Hard Data on SSRI's and Murder/Suicide
Celia Farber
I have been upbraided a few times for citing only "anecdotal" evidence on the "link" between SSRIs and violence.
May I ask those people who have expressed that, with a genuine spirit of open dialogue, if they find this collection of cases to be something approaching "proof?"
A Swedish journalist has recently uncovered that the Swedish government suppressed something like 80% of the damning data on SSRI's and suicide. There are a growing number of citizen-driven websites where this data is now being assembled. The Internet is a great tool for the liberation of information our governing powers think we can't handle or shouldn't have.
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- Hard Data on SSRI's and Murder/Suicide
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Is 'data' singular or plural?
Strictly speaking, data is the plural of datum, and should be used with a plural verb (like facts). However, there has been a growing tendency to use it as an equivalent to the uncountable noun information, followed by a singular verb. This is now regarded as generally acceptable in American use, and in the context of information technology. The traditional usage is still preferable, at least in Britain, but it may soon become a lost cause. Compare with agenda.
However, Chris, if you meant that anecdotal information doesn't convert to "data" at all, then I would answer that it doesn't equal scientific data perhaps but it does amount to knowledge. This is why I asked for you guys, who are more skeptical, to tell me what you think those facts, those cases, amount to. I am willing to keep learning. How to process and file information is a major part of being human.
One would expect that people who commit this sort of crime have mental health issues, and one would also expect a fairly large incidence of people with mental health issues to be taking some sort of medication for those issues. That there would be some correlation for these two things is unsurprising.
Further, a quick glance at your link shows that some incidences are after taking more medication, some are while on a stable dose, and some are after quiting the medication. This doesn't support a theory that the medication causes the incidents.
Over all, this reminds me of the recent NY Times story listing several horrible anecdotes about veterns who had killed themselves or someone else along with the raw numbers of how many times it had happened. What was missing was the context that the murder and suicide rate for this group wasn't all that different from a similar group of non-veterns.
The internet may be a great tool for the liberation of information, but it isn't necessarily a great tool for establishing rigorous methodology to ensure that information is accurate.
Look, one thing I meant to say last time but didn't; you've said that these days everybody is taking some kind of mind-altering medication like an SSRI. If that were literally true (and I'm not saying you think it is, but let's roll with it) then everyone committing any kind of crime would be on such a medication. Just like probably everyone committing a crime has probably ridden in a motor vehicle in the last week, because almost everyone in modern society is likely to have done so.
Now, of course in reality it's not literally true. A large percentage of the population may be on these drugs, but not everyone. Unless you think that the medications are prescribed totally at random and are equally as likely to be given to a mentally healthy person as to a disturbed one, then of course the percentage of the population taking such drugs is going to overlap a lot with whatever percentage of the population has mental issues in the first place. Given that, it'd almost be surprising if the population using these medications *didn't* substantially overlap with those sick enough to commit random acts of violence.
I'm a skeptic about this because I know how easy it is to see causation when there's only correlation (I'd mention another example prominent in the media right now but I bet it'd just start another argument) but I certainly don't think it's impossible and I agree it should be studied. I just don't find anecdotes convincing because you can "prove" anything that way.
I don't want to wait until this can be "proven" to become alarmed. Don't we wish somebody in Europe had assembled "anecdotal" cases of babies born with missing limbs and sounded the alarm about Thalidomide before it could be "proven?"
In other words, saying that they can cause dangerous behavior would have been entirely uncontroversial.
We've gotten increasingly liberal in our use of these drugs, and it should not surprise us at all if we therefore see an increase in negative instances and negative reactions.
I'll just go ahead and go public and mention that I take an SSRI. I'm very glad I do as the difference it makes in my daily life is very positive. On the other hand when I mixed it with alcohol it was extremely negative, which is part of why I don't drink anymore.
So what's the argument about, folks? The scientists and drug companies who put these out there state quite clearly that there's an increased risk here. Pick up a Physician's Desk Reference and it's right in there as one of the possible side effects of the drug: increased risk of suicide and other erratic behavior.
HankB
The question with the psychodrugs should be: does the good they do, when prescribed in accordance with some set of criteria, outweigh the harm? In addition to problems of data collection and analysis, answering this question involves value judgments. If the lives of 100 people are made marginally happier, at the cost of one life being totally destroyed, is this good or bad? If the 1000 people are made *much* happier, and 100 suicides are prevented, at the cost of 10 murders that otherwise would not have happened, is this good or bad?
My sense is that these drugs are justified in some circumstances, but that the bar for prescribing them is generally set too low.
David Foster
As one who takes an anti-depressant for clinical depression and anxiety matters, I know full well the drug helps me function like a normal human being. As a result, I find it quite disturbing an emotion-fueled campaign may well discourage or prevent others from getting medical treatment they need. I mean, it really bothers me. I like to think of myself as a dispassionate observer on policy matters, but I'm biting my lip as I write this. If a simple drug can correct chemical imbalances in the brain, and bring hope to people who would otherwise be lost in the gloomy darkness, why wouldn't we prescribe these drugs?
To me, blaming anti-depressants for suicide is an easy answer to the hardest of problems: why a person took his own life. It would not surprise me if, looking through the case histories of these patients, that there were other things that should have been done, and things that should not have been done. Perhaps the anti-depressants should have been combined with therapy, or hospitalization in extreme cases; perhaps the pharmacological treatment was too fast and too varied. But just because only one tool in the shed was used does not mean you automatically blame the tool for its improper or ineffective use.
That is not to make light of the tragedies these families have suffered -- God only knows what they have been through and will go through in the years to come. But I myself was once tempted to find a long-term solution to a short-term problem, and I can't in good conscience let a campaign against the medicines that saved my life go unchallenged.
Research Article
Do SSRIs cause suicide in children? The evidence is underwhelming
John Michael Bostwick *
Mayo Clinic
email: John Michael Bostwick (bostwick.john@mayo.edu)
*Correspondence to John Michael Bostwick, Mayo Clinic, 200 First Street SW, Rochester, MN 55905
Abstract
After regulatory agencies in the United Kingdom and United States recommended severe restrictions on antidepressant use in children, many lessons were learned, although one was not that these drugs cause suicide. We learned that pharmaceutical companies selectively released data that reflected positively on their products and that combining suppressed and published data suggested that most of these medications had questionable efficacy. We also learned that the studies lacked uniformity both in which age groups constituted children and which behavior was considered suicidal. Several recent, large nonindustry studies indicated that rates of suicide and suicidal behavior were actually reduced in children who used antidepressants, despite piteous anecdotal tales in the popular press purporting that selective serotonin reuptake inhibitors (SSRIs) caused children to kill themselves. Patients in pharmaceutical trials probably do not represent typical patients in routine clinical practice. Emerging implications are that suicidal behavior - if it does occur - is most likely soon after starting antidepressant use and that prescribers must be both vigilant in educating patients and families about warning signs and available to manage worrisome behavior.
If happy people start taking an SSRI and then kill themselves, I would pay more attention.
Of course we all lose our tempers now and then. Dean freely admits to being imperfect in this regard, which is why regulars to this establishment will generally be cut more slack than people who we don't know very well.
Still: behave like an adult, or go find somewhere else to play. Thanks.