Fluoxetine and Violence

[copenhagen]

In light of the recent shootings in Illinois which I am quite sure the anti's will try to blame on guns, I submit the following as taken from Wikipedia:

http://en.wikipedia.org/wiki/Fluoxetine

Fluoxetine and violence

"In 1989, Joseph Wesbecker shot dead eight people and injured 12 others before killing himself at his place of work in Kentucky. Wesbecker had been taking the selective serotonin reuptake inhibitor (SSRI) antidepressant fluoxetine for four weeks before these homicides, and this led to a legal action against the makers of fluoxetine, Eli Lilly [44]. The case was tried and settled in 1994, and as part of the settlement a number of pharmaceutical company documents about drug-induced activation were released into the public domain. Subsequent legal cases...have further raised the possibility of a link between antidepressant use and violence." [45]

I watched the interview of Steve Kazmierczak's girlfriend, and she said that the only drug he had been on recently was Fluoxetine, or Prozac. This interview is available on CNN at:

http://www.cnn.com/video/#/video/us/2008/02/18/bts.niu.shooter.girlfriend.cnn

Now, I would also like to point out this quote from Wikipedia as well:

The signs of violence and suicidality have existed since Prozac was tested in premarketing trials. In May 1984, Germany’s regulatory agency (Bundesgesundheitsamt, BGA) rejected Prozac as “totally unsuitable for treating depression.” In July 1985, Eli Lilly’s own data analysis—from a pool of 1,427 patients—showed high incidence of adverse drug effects and evidence of drug-induced violence in some patients. (Eli Lilly internal analysis submitted to the Joachim Wernicke (July 2, 1985)

Being as it seems from reading about Steve that violence was totally out of his character, and being as he was taking a drug which the manufacturers knew could cause violence yet continued to pedal to the public, I ask you, who really is the villain here? Guns? Steve? Parenting? Or...... Prozac? It isn't like tobacco... people get prescribed Prozac by a doctor and are told that it will help them!

It makes me wonder why the media is not digging here and pointing out the evils of these drugs which are sometimes almost being forced down people's throats who were probably just going through some hard times and would have been fine with out the drug . . . in my humble opinion.

 

[copenhagen]

Anonymous

I received this PM from a member of The Firing Line who wishes to remain anonymous. He/she requested that I repost, and it provides some interesting first hand experience, so here goes:

Original PM:

I'd like to reply anonymously to this. Care to handle it? I can PM it to you and you can post it to your thread as a post from a member who wishes to remain anonymous.

Next PM:

OK, here we go.

I have headaches. Constant headaches. Debilitating headaches. I have lived with a headache 24/7-365 days a year ranging from slightly annoying to to full-blown Migraines. 23 or so years ago, after finding nothing wrong with me, my Dr.s put me on Prozac and a few other meds (beta blockers etc) to try to control them. This DID reduce the headaches INTENSITY to a "livable" level but did not make them go away. At least the frequency of the Migraine level ones was reduced. When I first started taking Prozac, the only "Prozac like" effect was that when I got angry, I got over it quicker. There was no depression at the time.

Fast forward 22 years. My new doc (had him for 4 years now) wants to get me off of some of the meds I take and Prozac is one of them. Turns out that I now need them as I do get REAL depressed when I am not taking it and I had been slightly depressed as of late even on Prozac. After talking to my doc, we transitioned me off the Prozac on to Cymbalta and all is good.

Did I get "hooked" on Prozac? Maybe. Am I, or have I ever been suicidal? NO. Could I ever be? God I hope not. My wife and a friend and coworker know about this and I have asked them to let me/my wife know if I ever start getting "funny" in any way. I can't take a chance that it won't EVER happen. Am I OK now? Hell, I'm probably better than most folks... but I am taking my meds.

 

[copenhagen]

Update from same member:

Thanks. I figured a little personal experience at the start might be a good thing. None of that Friend of a Friend BS. It also shows, I hope, that there are responsible ways to take meds that MAY have these kind of effects.

Thanks for letting me post without endangering my privacy.

 

[Perldog007]

I think the mood altering drug connection goes back to patrick purdy, kip kingle, and others, kleibold and harris too.

The media doesn't like to talk about that, it's easier to fit these tragedies into their anti-gun agenda.

 

[homefires]

The school wanted to put one of my kids on Ridilan. And was told to piss off. People think the schools are the supream athority and that is the way it is.

When will they learn that the Government on any level is not what is best for you and your family?

 

[chris in va]

No, actually it's not Prozac that causes erratic behavior, it's abruptly coming OFF it that does. True for many antidepressants. And I live with a depressed person, so I know.

You have to be slowly weaned off the stuff, some meds more than others. Very scary when people don't take them like they should.

Frankly I'm not convinced many people need to be on these things. Some have been taking various meds so long there is no more 'baseline' control to find out exactly what they are like without them.

 

[HarrySchell]

I have lived with a depressed person for some time.

Coming off meds suddenly unbalances the mind. It may seem like a reasonable idea, but it isn't. Reactions can run the gamut, I understand, but in my experience have been limited to nausea, dislocation and deep unhappiness, without suicidal or homicidal impulses. If you have an overriding respect and love for others, even just a few, it seems that suicide/homicide are not viable paths, even when the person doesn't know what the viable path is. It does seem to help that the person has some connection with religious faith that supports individual value and forgiveness of errors (which we all make). A good cry and sleep can help.

