The media is now reporting details about the 18-year-old who shot and killed nine and wounded many others before killing himself on July 22 in Munich. My clinical and forensic experience leads to a distinction among people who murder under the influence of psychiatric drugs. Those who kill only one or two people, or close family members, often have little or no history of mental disturbance and violent tendencies. The drug itself seems like the sole cause of the violent outburst. On the other hand, most of those who commit mass violence while taking psychiatric drugs often have a long history of mental disturbance and sometimes violence. For these people, the mental health system seems to have provoked increasing violence without recognizing the danger.
The strongest evidence we have as to whether a drug causes a problem does not come from RCTs or any other controlled study but rather from good clinical accounts. Even if RCTs were done by angels, so there was no hiding, no miscoding, nothing untoward, RCTs can still hide adverse events. The onus is on large and powerful corporations who have a lot of resources to pinpoint the populations where the benefit is likely to exceed the risk, if they want to continue to make money out of vulnerable people.
One of psychiatry's most obvious vulnerabilities is the fact that various so-called antidepressant drugs induce homicidal and suicidal feelings and actions in some people, especially late adolescents and young adults. This fact is not in dispute, but psychiatry routinely downplays the risk, and insists that the benefits of these drugs outweigh any risks of actual violence that might exist.