SSRI Antidepressants Associated With Increase in Violent Crime in Some People

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Stockholm, Sweden: Scientists have actually discovered that some individuals being treated with selective serotonin reuptake inhibitors (SSRIs) have a higher propensity to dedicate violent criminal offense. In addition, this impact appears to continue for approximately 12 weeks after stopping SSRI treatment. This work is released in the peer-reviewed journal European Neuropsychopharmacology, along with a connected remark. The authors of both the paper and the remark note that the work suggests an association (instead of domino effect) and prompt care in how the findings are translated.

First author Tyra Lagerberg at the Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, stated:

“This work shows that SSRI (selective serotonin reuptake inhibitor) treatment appears to be associated with an increased risk for violent criminality in adults as well as adolescents, though the risk appears restricted to a small group of individuals. We don’t claim that SSRIs cause the increased risk we see in our data. It is possible that the disorders that SSRIs are prescribed to treat, such as depression, are driving the association. In that case, our findings may mean that SSRIs are unable to fully remove this tendency towards violent crime, which is also a potentially important insight. Previous work has found an association between SSRI use and violence in young individuals, but not in adults. Ours is a much bigger study which allows us to confirm that there is an association in adults as well.”

The scientists took a look at the records of 785,337 individuals aged 15 to 60 years who were recommended an SSRI in Sweden in 2006 through 2013. These clients were followed up for approximately around 7 years, that included durations when people took SSRIs and when they did not. Individuals in the research study were discovered to have actually devoted 6306 violent criminal offenses while taking SSRIs, and 25,897 when not taking SSRIs. After accounting for follow-up time and variables that were associated both with the likelihood of getting SSRI treatment and with the danger for violence, the scientists discovered that the danger of devoting a violent criminal offense was on average 26% greater throughout durations when people took SSRIs compared to durations when they did not, though just a little percentage of people went on to dedicate violent criminal offenses no matter treatment (<3% in the research study sample). Due to the rarity of violent criminal offenses, durations of SSRI medication are anticipated to accompany just a little boost in the rate of this occasion. When the scientists partitioned the research study follow-up according to time because start and end of SSRI treatment, they discovered that the danger for violent criminal offense was greater throughout dealt with durations.

The increased danger likewise continued for approximately 12 weeks after the approximated end of SSRI treatment, after which the danger went back to levels prior to start of SSRI treatment. The scientists revealed that the association in between SSRI treatment and violent criminal offense existed in young people along with in grownups aged approximately 60 years (the research study did not examine the association in grownups older than 60 years). However, just 2.7% of people in the research study devoted violent criminal offenses throughout the research study duration, implying the increased danger used to a little subgroup of SSRI users.

Tyra Lagerberg commented:

“Previous research studies have actually revealed that anxiety itself is connected with a 3-fold boost in the danger for violent criminal offense, and obviously lots of SSRIs are recommended for anxiety; so it might be the underlying anxiety that triggers the association with violent criminal offense, instead of any impact of the SSRI. More work is required to reveal the reasons for this association.

Our results recommend there might be a requirement for medical awareness of the danger for violence throughout and perhaps after SSRI treatment throughout age. However, a big bulk of SSRI-users, around 97% in our sample, will not experience the result of violent criminal offense, so our work requires to be comprehended in this context. Our findings do not impact the huge bulk of individuals taking antidepressants and must not be utilized as basis for people to stop their SSRI treatment, nor for prescribers to keep treatment from people who may gain from it. Nevertheless, clinicians must listen when recommending SSRIs to people with aggressive propensities. More work is needed to recognize what even more private qualities may provide somebody a greater danger of devoting violent criminal offenses throughout SSRI treatment, no matter whether the danger is increased since of the SSRI or since of the hidden condition that suggests a specific for treatment with these medications”.

An associated commentary, checks out possible descriptions for the boost. Lead author, Professor Eduard Vieta (University of Barcelona) stated:

“This observational study presents a firm basis for further investigations on SSRI use and criminality. However, as the authors themselves say, we need to emphasize that the study shows an association between violent crime and SSRI use in a small subset of patients, it doesn’t show that one causes the other. The study also shows that past offenders were more likely to commit a violent crime during SSRI treatment: this in itself is an interesting finding, which could be the main focus of future research on the topic”.

Reference: “Associations between selective serotonin reuptake inhibitors and violent crime in adolescents, young, and older adults – a Swedish register-based study” by Tyra Lagerberg, Seena Fazel, Yasmina Molero, Mikael Andersson Franko, Qi Chen, Clara Hellner, Paul Lichtenstein, Zheng Chang, 29 May 2020, European Neuropsychopharmacology (2020).
DOI: 10.1016/j.euroneuro.2020.03.024

Commentary: “Association between selective serotonin reuptake inhibitors and violent crime – could underlying psychopathology be the cause?” by Aiste Lengvenyte and Eduard Vieta, 29 May 2020, European Neuropsychopharmacology.
DOI: 10.1016/j.euroneuro.2020.04.005



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