Home Society & Culture Could the Increase in Antidepressant and SSRI Usage Contribute to Mass Shootings?

Could the Increase in Antidepressant and SSRI Usage Contribute to Mass Shootings?

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The issue of gun control is emotionally charged, but it’s important to consider facts. More gun control laws have been implemented, yet mass murders continue to occur. While it’s debatable whether this is correlation or causation, it’s undeniable that mass murderers tend to target “gun-free zones” where law-abiding citizens cannot carry firearms. Such areas represent the core philosophical tenet of gun control, which posits that laws alone can prevent violence.

Unfortunately, politicians and the media tend to focus on types of guns used in mass shootings, rather than addressing the underlying issues. This emotionally charged debate distracts from a crucial problem: mental health and prescription drugs. Ignoring these factors only perpetuates mass shootings and leads to misguided gun control laws that violate the Second Amendment.

Mass shootings are a complex manifestation of various thoughts, feelings, and external factors. An analysis of these factors reveals that mental health issues alone cannot explain the increase in violent acts. The use of prescription antidepressants, specifically (selective serotonin reuptake inhibitors) SSRIs, may play a role in a high percentage of these acts of violence.

While it’s understandable that those involved in mass shootings may be taking antidepressants due to mental health issues, the issue with SSRIs runs much deeper. These drugs have been linked to violent crimes, yet this is a story that anti-gun media and politicians tend to avoid. It’s important to address this issue and not simply blame legal gun ownership for the actions of criminals. As Jeff Snyder wrote in the Washington Times, “To ban guns because criminals use them is to tell the innocent and law-abiding that their rights and liberties depend not on their own conduct, but on the conduct of the guilty and the lawless.”

To comprehend the surge in antidepressant usage in the US, it’s crucial to understand the difference between clinical depression and typical sadness. While everyone experiences periods of low mood, clinical depression is a serious mental disorder that severely hinders an individual’s daily functioning. According to DSM-5, a patient must experience at least five of the listed symptoms for a minimum of two weeks for a clinical diagnosis.

Depression has become highly over-diagnosed in modern times, as evidenced by a study that found only 38.4% of US patients prescribed antidepressants met DSM criteria for depression. Nevertheless, almost one in four Americans are expected to be diagnosed with depression at some point in their lives and treated with medications that affect their brain function.

Antidepressants were first introduced in the 1950s, with MAOIs being the first class to gain FDA approval. Tricyclic antidepressants followed shortly after and remained the primary treatment option for depression for years. However, their side effects were problematic. In the 1980s, tranquilizer dependence had become a serious issue, leading to the introduction of Prozac, the first SSRI, for depression treatment in 1987.

Prozac’s popularity skyrocketed along with direct-to-consumer advertising that became legal in 1985, leading to a surge in SSRI sales. By 2010, 11% of Americans over the age of 12 were prescribed antidepressants, a 400% increase from 1988 to 2008.

SSRIs are the most commonly prescribed antidepressants in the US. These second-generation antidepressants are marketed as safe and effective with minimal side effects, designated to treat mild to moderate depression, anxiety, obsessive-compulsive disorder, and bulimia nervosa.

SSRIs work by increasing serotonin levels in the brain, a neurotransmitter associated with mood, among other body functions. Low serotonin levels are linked to depression, although the relationship is not entirely clear, and serotonin production in the gut may also play a role.

SSRIs inhibit the reuptake of serotonin, leading to more of the neurotransmitter’s release and increased levels in the brain. The FDA has approved various SSRIs, including Celexa, Lexapro, Prozac, Paxil, Pexeva, Zoloft, and Viibryd. However, SSRIs do not appear to have an effect on those with moderate to severe depression.

Too much serotonin can lead to serotonin syndrome, a potentially life-threatening condition caused by toxic levels of the neurotransmitter. Symptoms include physical symptoms of excessive nerve activity and mental symptoms such as agitation, restlessness, confusion, and anxiety.

SSRIs also have a risk of increasing violent behavior, even in patients with no prior history of aggression. The FDA has mandated a black box warning on all SSRIs to draw attention to the serious and life-threatening risks associated with these medications, including anxiety, agitation, panic attacks, insomnia, irritability, hostility, aggressiveness, impulsivity, akathisia, hypomania, and mania.

SSRIs, or selective serotonin reuptake inhibitors, are the most widely prescribed antidepressants in the US. They are marketed to be safe and effective with relatively mild side effects, and they are used to treat mild to moderate depression, anxiety, obsessive-compulsive disorder, and bulimia nervosa.

The drugs work by increasing the level of serotonin in the brain, a neurotransmitter associated with mood and happiness. However, low levels of serotonin are also linked to depression. While it is unclear whether low levels of serotonin cause depression or vice versa, it is known that SSRIs inhibit the reuptake of serotonin, causing neurons to release more of the neurotransmitter, thereby increasing its level in the brain.

