Violence Induced by Depression, or by Antidepressants?

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In The Lancet Psychiatry, David Menkes of the University of Auckland and Andrew Herxheimer of the UK Cochrane Centre argue that a recent headline-making Lancet study linking depression to acts of violence should have examined antidepressant medications — rather than depression alone — as possible causes.

An analysis of the study posted on The Mental Elf was previously reported by Mad in America.

“The authors downplay the possible contribution of antidepressant medicines, dismissing their link with violence as merely anecdotal,” write Menkes and Herxheimer. “However, in addition to several case reports, some with challenge–dechallenge–rechallenge causality assessments, antidepressants have been shown to increase the rate of hostility events compared with placebo in clinical trials. This effect has also been noted in other disorders that are not usually associated with serious violence (eg, anxiety, obsessive–compulsive disorder), and even in healthy volunteers.”

The authors of the original study, led by Seena Fazel, respond, “This argument might or might not be true. Our study did not investigate the effects of treatment, which need careful modelling of large datasets with advanced statistical approaches to avoid different types of biases and misinterpretations. Meaningful research needs numbers, not just words.”

Menkes, David B, and Andrew Herxheimer. “Depression and Violence—what Do We Really Know?” The Lancet Psychiatry 2, no. 6 (June 2015): 491–92. doi:10.1016/S2215-0366(15)00166-2. (Full text)

Fazel, Seena, Guy M Goodwin, and Paul Lichtenstein. “Depression and Violence—what Do We Really Know? – Authors’ Reply.” The Lancet Psychiatry 2, no. 6 (n.d.): 492. Accessed May 30, 2015. doi:10.1016/S2215-0366(15)00225-4. (Full text)

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9 COMMENTS

  1. Depression and violence linked? Yes it’s the medication. More correctly, the medication cocktails because everyone knows you never just get one drug to take (except maybe early on into the indoctrination process).
    As political policy aims to widen the wrong belief that all mentally ill are violent people there is a need to fight back with information that shows the truth.

  2. The interpersonal violence triggered by ssri’s and similar drugs is bad enough, but the REAL nightmare scenario is when somebody with access to nuclear weapons goes berserk on them. It’s only a matter of time. (It’s a comforting fiction that only the president can launch U.S. nukes. In fact, many, many U.S. service personnel, and even military personnel of allied countries from Norway to Turkey have access to American nuclear bombs, and can launch them in a crisis without a presidential directive.)

  3. I know I’m a bit late to this.

    But scientific academia and medicine should seriously look into this.

    If I remember correctly, 2012 Aurora shooter Holmes had been medicated without professional medical supervision.

    Also, the Germanwings crash, the co-pilot went through 7 doctors a month before the mass death. Imagine the number of medication he might’ve been through.

    Everyone seems to think that these people are crazy, our family and friends may think we are crazy… but the truth is, we’ve been on p-meds all along… Why do they still stigmatize us?

  4. They almost never control for the effect of drugs. It’s like taking a group of black people, feeding them meth and then running a study comparing them to white people not taking drugs. And then claiming there’s a link between paranoia and aggression and ethnicity. If they did that there would be world wide outcry about racial bias and they would all be kicked out of their positions. But you can run similarly idiotic “studies” on “mentally ill” and be treated like a real scientist. What a joke.

  5. Btw, the authors’ response is golden:

    “David Menkes and Andrew Herxheimer postulate that a possible explanation for the increased risk of violent crime in our study is the use of antidepressants (by which we assume they mean SSRI antidepressants), on the basis of some case reports. This argument might or might not be true. Our study did not investigate the effects of treatment, which need careful modelling of large datasets with advanced statistical approaches to avoid different types of biases and misinterpretations. Meaningful research needs numbers, not just words.”

    Oh, so doing a properly controlled study actually requires some effort and proper statistics? Too bad, that apparently what the authors are into.

    Plus it’s nice that they’re worried about biases and misinterpretations when linking anti-depressants to violence but they’re a-OK linking depressed people to violence with a poorly controlled study. Of course one would not want to harm corporate bottomline but if some random crazy people get stigmatized or locked up and their lives are destroyed because of that… well, who cares about them anyway.

    “SF has received one speaker’s fee from Janssen outside of the submitted work, which was donated to charity. GMG reports grants and personal fees from Servier, Cephalon/Teva, Lundbeck/Otsuka, Takeda, Merck, Eli Lilly, Sunovion, Convergence, AstraZeneca, GSK, and Medscape outside of the submitted work. PL declares no competing interests.”

    I’m sure that have nothing to do with the way the study was conducted and analyzed.