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Some experts say prescription drugs are a main factor. Anti-depressants that are supposed to help people cope with depression may have played a role in triggering a Columbine killer.
April 20, 1999, is a day Mark Taylor will never forget. That was the day Mark was hit by more than a dozen rounds fired by gunman Eric Harris at Columbine High School. Taylor just barely survived the rampage in which Harris and fellow student Dylan Klebold carried out the nation's deadliest school shooting, killing 12 students and a teacher, before shooting themselves.
Taylor said, "I think of it every single day."
Five years later, questions remain as to why they did it. Taylor's convinced it has to do with anti-depressants called SSRI's, short for the scientific name, Selective Serotonin Reuptake Inhibitors.
Harris was on one of them. Autopsy reports show he had the anti-depressant Luvox in his system at the time of the Columbine shootings. Harris had been taking the drug since early 1998. And just three months before the Columbine killings, his dose was doubled.
Taylor thinks Luvox triggered Harris' attack on Columbine, and is now on a crusade to ban it and others like it.
SSRI anti-depressants hit the headlines in March, when the Food and Drug Administration issued a health advisory on 10 popular types. With more than 150 million prescriptions written in the U.S. alone, the names are quite familiar: Prozac, Paxil, Zoloft, Effexor, Celexa, Remeron, Lexapro, Luvox, Serzone and Wellbutrin.
But the FDA is now concerned about clinical trials, where some patients taking the drugs demonstrated increased hostility and more suicidal thoughts.
Dr. Ann Tracey, the director of the International Coalition for Drug Awareness, says, "I think these drugs are far too deadly to remain on the market." She says the way SSRI's work makes them deadly: they regulate a chemical in the brain called Serotonin, a neurotransmitter that plays a role in mood and behavior.
Infamous crimes have been committed by people on SSRI's. Andrea Yates, convicted of killing her children in Texas, was on Effexor. Nineteen-year-old Corey Baadsgaard had just increased his dose of the SSRI Zoloft when he walked into his high school carrying a loaded rifle.
Baadsgaard said, "I was getting pretty low, like rock bottom. You know? Suicide was the constant thought I was having."
In early February, FDA advisors discussed concerns about the unknown effects of the drugs on children and the fear that some antidepressants may increase suicidal tendencies. Advisors told the FDA that the use of antidepressants by children and teenagers is skyrocketing, despite lack of evidence that they alleviate depression and for some, may even make it worse. FDA officials responded by asking manufacturers to place bolder warning labels on the drugs.
Dr. Aradhana Sood is a leading researcher on the effects of SSRI's and other mood-altering medications on children. She is the chairman of Child and Adolescent Psychiatry at Virginia Commonwealth University, and Medical Director for the Virginia Treatment Center for Children in Richmond, Virginia.
Dr. Sood said, "I feel that we have known for at least a decade that SSRI's do cause what is called a hypo-manic disenhibition, meaning in certain children they will produce a heightened sense of impulsiveness."
But unlike Taylor, Dr. Sood says the problem is not the medication, but the physicians prescribing them.
"There is a wide variety of people who are, and I don't want to be patronizing, but who are not trained adequately in child psychiatry," said Dr. Sood, "who are now prescribing anti-depressants a great deal and who do not realize the risk that that carries. They might think that because the child is getting more irritable, the depression is increasing, so they increase the medication, which makes it even worse."
In 2002, the FDA estimates that doctors wrote a record number of anti-depressant prescriptions for children under 18, about 11 million. Nearly three million of those prescriptions were for children 11 and under. Overall, the FDA estimates that sales of anti-depressant drugs in the United States increased from 14 million prescriptions in 1992 to 157 million in 2002.
Dr. Tracey said, "I find more that doctors are actually encouraging and pushing, putting lots of pressure on parents to medicate their children."
The government has been reviewing the safety of antidepressants since last summer. The FDA's counterpart in Britain first sounded the alarm last year, when it banned all SSRI's except Prozac for patients under 18.
Taylor says he hopes the U.S. will eventually do the same. But until then, he will be working toward that goal. "This is a mission that I can't stop," he said. "I want to stop it. I mean, I want to get on with my own life, but it's just too important."
And while Dr. Sood believes the drugs work in helping children overcome major depressive disorders, she does take the decision to place a child on antidepressants seriously.
Sood said, "The decision to be put on medication is a very important one. It's what's going to effect their life for a long period of time, because this isn't an antibiotic."
Until the questions about SSRI's are settled, FDA officials say parents with kids who are taking them need to watch for symptoms of agitation, anxiety and hostility, signs that their children may be heading for trouble.