STOP DENYING THE CONNECTION BETWEEN ANTIDEPRESSANTS AND VIOLENCE

By Brooke Seim

The link between antidepressants and violence, heart attacks, sudden death, is becoming ever present. One of the latest articles highlighted that 1 in 8 American take some type of antidepressant and is linked to substanital increase in the risk of sudden cardiac death. This was presented at the recent European Society of Cardiology.

Enter Brooke Seim, she’s a writer, speaker, and advocate for safe de-prescribing of psychiatric drugs, particularly antidepressants. Her work stems from personal experience—she was prescribed antidepressants as a teenager after her father’s death and spent 15 years on them. At 30, she decided to taper off, facing severe withdrawal symptoms that she details in her memoir, May Cause Side Effects. We both participated in the 2023 SPEAK HEALTH event in New York organized by George Andriopoulos.

SPEAK HEALTH Event. Brooke is third from the left, I am next to Freddy, second from the right.

Article by Brooke Seim:

When I first began speaking publicly about antidepressant withdrawal in 2017, I never imagined the day would come when the topic would be discussed in Congress. But that moment arrived on January 29, Senator Tina Smith asked Kennedy a “simple” question: “Do antidepressants cause school shootings?” To reduce the topic to an argument about school shootings specifically is to sidestep the broader issue of antidepressant-induced violence, which includes everything from mass shootings to homicide to suicide.

Kennedy told Senator Smith, “I know members of my family who have had a harder time getting off SSRIs than heroin.” Senator Smith swiftly countered with her own positive experience on antidepressants, dismissing concerns about their risks—including antidepressant-induced violence. Anyone who has spent time in the world of mental health and psychiatric drugs knows there is nothing simple about the effects of antidepressants.

I am the unlikely face of antidepressant withdrawal and safe deprescribing advocacy. I came to this accidental vocation after spending half my life on a cocktail of antidepressants prescribed to me as a teenager after my father died unexpectedly. Fifteen years and 10,000 antidepressant pills later, a different psychiatrist pulled me off one of my drugs, sending me into withdrawal so horrific, I got a book deal out of the experience.

The worst of my side effects was violent, intrusive thoughts and uncontrollable rage. For context, I am 5’3”, weigh 120 pounds, and once found an injured songbird in Brooklyn, hailed a cab at midnight to take it to a 24-hour animal hospital in Manhattan, then paid for its care even though I never saw the bird again. I don’t hurt things. I rescue them. But during withdrawal, the visions I saw in my mind’s eye were so violent, I was terrified my psychiatrist would put me on an involuntary hold if I told her what I was experiencing. So, I locked myself in my apartment, where I pulled out my own toenails and beat my legs until they were the color of plums, inflicting the violence within me onto the only body I was willing to sacrifice—my own.

When the hell of withdrawal lifted, I began to seek answers to the questions I had about what happened to me. That search led me to reports and research that validated my experience. In 2018, I read a New York Times article by Benedict Carey, “Many People Taking Antidepressants Discover They Cannot Quit.” Much of my early information on the topic was shaped by other great Times reports published: mounting Prozac lawsuits in 1990, “Jury Awards $6.4 Million In Killings Tied to Drug in 2001,” 12-year-old boy who killed his grandparents while on Zoloft in 2005, and “Families Wonder if Prozac Prompted School Shootings” also in 2005.

It troubles me that the current narrative of the Times and other major media outlets denies the documented risks between the use of antidepressants and violence. Maybe this why Senator Smith now claims that even suggesting SSRIs can induce violence is “false and misleading information.”

The truth is that while SSRIs help many people, they also pose serious risks for a subset of users—risks that have been acknowledged in both research and legal cases. In the 1990s, pharmaceutical giant Eli Lilly paid out an estimated $50 million across 300 lawsuits linked to Prozac-related homicides, suicides, and suicide attempts.

More recently, in 2021, forensic researcher Selma Eikelenboom-Schieveld—who worked on the Aurora shooter case—identified four genetic risk factors associated with developing an altered emotional state and acts of violence in connection to antidepressants. In simple terms, Eikelenboom-Schieveld’s research showed that some people metabolize SSRIs differently due to genetic variations. For those with specific markers that we can test for, the risk of paradoxical reactions—including violent aggression, akathisia (severe restlessness), mania, and suicidal ideation—is significantly heightened. This is not fringe science; it is established pharmacogenetics. Yet, there is no routine testing before prescribing these medications, leaving patients and their families unaware of potentially life-altering risks.

Eikelenboom-Schieveld is not alone in her findings. Other studies reinforce the link between antidepressants and violent reactions. These include, for example, violence linked to 31 medications, including 11 antidepressants; twice the risk of antidepressant-induced suicidality and violence of in healthy adult volunteers; and increased risk of extreme aggression and suicide among individuals diagnosed with akathisia or serotonin toxicity after taking psychiatric medication. Legal precent also acknowledges data that have connected antidepressants and violence.

The debate is not about whether SSRIs work for some people—they clearly do. The issue is that we continue to ignore well-documented risks for others. According to the Substance Abuse and Mental Health Services Administration (SAMHSA), 22.8% of U.S. adults have a mental illness, equating to 58.7 million people. If even 0.1% of them experience a violent, paradoxical reaction to psychiatric drugs, that is 58,700 individuals. Even at 0.01%, we are still looking at nearly 6,000 cases. These numbers are too high to dismiss.

Though I committed violence against myself during antidepressant withdrawal, I am lucky that something within me kept me from turning that violence onto others. And Senator Smith, too, is lucky that as a young woman, she had a good experience with antidepressants. But we must move beyond anecdotes—positive or negative—and engage with the full scope of scientific evidence.

Wouldn’t you want to know ahead of time if you, your child, or your partner fell into that at-risk category? Or would you prefer to wait until something happens?

A public conversation that only acknowledges the benefits of SSRIs while denying their paradoxical effects does a disservice to both science and the individuals affected. Senator Smith, by reducing the entire breadth of antidepressant experiences to her own, exemplifies the myopic, anti-scientific thinking that prevents necessary reform. At a minimum, patients should have access to pharmacogenetic testing before being prescribed SSRIs. It’s not a perfect test—and I hope research makes it better—but it at least gives us a shot at identifying vulnerable individuals.

But if we continue to deny a known reality, however rare, we will continue to put countless individuals at risk.

Brooke’s Substack:

HAPPINESS IS A SKILL is devoted to the science of antidepressant withdrawal, healing from depression, and the skill of happiness. Expect candid thoughts on facing trauma and grief, tips from experts around the world, the latest research, and the history of psychiatry around the world.

About the author, Brooke Siem:

Brooke Siem (@brookesiem) is a writer, chef, and speaker whose work on antidepressant withdrawal has appeared in The Washington Post, New York Post, Psychology Today, and more. Her memoir, MAY CAUSE SIDE EFFECTS is the first book on antidepressant withdrawal to hit the mass-market. She is also a Food Network "Chopped" Champion and creator of the F*ckit Bucket™.

My debut memoir, MAY CAUSE SIDE EFFECTS is out now. Order your copy here.