The Zoloft-rage/violence connection

[This post is quite lengthy so I suggest you grab a cup of coffee or tea and sit down and read it. The following is not for the faint of heart (or those with a lack of time).]

It’s been amazing to me that I’ve received numerous comments on Zoloft inducing rage. I’m humbled by having a Pittman supporter visit my site and post some comments from the ChristopherPittman.org forums. Read the following:

In my senior year in high school I was diagnosed as being severely depressed and put on medication. The first medication that I was on I took for 5 months and it made me really aggressive. My friends and family noticed the change and I told my doctor about it and she changed my meds. After that I was fine. I am normally a very passive person and will let just about anything fly. But the medication made me really aggravated and aggressive toward my friends and family and it seemed that I wasn’t overcoming my depression. I just got done watching the 48 hours investigation on the Discovery Times Channel and felt a connection with Chris. I felt that I had to write this to let you know that Chris is not the only one out there that had these side effects. I think there should be a study done to see how many people that take antidepressants have increased aggression. The problem is that the pharmaceutical industry has deep pockets and many lobbyists. I hope this helps in some way.

And another:

I remember the case when it happened.

At the time I thought, “Zoloft right”.

Let me tell you my physician put me on Zoloft and it took about three weeks for my to become psychotic and I’m a 50 year old woman.

I have three children and I don’t make a lot of money but please let me know if I can do anything for the Pittman boy.

The jury should have been placed on Zoloft before they made they decision. Unless you’ve experience it you simply cannot believe its’ effect.

Brynn and Phil HartmanI did a bit of quick reading/research into Zoloft triggering violence in people who otherwise would have never been violent and it seems that are a few stories out there to support the assertion. I found a few comments on depressionblog.com that mentioned a link between Zoloft and rage fits. A Salon.com article published a story antidepressants inducing rage in 1999. Apparently, Brynn Hartman, the wife of famous comedian Phil Hartman, killed herself and her husband while taking Zoloft. While close friends attribute the sudden behavior on the antidepressant, others attribute it to a combination of the medication with cocaine and alcohol in her system. (Zoloft does have a warning against alcohol use in conjunction with the drug.)

One interesting thing I learned from the article is that this kind of behavior is often labeled under the name akathisia on patient safety guides. Most – if not all – of the major antidepressants list akathisia as a side effect. Here’s the initial description of this condition from Wikipedia:

Akathisia, or acathisia, is an unpleasant subjective sensation of “inner” restlessness that manifests itself with an inability to sit still or remain motionless… Its most common cause is as a side effect of medications, mainly neuroleptic antipsychotics especially the phenothiazines (such as perphenazine and chlorpromazine), thioxanthenes (such as flupenthixol and zuclopenthixol) and butyrophenones (such as haloperidol (Haldol)), and rarely, antidepressants.

Akathisia may range in intensity from a mild sense of disquiet or anxiety (which may be easily overlooked) to a total inability to sit still, accompanied by overwhelming anxiety, malaise, and severe dysphoria (manifesting as an almost indescribable sense of terror and doom).

No real mention of extreme anger or irritability mentioned there. But if you read on…

The 2006 U.K. study by Healy, Herxheimer, and Menkes observed that akathisia is often miscoded in antidepressant clinical trials as “agitation, emotional lability, and hyperkinesis (overactivity)”. The study further points out that misdiagnosis of akathisia as simple motor restlessness occurs, but that this is more properly classed as dyskinesia. Healy, et. al., further show links between antidepressant-induced akathisia and violence, including suicide, as akathisia can “exacerbate psychopathology.” The study goes on to state that there is extensive clinical evidence correlating akathisia with SSRI use, showing that approximately ten times as many patients on SSRIs as those on placebos showed symptoms severe enough to drop out of a trial (5.0% compared to 0.5%).

Read the rest of this entry »

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The overreaction begins

A few days ago, I wrote about whether violent writing could predict who could become a murderer. Well, 18-year-old Allen Lee of Cary-Grove High School in Chicago, has been charged with disorderly conduct because his essay in his creative writing class was "violently disturbing."

"I understand what happened recently at Virginia Tech," said the teen's father, Albert Lee, referring to last week's massacre of 32 students by gunman Seung-Hui Cho. "I understand the situation."

But he added: "I don't see how somebody can get charged by writing in their homework. The teacher asked them to express themselves, and he followed instructions."

Experts say the charge against Lee is troubling because it was over an essay that even police say contained no direct threats against anyone at the school. However, Virginia Tech's actions toward Cho came under heavy scrutiny after the killings because of the "disturbing" plays and essays teachers say he had written for classes.

This is a roll-your-eyes kind of story, but it angers me beyond belief. A student who appeared to be a straight-A student and apparently didn't freak anyone out like Cho did may spend 30 days in jail and pay a $1,500 fine.

Today, Cary-Grove students rallied behind the arrested teen by organizing a petition drive to let him back in their school. They posted on walls quotes from the English teacher in which she had encouraged students to express their emotions through writing.

"I'm not going to lie. I signed the petition," said senior James Gitzinger. "But I can understand where the administration is coming from. I think I would react the same way if I was a teacher."

Normally, according to the article, disorderly conduct charges apply to pranks gone awry like pulling a fire alarm or dialing 911, but also "when someone's writings can disturb an individual."

There will probably be mixed reactions to this incident. I am a complete proponent of free speech. (I'll probably get a little political here, but you'll deal with it.) I'm black, but I totally support the Ku Klux Klan's right to say whatever racist things they want. Imus can call a basketball team "nappy-headed hos," but not get arrested. That's OK. Of course, the public tends to self-censor themselves on the issue of free speech so he was forced out of a job. People are free to use the "N" word if they'd like, even if I hate it. The only limit on free speech should be if it clearly endangers the welfare of others or incite violence. For example, "Saying I'm going to kill so-and-so" is NOT free speech and can get a person arrested.

I  mentioned in another post that writing can be a safe outlet for people to get their frustrations out. I also said that I tried being creative when writing an essay for Health class that highlighted the positive aspects of suicide instead of the negative ones. (In fairness, I was told to write three negative aspects of suicide and decided to try and be different.) I was sent to a school district counselor for evalution. You can read the entire post for the rest of the story.

I should probably also mention that I took a theater class in which we all had to write a one-act play. Mine clearly disturbed my classmates the most: It was a parallel world in which everyone was gay and anyone who was straight was ostracized. This wasn't revealed until the very end of the one-act. My classmates were horrified and my teacher was cool enough to see it for what it was – creative writing.

Now, for devil's advocate, Lee should have used better judgment in light of the VTech incident and written something else. My main issue is that he didn't specify a person, date, or location in what he wrote. The teacher felt "alarmed and distubed by the content" so she reported it to the correct authorities.

The difference between Lee and Cho is that Cho's behavior gave credence to people worrying about his mental state. If Lee has students rallying around him to return to school, I don't think he's scaring anyone. I'll stand corrected if I hear any stories about him stalking women.

P.S. If the Chicago Tribune tries to get you to register to read the story, here's some log-in info to use (not mine):