Do Antidepressants Really Increase Violent Behavior Among Patients?

New research suggests that teenagers on antidepressants may be nearly twice as likely to commit or be arrested for violent crimes than their counterparts, so what is going on here? Is it the antidepressants themselves or is there another problem?

The research, which was conducted by a team at Oxford University and published in PLoS Medicine this month, cites that even though what are known as SSRIs, or selective serotonin reuptake inhibitors, are being prescribed with growing frequency across much of the West, their link to a potential increase in violent behavior isn’t yet well understood. As such, the researchers wanted to look at whether a large cohort study would reflect a rise in violence and if so who might be most vulnerable.

To do this, the researchers did something that hadn’t been tried on this scale before: They compared people’s behavior while both on and off the medication, thereby trying to limit any potential issues of other factors affecting the result. So, they looked at health data from around 850,000 people from Sweden aged 15 and above. These people were all on Sweden’s drug registry as having been prescribed SSRIs. The researchers then compared that to incidents of violent crime from Sweden’s criminal data logs, specifically looking at whether the patients were convicted for a violent episode, and if so whether they were on medication at the time or were at that time drug-free.

Overall the figures weren’t that staggering. Over a three year period, around one percent of the total sample of people were convicted for a violent crime which isn’t out of the ordinary for a sample of that size. However, when the researchers looked more closely at how that broke down by age, something more interesting emerged. While for most age groups there was no significant rise above the norm when people were taking SSRIs, among young people aged 15 to 24 the likelihood of committing a violent crime if those teenagers were taking SSRIs went up by 43 percent. In addition, the researchers were able to identify a few other troubling increases: Young adults in this age bracket who were prescribed SSRIs were also more likely to have non-violent convictions and arrests, suffer more injuries and have alcohol related run-ins with the law, when compared to their counterparts.

What was even more interesting was that when the researchers examined dosages for this group, it appeared that those on a lower dose were more likely to have committed or been arrested for a violent crime than others. Why that might be isn’t clear, and the researchers stress that before any recommendations are changed over prescribing SSRIs this research must be replicated and expanded so we can be sure of the analysis. However, based on the strength of the study, the way in which it attempted to limit other factors from interfering with the data, and how these findings sit with what we already know about some of the side-effects of antidepressants (namely a rise in suicidal ideation), it’s worth taking this study seriously.

Professor Seena Fazel, a co-author on this study, is warning though that this research shouldn’t mean people should stop taking their medication:

“Adherence is important. If you are recommended to take this medication, follow the course of treatment. The other thing is, this important association with higher alcohol problems. I think that is something people should be aware of, that there is this link with alcohol misuse.”

What Professor Fazel seems to be suggesting there is that if young people in particular are also drinking–and quite heavily–while on antidepressants, there might be an as yet largely unexplored issue where that leads to an increased risk of violent behavior. That is something future research will now need to determine.

This isn’t actually the first time that antidepressants have been linked to a potential rise in violent behavior. Studies, such as the Safe Medication Practices study from 2010, have shown that there appears to be a higher risk of violent behavior among people who take antidepressants.

You may have already guessed why this topic is controversial however. Some scientists have argued that people taking antidepressants are themselves more prone to violent outbursts by the nature of their illnesses and so such figures might not be that surprising. Mental health charities have complained this is stigmatizing and isn’t accurate: The vast majority of people who take antidepressants will do so without ever having a violent episode while on their medication.

Even more controversially, some drug campaigners and even members of the public who have launched lawsuits (most famously over Prozac’s effects) have attempted to get big pharmaceutical companies to admit that certain antidepressants may actually lead people toward violent behavior even when they have no prior history of aggression, and that this fact was not made clear when the drugs went onto the market.

As above, this remains controversial and this research can’t give us concrete answers in that regard. Yet, this study certainly points toward a need for health regulators to investigate more closely whether there are potential side effects that are not being disclosed or at least not being properly emphasized to young adult patients given SSRI medications, and it does raise questions about safeguarding against over-prescription of SSRIs which is still a common problem in much of the West.

Photo credit: Thinkstock.

63 comments

Danuta W
Danuta W12 days ago

Thank you for sharing

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Chrissie R
Chrissie R12 days ago

There are many aspects of this "study" that are not considered and it's seriously flawed.

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Sue H
Sue H12 days ago

Thanks for this information.

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Lisa M
Lisa M13 days ago

Noted.

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Lisa M
Lisa M13 days ago

Noted.

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Lisa M
Lisa M13 days ago

Noted.

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Lisa M
Lisa M13 days ago

Noted.

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Lisa M
Lisa M13 days ago

Noted.

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Lisa M
Lisa M13 days ago

Noted.

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Siyus Copetallus
Siyus Copetallus2 years ago

Thank you for sharing.

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