I dunno what happened at NIU. The human mind is far too complex for exact characterization, and those who think they know it all have simply stopped learning and started working on a self-approval rating that regularly exceeds 100%

I am confident however that the guns involved did not destroy themselves. They ceased to take lives when the operator stepped out of the picture.

The desire to assign blame to inanimate objects is a human problem, and enables one to deny all sorts of human and social policy failings. It is so easy...and humans like easy.

All I think I can say is stuff like this is not easy, never will be. And the easy, utopian images of a solution do not mitigate the problem. They for sure cannot solve the problem of random violence. I think the question is how to mitigate the damage of the deranged among us.

It is not through disarmament and hope, or treating the sane as if they are insane (but just haven't got there yet), as gun bans do.

Prayers are important, but bad stuff will continue, evil will come knocking. The question is whether evil does as he wishes or someone sends evil back to the hell from whence he came, mitigating the damage.

 

[uncballzer]

Coincidence or what? I just had a test on this drug this morning. Here's what the pharmacologist had taught us:

First, the SSRI (of which fluoxetine is) is the first choice as an anti-depressant. Before I get into the other stuff with it, to treat depression can expose a manic episode in the person (such as our anonymous person that wrote in) but this is because the person has underlying bipolar (alternating depression and manic episodes) that is "unmasked" by the anti-depressant.
SSRI are not general stimulants (in the sense that a normal person taking it will not get excited), but they do elevate the mood in depressed after 2-3 weeks (and it could be longer, as in the case from your first post who had been on it only 4 weeks). This is Prozac's general use. Now the side effects are many, BUT, the SSRI are the best drugs we have currently to treat depression, and this is true because the side effects of the other/older drugs are much worse (at least in terms of cardiotoxicity and other very very dangerous, life-threatening events.) The MOST COMMON side effects (SE for short) are nausea, diarrhea, and headache. Fluoxetine may stimulate anxiety and motor restlessness (may be accompanied by insomnia). Other less common SE: sexual dysfunction, dizziness, tremor, rash, hyponatremia (low sodium). Some of the other SSRI drugs are associated with birth defects and paroxetine has been noted to increase suicide risk in adults. Now the SSRI doesn't have the cardio SE of the older drugs, but they may cause platelet dysfunction and increase the risk of GI bleeding; lastly they may increase osteoporosis risk in elderly or women.

Now, this is the hard part. If you're on prozac/fluoxetine, or any of these other drugs, you are very very very likely to be on something else. It's the drug interactions that can really cause problems. This is why it's very important to tell your doctor if you're taking anything else, INCLUDING herbals, OTC drugs, etc. Fluoxetine may increase, or decrease the levels of lithium. Lithium is the gold standard treatment right now for mania, the other half of bipolar disorder. Valproate is another drug that works just as well as Lithium, and it is gaining ground in the use of manics. Other interactions are with other drugs that increase/decrease serotonin--tricyclic antidepressants, monoamine oxidase inhibitors, meperidine (an opioid like morphine). This could cause something called Serotonin syndrome, which can be fatal--mental status changes, motor activity disorders and autonomic disturbances (part of the nervous system that is the other half of the "fight or flight" system).

One last thing and I'll shut up. Fluoxetine has a very long half-life in the blood. It is true that you can get withdrawal symptoms from these drugs, but this is very unlikely to not noticeable with fluoxetine because it stays in the system for 2-3 weeks before it is completely eliminated, creating a more gentle withdrawal than say Zoloft.

Oh, be careful with St. John's wort--it has some of the serotonin increasing activity, so it can interact. Definitely tell your doc if you're taking this one.

I hope this helps clarify some things about these drugs. Sorry if there's some things that may be difficult to understand in it, don't have a lot of time and there's too much to break everything down.

 

[copenhagen]

Anonymous Response

"Please post this response to uncballzer sir.

Thanks

Quote:
First, the SSRI (of which fluoxetine is) is the first choice as an anti-depressant. Before I get into the other stuff with it, to treat depression can expose a manic episode in the person (such as our anonymous person that wrote in) but this is because the person has underlying bipolar (alternating depression and manic episodes) that is "unmasked" by the anti-depressant.

I haven't had any manic events. I don't believe that getting angry and getting over it quicker once I started the Prozac is evidence of a manic event either. I have very recently had a psychological screening pro-op and passed with flying colors. Nothing was diagnosed and I was 100% honest with the Dr. doing the evaluation. I AM a type "A", "take charge" individual and am obsessive to a degree but not enough to matter according to the Doc as it does not negatively affect my life. In fact, it is a desired trait in my job!

Again, just observations from one who is there and has not "gone nuts" from either taking or NOT taking Prozac. I DID get depressed and I recognized that and took actions to deal with it. I see my Dr. no less than once every 2 months, not for depression but for other major health issues. In short, I keep my doctor, wife and close friends and even my boss at work informed and I take the responsibility to look out for and after myself."

 

[9mmHP]

Obviously, there are a range of effects possible depending on the individual, their particular dysfunction, other drugs they are taking, etc. Which leads us back to, if we can't predict and can't stop them going beserk, at least let us have the means to stop them after they do.