However, SSRIs have been linked to an increased risk of suicide, particularly in patients under 25, and violence against others. One study found that six patients who were given fluoxetine developed a preoccupation with violent suicide within two to seven weeks of starting the medication. The risk of violence against others has been linked to emotional blunting, psychosis, and hallucinations, which have been known to increase the risk of violence.

Some of the SSRIs that have been most consistently and strongly associated with violence include fluoxetine, paroxetine, fluvoxamine, venlafaxine, and desvenlafaxine. During the clinical trials for paroxetine, hostility, including homicidal ideation and aggression, presented in 60 out of 9,219 participants, and hostile acts were documented both while taking the medication and after tapering off.

There is a significant association between violent crime convictions and SSRI use in patients between the ages of 15 and 24, according to a Swedish study. Additionally, the Japanese Ministry of Health, Labour, and Welfare revised the label warnings on SSRIs in 2009 to indicate that there are cases where a causal relationship of hostility, anxiety, and sudden acts of violence with the medication cannot be ruled out.

While the majority of people who suffer from mental illness, including those who self-harm, are not violent and are actually more likely to become victims of violent crimes, after each mass shooting tragedy, psychiatrists often claim that proper treatment could have prevented the tragedy. However, research does not support this notion. Despite the fact that depression does not typically lead to violence, the rise in mass shootings has coincided with the increased prescription of SSRIs, which many mass shooters were either taking or had recently taken. A number of examples highlight this trend, including Joseph Wesbecker, Jarred Viktor, Kurt Danysh, Luke Woodham, Kip Kinkel, Eric Harris, Andrea Yates, Jeff Weise, Steven Kazmierczak, Robert Stewart, James Holmes, Aaron Alexis, and Ivan Lopez. These individuals were taking various antidepressants when they committed violent acts, and evidence suggests that the medication may have played a role in their actions.

The connection between SSRI use and violence continues to be a contentious issue, and it is difficult to obtain information on the mental health diagnoses and medication use of individuals due to patient privacy laws. In 1996, the Health Insurance Portability and Accountability Act (HIPAA) was enacted to regulate the use and disclosure of personal health information (PHI). HIPAA makes it challenging for medical professionals to release details about a person’s medical care, diagnosis, and prescription drugs, including those involved in mental health-related crimes.

For instance, in the 2008 Virginia Tech shooting, Seung Hui Cho had multiple interactions with the mental health department on campus, but his parents and the authorities were not notified due to privacy laws. Furthermore, even after these incidents, the perpetrator’s records are often protected under HIPAA, even in cases where they die during the shooting. This means that the public is often unaware of the type of medications these individuals were taking and whether they may have contributed to their violent actions.

Over the last five years, there have been several public shootings involving murderers who were potentially taking SSRIs. However, due to privacy laws, it is challenging to confirm the medication use of these individuals. Some examples of such shootings include the SunTrust Bank shooting, the Thousand Oaks Nightclub shooting, the Waffle House shooting, the Parkland, Florida school shooting, and the Texas church shooting.

The media’s coverage of mass shootings has led to an increase in legislation that restricts the rights of individuals with mental health issues. However, knee-jerk mental health legislation can be dangerous due to the lack of clear language surrounding mental illness and government red tape. Policies that focus on the violence of mental illness often unfairly target individuals who are unlikely to act violently.

Research shows that substance abuse is more responsible for violence committed by discharged psychiatric patients than their mental health. Patients who do not abuse drugs or alcohol have no higher risk for violence than others without mental health issues in their communities. Despite this, laws are being created based on the fear of guns, rather than focusing on research.

New gun legislation, such as red flag laws, are being proposed without clear definitions of what constitutes a threat. Universal background checks on all gun sales and the FixNICS campaign are also being pushed. The latter aims to strengthen the background check system by adding more records, especially regarding mental health issues and domestic violence.

The lack of such records has led to tragedies like the Sutherland Springs church shooting in 2017, where the gunman was able to pass a background check despite being prohibited from purchasing firearms due to a history of domestic abuse. Gun control is not the solution to mass shootings, as the rate of such incidents has increased despite the implementation of multiple gun control laws. Taking firearms away from law-abiding citizens is not an effective way to stop these tragedies.

Doctors should educate patients about the risks of medication and mental health diagnoses, and patients should take responsibility for their own health by seeking treatment from mental health professionals and improving their lifestyle. However, government red tape and knee-jerk mental health legislation based on fear can be dangerous and lead to increased government control. The FDA and big pharmaceutical companies should be held accountable for not sharing what they know about medications, and drug companies have too much influence over the FDA through lobbying and campaign contributions. The FDA approval process is expensive and laborious, making it difficult for natural supplements to go through the process and claim to treat a condition, even if research supports the claim. The government’s control over federal agencies and the frequency of mass shootings are distractions from the real cause of the nation’s problems, and it’s time for individuals to explore the evidence and come to their own conclusions.

Tim Williamson, a psychology graduate from the University of Hertfordshire, has a keen interest in the fields of mental health, wellness, and lifestyle. 

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