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SSRIs May Be Associated With Increased Risk of Violent Crimes

Authors report 43% increase risk of violent crime in 15- to 24-year-olds

Young people taking antidepressants such as Prozac and Paxil are significantly more likely to commit violent crimes when they are on the medications, but taking higher doses of the drugs appears to reduce that risk, scientists have reported in PLoS Medicine.

The authors say that while their finding of a link does not prove that such drugs cause people to be more violent, further studies should be conducted, and extra warnings may be needed in the future when antidepressants are prescribed to people 15 to 24 years of age.

As Reuter notes, selective serotonin re-uptake inhibitors (SSRIs) are a class of widely prescribed drugs, including fluoxetine (Prozac, Eli Lilly) and paroxetine (Paxil, GlaxoSmithKline), which are designed to ease the symptoms of anxiety and depression.

In the new report, researchers led by Dr. Seena Fazel of Oxford University in the United Kingdom used a unique study design that aimed to avoid confounding factors by comparing the same individuals' behavior while they were on and while they were off medication.

"The point of the design is that we're comparing people with themselves," Fazel told reporters at a briefing, adding that this helped minimize the impact of genetics or lifestyle factors.

Using matched data from Sweden's prescribed drug register and its national crime register over a three-year period, the investigators found that about 850,000 people were prescribed SSRIs, and that 1.0 percent of these individuals were convicted of a violent crime.

While in most age groups the likelihood of criminal violence was not significantly different when people were taking SSRIs and when they were not, in 15- to 24-year-olds there was an increase of 43 percent in their risk of committing a violent crime while on the medication.

The results also found a higher risk of young people being involved in violent arrests, in nonviolent convictions and arrests, in nonfatal injuries, and in having alcohol problems when they were taking antidepressants. Paradoxically, those who took lower doses had a higher risk of being violent.

According to Fazel, the findings raise important questions and should be investigated further before any changes can be recommended with regard to prescribing SSRIs. Fazel said it was possible that young people taking lower doses of antidepressants were not being "fully treated" for their mental disorder, leaving them more likely to engage in impulsive behavior. He added, however, that if the results are confirmed in further studies, "warnings about the increased risk of violent behavior among young people taking SSRIs might be needed."

Sources: Reuters; September 15, 2015; and PLoS Medicine; September 15, 2015

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