Monday, November 9, 2009

Was the Fort Hood shooter taking antidepressants?

In the days since the Fort Hood shooting, I have wondered whether the gunman, Major Nidal Malik Hasan, was taking antidepressants in the weeks or months before he sprayed a medical clinic with bullets, killing 13 people. I hesitated to raise that question since there is at present no evidence Hasan was on SSRI antidepressants, which have been linked to violent and suicidal actions, as I've blogged about here. (Nor, in fact, is there much hard information of any kind about his motives, although a story in The Boston Globe today raises questions about his link to a radical iman.)

Now, however, Dr. Peter Breggin has raised the drug issue in a provocative column for The Huffington Post:

The odds are that Dr. Hasan was self-medicating with antidepressants and tranquilizers that were causing his increasing disinhibition, at least in his pronouncements, until his final Allahu Akbar before he began shooting. In my book Medication Madness , I describe dozens of cases that I have personally evaluated involving relatively normal individuals who committed murder, mayhem and suicide while taking psychiatric drugs, especially antidepressants and tranquilizers. One of these cases involves a psychiatrist who began by self-medicating himself, then came under another psychiatrist's care who continued to give him antidepressants, until he ended up in a manic state assaulting a helpless woman. Before being driven mad by antidepressants, he was a relatively stable and highly accomplished doctor with no special inclination toward violence. These psychiatric drugs will have an even greater triggering effect on someone like Hasan who was already ideologically and psychologically primed to explode in violence.

While Breggin's speculation about self-medication is intriguing and worth investgiating, I have to take issue with his screed against all psychiatrists. He writes:

Modern psychiatry is not about counseling and empowering people. It's about controlling and suppressing them, and that's a dismal affair for patients and doctors alike.


I happen to know psychiatrists who do an amazing job of counseling and empowering their patients. Yes, there are many doctors (not only psychiatrists) who rely too heavily on drugs with serious side effects to medicate people with only mild symptoms of depression or anxiety, without considering other alternatives first. But there are many others who listen carefully to their patients and work with them to live full lives with or without medication.

Obviously, Major Hasan was grappling with a number of powerful demons before he went on his tragic rampage. I just hope that Congressional investigators don't let the Army, for its own reasons, suppress factual information about Hasan's medication usage or any other details that might help explain his wholly despicable actions.

Hat tip to Furious Seasons for alerting me to Breggin's post.

6 comments:

Curse You Khan! said...

Hey Allison, don't mean to be a pest but why is the issue of whether he was on SSRIs relevant? He was clearly a man under great stress who, to the horror of us all, clearly did not seek or get the help he needed. Despite the fact that he had no prior history of violence, he was a trained soldier. The weapons he used that day were not randomly selected. The guns and ammo were designed to shred body armor. Isn't it just as likely -- if not more so -- that his instability and circumstances combined and allowed him to think of this attack as a rational or justified action?

There is a question that always bothers me when I see psych meds and violence linked in a specific case (not in research): If you are on these meds it is assumed you have mental health problems, so doesn't it make sad sense that some of the people who receive these meds will do something violent? It isn't a surprising outcome when someone who is depressed and then goes on meds commits suicide. It is sad and suggests other treatments should have been tried but it is hard for me to understand how we can tell from that outcome if the meds exacerbated the problem.

I also don't know how to assess the point about someone having no previous history of violence. Sometimes I see that used as a way to say "well he or she wasn't violent before this." While that is true, all we really know is that there weren't any reported instances in which he or she was outwardly violent. We do not know what was going on behind the scenes and what rage/anger/violence issues were there that just hadn't become part of the record yet. Someone may have violent tendencies or inclinations for a long time before acting on them.

None of this is to say that I have any idea if psych meds do or don't sometimes cause people to act violently. I am not a doctor or scientist nor have I done even a smidgen of the research you have done into all this. These are just the questions of an interested bystander. Keep up the great work. As you can tell your post gave me a lot to think about.

Con

Peggy Karp said...

The question of whether Malik Hasan was on SSRIs is important because these drugs have caused large numbers of homicides and suicides. There is a good article at http://www.medicationsense.com/articles/april_june_04/underlying_cause.html

and an index of cases at http://ssristories.com/index.php

These drugs can cause otherwise sane people to go temporarily insane and kill others and/or themselves. I think they should be banned.

Michael Kirsch, M.D. said...

Alison, Let's assign responsbility where it rightly belongs - with the shooter. Yes, we should presume his innocence,and await the results of fair trial, but no need to victimize him. Indeed, some others have suggested that the military might bear some measure of responsbility for not being sufficiently senstive to his stress. No need for policital correctness in such a cowardly and evil act commited by an individual. www.MDWhistleblower.blogspot.com

NP said...

Con makes a good point about making a causal inference when people on SSRIs commit violent acts.

IMO, when something as tragic and inexplicable as this shooting happens, people are often quick to assign blame to a single factor. Religion, bullying, antidepressants, video games, etc when the answer may be all or none of the above.

Kelly said...

I think it must be hard for some people who havent had any reactions to an antidepressant to understand just how radically they can change a person. There are so many people on antidepressants and some are ticking timebombs... In the 50's you didnt have extreme mass murders like you do now. And its scary to know that these events will happen in the future as long as these medications are on the market... I dont know if the Fort Hood shooter was on them, but I know they can turn people insane...

AJ said...

I think the same. The guy was on anti-depressants but its politically correct to blame everything on Islam and jihad these days. BTW his mentor the Awlaki guy is another fake Muslim radical, actually a US stooge that was a prostitute lover when he lived in the USA.