Antidepressants are psychiatric drugs that form a common thread in school shootings. There are five categories of anti*depressants: selective serotonin reuptake inhibitors (SSRI), selective norepinephrine reuptake inhibitors (SNRI), monoamine oxidase inhibitors (MAOI), tricyclic antidepressants (TCA), and atypical antidepressants. Despite the moniker, doctors prescribe these medicines for much more than depression. They use them to treat such ailments as obsessive-compulsive disorder (OCD), bipolar disorder, bulimia nervosa, panic disorder, social anxiety disorder (SAD), premenstrual dysphoric disorder (PMDD), and attention deficit hyperactivity disorder (ADHD). Other suspect medications, such as Ritalin, Adderal, and Concerta, are sympathomimetic amines, prescribed to treat ADHD.
These medicines act on the body’s nervous system — altering its chemical communication pathways to affect areas of the brain involved in judgment, abstract reasoning, memory, emotions, and the fight-or-flight response — explains Michelle Morrison-Valfre, MHS, FNP in her 2005 book, Foundations of Mental Health Care. The expected result is a calm mood and clear thinking. However, in some cases unexpected results occur.
The Physicians’ Desk Reference (PDR), an authoritative source of all FDA-approved drug labeling information, identifies the potential hazardous side effects of psychotherapeutics, including suicidal and homicidal ideation. Unfortunately, such effects are not uncommon. In fact, when taking a particular medication poses serious risks, the FDA requires drug manufacturers to highlight the dangers in eye-catching boxes on pharmaceutical packaging. A drug’s “black box warning” alerts consumers to the major hazards they face when taking that medicine. Most prescriptions do not have black box warnings — only those that can cause extreme adverse reactions compared to the potential benefit. Among psychotherapeutics’ black box warnings are:
• “Increased risk of suicidal ideation in short-term studies in children and adolescents with ADHD.” (Strattera, SNRI)
• “Antidepressants increased risk of suicidal thinking and behavior (suicidality) in short-term studies in children, adolescents and young adults with major depressive disorder and other psychiatric disorders.” (Zoloft, SSRI)
• “Monitor appropriately and observe closely for clinical worsening, suicidality or unusual changes in behavior for all patients who are started on antidepressant therapy.” (Parnate, MAOI)
• “High potential for abuse; avoid prolonged use. Misuse of amphetamine may cause sudden death and serious cardiovascular events.” (Adderal, sympathomimetic amine)
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