Antidepressants increase the risk of suicide, violence and homicide at all... https://www.bmj.com/content/358/bmj.

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Feature Medicine and the Media

Antidepressants and murder: case not closed

BMJ 2017; 358 doi: https://doi.org/10.1136/bmj.j3697 (Published 02 August 2017) Cite this as: BMJ
2017;358:j3697

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Antidepressants increase the risk of suicide, violence and

homicide at all ages
The FDA admitted in 2007 that SSRIs can cause madness at all ages and that the drugs are very dangerous;
otherwise daily monitoring wouldn’t be needed: “Families and caregivers of patients should be advised to look for
the emergence of such symptoms on a day-to-day basis, since changes may be abrupt” ... “All patients being
treated with antidepressants for any indication should be monitored appropriately and observed closely for clinical
worsening, suicidality, and unusual changes in behavior, especially during the initial few months of a course of
drug therapy, or at times of dose changes, either increases or decreases. The following symptoms, anxiety,
agitation, panic attacks, insomnia, irritability, hostility, aggressiveness, impulsivity, akathisia (psychomotor
restlessness), hypomania, and mania, have been reported in adult and pediatric patients being treated with
antidepressants” (1).

Such daily monitoring is, however, a fake fix. People cannot be monitored every minute and many have
committed SSRI-induced suicide or homicide within a few hours after everyone thought they were perfectly okay.

As the published trial literature related to suicidality and aggression on antidepressants is unreliable, we looked at
64,381 pages of clinical study reports (70 trials) we got from the European Medicines Agency. We showed for the
first time that SSRIs in comparison with placebo increase aggression in children and adolescents, odds ratio 2.79
(95% CI 1.62 to 4.81) (2). This is an important finding considering the many school shootings where the killers
were on SSRIs.

In a systematic review of placebo-controlled trials in adult healthy volunteers, we showed that antidepressants
double the occurrence of events that the FDA has defined as possible precursors to suicide and violence, odds
ratio 1.85 (95% CI 1.11 to 3.08)(3). The number needed to treat to harm one healthy adult person was only 16
(95% CI 8 to 100).

Based on the clinical study reports, we showed that adverse effects that increase the risk of suicide and violence
were 4-5 times more common with duloxetine than with placebo in trials in middle-aged women with stress
urinary incontinence (4). There were also more women on duloxetine who experienced a core or potential
psychotic event, relative risk RR 2.25 (95% CI 1.06 to 4.81). The number needed to harm was only seven. It

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Antidepressants increase the risk of suicide, violence and homicide at all... https://www.bmj.com/content/358/bmj.j3697/rr-4

would have been quite impossible to demonstrate how dangerous duloxetine is, if we had only had access to
published research. In accordance with our findings, the FDA has previously announced that women who were
treated with duloxetine for incontinence in the open-label extension phase of the clinical studies had 2.6 times
more suicide attempts than other women of the same age (5).

Looking at precursor events to suicide and violence is just like looking at prognostic factors for heart disease. We
say that increased cholesterol, smoking and inactivity increase the risk of heart attacks and heart deaths and
therefore recommend people to do something about it. Psychiatric leaders, however, routinely try to get away with
untenable arguments. Many say, for example, that antidepressants can be given safely to children arguing that
there were no more suicides in the trials, only more suicidal events, as if there was no relation between the two,
although we all know that a suicide starts with suicidal thoughts, followed by preparations and one or more
attempts. The same can be said about homicide. It can no longer be doubted that antidepressants are dangerous
and can cause suicide and homicide at any age (5-7). It is absurd to use drugs for depression that increase the
risk of suicide and homicide when we know that cognitive behavioural therapy can halve the risk of suicide in
patients who have been admitted after a suicide attempt (8) and when psychotherapy does not increase the risk
of murder.

References

1. FDA. Antidepressant use in children, adolescents, and adults. http://wayback.archive-it.org

/7993/20170111122946/http://www.fda.gov/Dru...
2. Sharma T, Guski LS, Freund N, Gøtzsche PC. Suicidality and aggression during antidepressant treatment:
systematic review and meta-analyses based on clinical study reports. BMJ 2016;352:i65.
3. Bielefeldt AØ, Danborg PB, Gøtzsche PC. Precursors to suicidality and violence on antidepressants:
systematic review of trials in adult healthy volunteers. J R Soc Med 2016;109:381-392.
4. Maund E, Guski LS, Gøtzsche PC. Considering benefits and harms of duloxetine for treatment of stress urinary
incontinence: a meta-analysis of clinical study reports. CMAJ 2017;189:E194-203.
5. Gøtzsche PC. Deadly psychiatry and organised denial. Copenhagen: People’s Press; 2015.
6. Healy D. Let them eat Prozac. New York: New York University Press; 2004.
7. Breggin P. Medication madness. New York: St. Martin’s Griffin; 2008.
8. Gøtzsche PC, Gøtzsche PK. Cognitive behavioural therapy halves the risk of repeated suicide attempts:
systematic review. J R Soc Med 2017 (in press).

Competing interests: No competing interests

03 September 2017
Peter C Gøtzsche
Professor
Nordic Cochrane Centre
Copenhagen

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