This is speculation, but we may wish to consider whether the bizarre and violent behavior of the Virginia Tech killer was induced in part by an antidepressant.
From the Mother Jones blog:
The Times reported that Cho Seung-Hui was taking a psychoactive medication. Was it an antidepressant? No doubt antidepressants save many lives, but they also cause side effects. Psychiatrists know that in a percentage of patients, they trigger mania, exacerbate delusional thinking, and agitate suicidal ideation.
Our brains are remarkably complex electrochemical machines which develop organically, sometimes in ideosynchratic ways. We differ genetically, and on a basic level, this means that one person may have more dopamine receptors than another.
Such a difference gets built into our personalities in complex ways through neurochemical and cognitive feedback loops. This is why people react differently to stimuli, and in particular, why they react differently to drugs. Drugs which work okay for some people can have very negative side effects for others.
In the past year or so, a red flag has been raised regarding the bizarre and self-destructive behavior of some young people taking the antiviral medication Tamiflu.
Over a somewhat longer period of time, concern has been brewing over the possibility that the antidepressants known as SSRIs can cause suicidal ideation (and worse) in some people.
An article by Fred Gardener in Counterpunch explores this issue.
In February, 1990 psychiatrists Martin Teicher and Jonathan Cole and nurse Carol Glod published "Emergence of intense suicidal preoccupations during fluoxetine treatment" American Journal of Psychiatry, It described six patients who developed "intense, violent suicidal preoccupations" within two to seven weeks of starting treatment with Prozac. The authors estimated that between 1.9 and 7.7 percent of Prozac users would develop suicidal obsessions. Teicher and his co-workers subsequently reported that Prozac patients were "at least three-fold more likely to develop new suicidal ideation" than patients treated with the older antidepressants, and that patients were also more likely to develop suicidal thoughts for the first time ever while taking Prozac.
According to the Counterpunch article, in 2004, the British Medical Journal had a report saying that GlaxoSmithKline had concealed data which showed that teenagers taking Paxil had a quadrupled rate of suicidal ideation.
But it's not just suicidal tendencies, it's also hostility.
In 1989, Joseph Wesbecker shot 20 people, killing 8, before shooting himself. He had been taking Prozac for four weeks.
In 2001, a jury in Wyoming found SmithKline Beecham (now GSK) liable for the deaths caused by a patient taking an SSRI.
Schell, 60, had been taking Paxil for just 48 hours when he shot and killed his wife, his daughter, his granddaughter and himself.
Last September, David Healy (a noted critic of SSRI's) and others published an article in Public Library of Science Medicine titled Antidepressants and Violence: Problems at the Interface of Medicine and Law. They found evidence for increased hostility in people who take Paxil.
Let's return to the Counterpunch article, because it makes the feelings some people have when they are on SSRI's:
"Suicidal ideation," "Suicide gesture," "Suicide attempt," and other such terms do not accurately characterize the extremely bizarre flip-outs induced by SSRIs. Carefully planning to annihilate the student body fits the profile. Biting your mother 57 times. Driving your car around in circles until you smash into a tree...
One person who had troubles with Prozac said:
"It's hard for people to understand. They say 'you must know what you're doing,' but you do not. You cannot distinguish reality. I could never tell if I was awake or asleep. That was the hardest thing for me to determine. I would lay down in bed and I would think 'Now am I dreaming this or am I awake and doing this?" My mind constantly ran, it never would stop.
I could be having this conversation with you and the whole time if I was drinking coffee, I could be thinking about running it on my hand and wondering what it would feel like.
Thinking irrational thoughts. And yet still able to communicate at what would appear to be a rational level. ... [B]eing able to come to you and say 'I'm fine.' But the whole time they might be thinking 'I wonder what it would feel like to stick this knife in my hand?' And, 'I can take on a motorcycyle gang and kill 'em all.'
It's important to take this in a balanced fashion. The majority of people who take SSRI's don't exhibit these kinds of symptoms. But the link may be there, and we should think about what that means.
There's been a lot of talk about warning signs with that Seung Hui Cho displayed, and consideration of whether or not the school could have done better monitoring or intervention. I'll ask this: after Cho was given his prescription, was he monitored by anyone at that point for hostile or suicidal behavior?
Taking a larger perspective on drugs and ourselves, a 2006 study by University of California found that one-quarter of its students arrived on campus already taking anti-depressants, lithium or other psychoactive drugs. I, the author of this diary, am among this group. But I know that drugs aren't a complete answer. They are probably over-prescribed. And giving a person a prescription to mind-altering substances is not a solution unless you also give them other support.