but:
- was not taking them in months prior to hospitalization
- was not in withdrawal and did not have tardive akathisia
I once saw a pt hospitalized for plans to commit a mass shooting. He had been treated with SSRIs in the past, but:
- was not taking them in months prior to hospitalization
- was not in withdrawal and did not have tardive akathisia
4/7
- was using psychostimulants in the preceding months
- had also used androgens/performance enhancing drugs
- during previous similar hospitalizations, aggressive thoughts rapidly resolved with SSRI treatment (but more likely attributable to detox & supportive therapy/care)
- was using psychostimulants in the preceding months
- had also used androgens/performance enhancing drugs
- during previous similar hospitalizations, aggressive thoughts rapidly resolved with SSRI treatment (but more likely attributable to detox & supportive therapy/care)
5/7
This case might be considered a "positive" in a study trying to explore a connection between SSRIs & aggression/violence.
And so, not considering potential confounds in epidemiologic studies is a major limitation to drawing causal conclusions.
coyneoftherealm.com/2015/09/30/wha…
This case might be considered a "positive" in a study trying to explore a connection between SSRIs & aggression/violence.
And so, not considering potential confounds in epidemiologic studies is a major limitation to drawing causal conclusions.
coyneoftherealm.com/2015/09/30/wha…
6/7
"...there's the issue of correlation vs. causality. After all, I'm fairly certain all known mass murderers were drinkers of tap water, which has also been linked to violent outbursts."
psychologytoday.com/us/blog/psych-…
"...there's the issue of correlation vs. causality. After all, I'm fairly certain all known mass murderers were drinkers of tap water, which has also been linked to violent outbursts."
psychologytoday.com/us/blog/psych-…
