Posted on 12/18/2007 1:06:45 PM PST by neverdem
This is a myth.
Only one-third of the attackers had ever been seen by a mental health professional, and only one-fifth had been diagnosed with a mental disorder. Substance abuse problems were also not prevalent. “However, most attackers showed some history of suicidal attempts or thoughts, or a history of feeling extreme depression or desperation.” Most attackers had difficulty coping with significant losses or personal failures.
Another myth that is the idea that school violence is rampant. Your claim that SSRI usage causes violence would seem to require an uptick in school violence corresponding to the increased usage of SSRIs. The facts say otherwise. Same source.
In fact, school shootings are extremely rare. Even including the more common violence that is gang-related or dispute-related, only 12 to 20 homicides a year occur in the 100,000 schools in the U.S. In general, school assaults and other violence have dropped by nearly half in the past decade.Although the class was original submitted to the FDA as having ‘no addictive qualities’ it became imperical within a decade that you couldn’t stop taking them because of the withdrawal symptoms. Would Dylan Klebold have killed a bunch of stranger in the next few years had he NOT been on Luvox? Can’t say. But we know for sure that he was put on Luvox and we know he did shoot all those people.
A) Withdrawal symptoms is a sign of addiction potential, but no guarantor of such. B) Dylan Klebold did not take Luvox, that was Eric Harris. Dylan Klebold was not on an SSRI. C) It is ridiculous to say that one "cannot stop taking an SSRI" simply because there are withdrawal symptoms. You simply titrate down the dose to get off them. The SNRIs (Cymbalta and Effexor) seem to be harder to abrubtly discontinue than the SSRIs. D) If it was "imperical" that the SSRIs are addictive, why hasn't the FDA added that to their labels? Probably because they're not. If they were addictive, they'd have to be scheduled. Which, of course, they are not.
We also were told that there were no long term effects and no addiction problems.
You're comparing a Class II Narcotic with a non-scheduled product. Apples and walnuts.
Of course, responsible physicians would need to have responsible information from their drug reps in order to form those decisions.
Tell it to the physicians. Probably 25% of the doctors are interested in getting any information from the reps other than where they spent vacation and how their kids are doing. That's both doctors and reps fault. Both have performed in these relationships to the lowest expectations of each other. The FDA restrictions on what a rep can and cannot discuss do not help. And the crush of managed care on a doctor limits his/her interactions with anyone who is not making him/her money.
And because the media didn’t report on the last shooter in Omaha being on drugs yet doesn’t yet interrupt the streak. It just means that we don’t yet know which drugs he was on.
I'll simply note that you ignored that neither Dylan Klebold or Cho Seung Hui were on antidepressants.
If we can see that people who were previously violent can get even more violent when introduced to or removed from SSRIs, wouldn’t any responsible physician avoid prescribing them?
Do you think that physicians are that irresponsible? Perhaps, just perhaps, thousands of physicians have prescribed millions of SSRIs for exactly the opposite reason. That most people who have depression are helped by these drugs. I am not yet so cynical that I believe that doctors are simply throwing out SSRIs for no reason. The doctors I know are a bit more patient-focused than that. Plus, 95% of them (probably higher) never make a thin dime from the SSRI manufacturers (unless you want to count the pens, the notepads and the pizza brought in for lunch as payment - rolls eyes).
But I also don’t want to see them put in stressful situations where that problem will likely be exploded or put them on drugs which will remove the subjects ability to perceive reality.
This is a bit different from what you have posited to this point. It is my understanding that the atypical anti-psychotics (Risperdal, Geodon, Abilify, et. al.) do cause patients to perceive in a completely different manner. The SSRIs do not seem to do this. They do elevate the "feel good" (serotonin) so that the patient feels better more of the time. Simplification, yes, but points in the right way. Do I think SSRIs are overprescribed? Absolutely. Is that the doctor's fault? Probably not, in the main. Do SSRIs help some people "feel better" when they probably shouldn't? Um...yeah. Are they the cause of a school shooting? Nope. Definitively.
Of course, intranasal steroids have the same problem. As do all allergy medicines. As do all medications which treat symptoms that can only reasonably be tested by patient's perceptions of outcomes. But don't let that slow you down.
I found only this on the subject. New Report Finds Little Evidence To Determine the Usefulness of Genetic Tests in the Treatment of Depression
The report found that tests evaluating differences in genes belonging to the Cytochrome P450, or CYP450, family that affect the rate at which a person metabolizes SSRIs are largely accurate. However, the researchers did not find any evidence that such tests led to improved patient outcomes or had an impact on treatment decisions for patients with depression. The researchers noted that other genetic factors and non-genetic factors such as diet and other medical conditions may have an impact on a patient's response to treatment.For fair balance, it doesn't appear any really good studies have been designed. So the answer is, right now, we don't know.
Why should anybody be surprised with psychotic episodes in folks taking stimulants?
SSRIs are not considered to be stimulants, their molecular similarity to the same notwithstanding. They interact with different neurotransmitters with very different effects. In fact, within the class of SSRIs, the drugs tend to be viewed on a scale of sedating/activating. Zoloft is viewed as more sedating. Lexapro/Celexa as more activating (with apologies to all the Forrest reps who view those as separate products). I'm not sure that this is supported by data or simply the results of doctor's clinical experiences with the drugs.
The difference is:
There is no/little attempt by the doctor to determine the cause of depression other than spouting the nonsense of “it’s a chemical imbalance”. The patient is left to tough it out thinking it’s a physical issue when in most cases it’s a family/job/life issue.
