There has been a lot of press lately about SSRIs (one of the types of antidepressants) and violent behavior. The ShrinkRap blog has an excellent article on the topic written by a psychiatrist. Is this something people on SSRIs should be concerned about?
This seems like another case of the press, who are not medically trained and do not truly understand the topic, inflaming a potential headliner to sell copy. As the psychiatrist on ShrinkRap states:
"Regarding the clinical issues: violence is a multifactorial behavior, and I think it's overly simplistic to reduce it to a simple medication cause-and-effect. Confounding variables are the presence of personality disorders, previous acts of violence, active affective disorder symptoms and co-existing substance abuse. We know nothing about these confounding variables from this article. While clinical trial data will be useful to identify strong associations that could be attributed to medications (eg. weight gain, increases in prolactin levels) it is less useful for low base-rate phenomena like homicide. As Roy has already pointed out, base rates of general aggression were low to begin with in the clinical monitoring data from the UK."
I have not experienced this phenomenon in my practice. If anything, SSRIs tend to reduce agitated and aggressive behavior. I have several clients who take them specifically to address road rage. Why might this be? One of the symptoms of depression is lowered frustration tolerance. Being angry and irritable are very common with people struggling wtih depression. When one has no energy, motivation or concentration, even the simplest task requires a Herculean effort and provokes agitation, irritability or even rage when met with obstacles or difficulties. By increases energy, motivation and concentration as well as improving overall mood, SSRIs often help increase one's frustration tolerance and lower irritability.