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)