That’s the difference - you don’t take an allergy medication thinking it’s going to fix the problem - you take it because the symptoms are causing misery in your life. You have no expectation that the medicine is for anything other than ameliorating symptoms - unlike the way anti-psychotic medicines are “sold” to patients.
Sorry to ignore for you so long, but real life got in the way as I’m sure it has for you as well. Hope you had a rewarding and enjoyable Christmas.
I’m gonna presume that you are in the business? You are sounding much more like somebody who has seen the industry publications. And if you know that the drug companies give out the best goodies then you’ve either been on one side of the other of the drug reps or the medical convention circuit.
I’m sorry but I can’t take MSNBC as a source for any facts since they aren’t sourcing them at a level remotely close to being verifiable. One third of attackers were seen by a mental health professional? Which attackers are they including? Who counts as a professional? I don’t think they are helping anybodies argument other than some generalities about this not being an everyday occurrence.
Instead of arguing about who was and was not taking which drugs (you claim one thing, I claim to have seen another), I’d rather end on a point of agreement. I’ve got two very close family members working in Northern NJ in two of the largest pharma companies and both work in the marketing/development arena (the MBA types who put together the materials and instructions you probably get handed). I’m not somebody antagonistic to the industry as a whole or have some conspiratorial theories. I know they are in it for the money and that money is made mostly by creating products which are beneficial enough for the public to pay for. I could even go on about parallel importation and the EU plans for collective pricing which would hurt France but be great for Italy and England or inventory leakage from African nations back into US markets.
I’ve actually spoken with some fairly big names in the research end, mostly neurologists, who have spent a lot of time working on SSRIs. While they almost uniformly believe that these drugs are more beneficial than harmful, none of them have anywhere near the certainty that you do that behavior is predictable on them. I’m not talking about heretics or guys who turned on their masters and are now expert witnesses for plaintiffs lawyers. These were all people who practiced still and made a substantial portion of their income from this research.
And if there is one thing there is consensus on it is that these drugs are being overprescribed. I like physicians, generally. But I think you would probably agree that they are undereducated about the effects and interactions of this class of drugs. I would bet that you know more about them than about 90% of practicing physicians. And that creates a sad or dangerous situation in that you are more qualified to point out who should NOT be using these drugs than the people who have the script pads.
Nobody - regardless of their brilliance or arrogance - could possibly prove without question that SSRIs did or did not cause any individual mass killing. The studies cannot disprove it and circumstantial evidence cannot prove that it was THE reason. I’d predict that sometime in the next decade we’ll see a jury deciding this. And in a civil trial, even ‘beyond a reasonable doubt’ is above the standard needed for evidentiary proof. 12 (relatively) reasonable people will listen to the experts and look at the circumstances and make decision. And neither of us will be on that jury since we are both unqualified on the grounds of prior bias.
Have a good new year! Thanks for the entertaining discuss.
Perhaps I portrayed a certainty which I do not have. I know for certain that people's behavior is not predictable on them. I am fairly certain that they don't cause homicidal rampages ex nihilo.
And if there is one thing there is consensus on it is that these drugs are being overprescribed.
I'm not sure there is a class of drug which is not overprescribed. But this seems to be one of the more blatantly overused (neck and neck with "ADHD" meds).
I’m gonna presume that you are in the business?
Guilty as charged. Rep. But not for an SSRI (or even antidepressant or antipsychotic). My medicine kind of rubs up on their areas, however, so I need to know a bit about it.
Thanks for the entertaining discuss.
You as well. Have a great new year and I hope your Christmas was as enjoyable as mine.
Maybe we need to return to the days of longer hospitalizations. It may be that patients - especially teens - should be in the hospital under suicide watch during this "boost" phase. It's irreponsible to just prescribe the drugs - knowing that there's a suicide risk during this phase of treatment. If the drugs caused heart attacks or seizures instead of suicide, you can be sure there would be in-hospital monitoring.
Man, that sounds like something right out of a Walker Percy novel.
Let him rot, else the real cruelty is subjecting future innocents to his aptitude for murder.
The current Juvenile Court System is responsible for getting a lot of non juvenile innocent folks dead prematurely.
I can call it killing. It's not murder when you're in a state mandated psychosis after the doc just increased the dose. Some folks metabolize selective serotonin re-uptake inhibitors, SSRIs, much more slowly than most of the general population.
If you want to understand why the FDA mandated black box warnings on SSRIs, read the links.
Genetic Markers of Suicidal Ideation Emerging During Citalopram Treatment of Major Depression
A Mix of Medicines That Can Be Lethal my thread
A Mix of Medicines That Can Be Lethal the NY Times printer friendly version
The Serotonin Syndrome pdf link to the New England Journal of Medicine article
Antidepressants and Violence: Problems at the Interface of Medicine and Law
Eighty five percent of physicians were unaware of the serotonin syndrome when that journal article was prepared. IIRC, the Chris Pittmann case is the last one discussed in the last link.
Wasn't the women who killed her 5 kids in Houston on a very high dosage of Paxil?
Amazing how folks (including kids) who suffer from "depression" might actually do something that a depressed person might do... what a shock.
The reason I'm just now posting on this old thread - I just watched an old episode of 48 Hours that was about this particular case.
Truth of the matter - this kid is a murderer. His age at the time of the crime does not diminish his guilt.
But the connection to young people (and some adults), Zoloft (and other anti-depressants), and suicide are reaching. What do you hear in most suicide cases? The person was "suffering from depression". So if someone kills themselves while ON an antidepressant should not be all that surprising.
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