NIU Shooting Sharpens Debate Over Effects of Antidepressants

From the LA Times via the Lakeland Ledger

A young man reportedly taking the antidepressant Prozac has a history of significant psychiatric troubles, including self-cutting, obsessive thoughts and anxiety. But among the 27-year-old's current teachers and acquaintances, he has a reputation as a caring, dependable friend and a highly motivated student.

Surely, say mental health professionals, this recovery was brought about by Prozac.

The same young man, saying the drug makes him feel "like a zombie," abruptly discontinues his antidepressant and begins to behave erratically. Three weeks later, he steps from behind a curtain in a classroom at Northern Illinois University, his alma mater and begins shooting, killing five students and himself.

Just as surely, say critics of antidepressants' widespread use, this unraveling was brought about by Prozac.

Steven Kazmierczak's bolt-from-the-blue shooting rampage Feb. 14 reignited a long-running debate over the benefits and risks of antidepressants - taking them and discontinuing them.

"It's sad to watch this," says Ann Blake Tracy, executive director of the International Coalition for Drug Awareness and co-founder of a Web site, SSRIstories.com, that catalogs violent crimes like Kazmierczak's and links them to psychiatric drug use. "You find suicide, murder, rape, arson" - all caused by drugs such as Prozac, she says. "How did they convince us that this is therapeutic?"

Most in the psychiatric profession would counter that antidepressants overwhelmingly save lives, and salvage those hobbled by sadness and anxiety. They doubt that coming off these drugs - especially Prozac, which Kazmierczak was reported to have taken - led the Illinois man to kill.

[...]

Twenty years after Prozac appeared on the U.S. landscape, roughly 10 percent of American women and 4 percent of American men take an antidepressant regularly. The selective serotonin reuptake inhibitors, or SSRIs, and their close cousins have revolutionized attitudes toward mental illness and its medication. But they remain a lightning rod for controversy.

The role that antidepressants played in Kazmierczak's violent end probably will never be clear. Did Prozac, which Kazmierczak's girlfriend, Jessica Baty, said he had recently discontinued, help keep the 27-year-old's mental illness in check and, when halted, allow it to roar back? Or did it distort his personality, contort his thoughts and, when abandoned, cause a chemical storm in Kazmierczak's brain that spawned a fury of aggression?

The weight of clinical observations and psychiatric research favors the view that antidepressants helped Kazmierczak until the time he abandoned them. But skeptics charge that antidepressants may have caused or contributed to Kazmierczak's spasm of violence. And mental health experts acknowledge they cannot rule out that possibility.