The headline from the Winnipeg Free Press in Canada tells the story: "Judge Says Prozac Factor in Teen Murder." Provincial court judge Robert Heinrichs listened to my testimony as a psychiatric expert on behalf of the defense and weighed it against that of a Canadian psychiatrist brought in by the prosecution.
After deliberating for several months, the judge rendered his opinion on September 16, 2011. He declared in his decision, "His basic normalcy now further confirms he no longer poses a risk of violence to anyone and that his mental deterioration and resulting violence would not have taken place without exposure to Prozac." Also consistent with my lengthy report and testimony, the judge observed, "He has none of the characteristics of a perpetrator of violence. The prospects for rehabilitation are good."
This appears to be the first criminal case in North America where a judge has specifically found that an antidepressant was the cause of a murder.
The case involved a 16-year-old high school student with no prior history of violence who, while chatting in his home with two friends, abruptly stabbed one of them to death with a single wound to the chest. He could give no explanation for his behavior. Earlier in the day, his two friends had stopped by his house in his absence and gotten into a mild altercation with the teen's younger brother in which no one was hurt. The teen then invited his friends over for a visit and while calmly sitting together, he committed the abrupt assault. Immediately afterward he called the police.
The teenager had been taking Prozac for three months, during which time his behavior deteriorated. He became impulsive and unpredictable and suicidal. He also began to talk at times as if fantasizing about violence. He seemed to become a different person to his distraught parents. I testified that his primary care physician and his parents alerted the prescribing psychiatric clinic to the teenager's deteriorating condition and raised questions about continuing Prozac. Despite these concerns, the clinic continued his Prozac and then doubled it on his last visit. Seventeen days after the increase in dosage, the teen committed the violence.
The Canadian drug regulatory agency, Health Canada, has warned that Prozac is not authorized for use in children and that it can cause "self-harm or harm to others." According to a warning issued in 2004 by the drug manufacturer, Eli Lilly and Health Canada: "There are clinical trial and post-marketing reports with SSRIs and other newer anti-depressants, in both pediatrics and adults, of severe agitation-type adverse events coupled with self-harm or harm to others. The agitation-type events include: akathisia, agitation, disinhibition, emotional lability, hostility, aggression, depersonalization. In some cases, the events occurred within several weeks of starting treatment."
I wrote in my report and testified that the boy's symptoms were consistent with a "Prozac (fluoxetine) Induced Mood Disorder" with manic features and that he would not have committed the violence if he had not been given the antidepressant. I also testified that he had improved dramatically when removed from the Prozac after a few months in jail and that he was no longer a danger to himself or others.
The original hearing was to determine whether or not the now 17-year-old should be sentenced as a minor, in which case his maximum jail time would be limited to four years. The prosecution wanted him tried as an adult. On September 16, 2011, Judge Heinrichs decided that the boy would be tried as a minor and that his deterioration and violent behavior was caused by Prozac. On November 4, 2011 the judge will determine how much of the remaining four years the teenager will serve.
The judge's decision represents an enormous step forward in society recognizing that the newer antidepressants can cause violence.
Peter R. Breggin, MD is a psychiatrist in private practice in Ithaca, New York, and the author of dozens of scientific articles and more than twenty scientific and popular books. His two most recent books deal with medication induced violence: Brain-Disabling Treatments in Psychiatry, Second Edition, and Medication Madness: the Role of Psychiatric Drugs in Cases of Violence, Suicide and Crime. Dr. Breggin's home website is www.breggin.com where many of his scientific reports on antidepressants and other subjects can be retrieved. On April 13-15, 2012 in Syracuse, New York, the annual meeting of Dr. Breggin's international organization, The Center for the Study of Empathic Therapy, will present a panel of lawyers, experts, survivors and families concerning antidepressant-induced violence.