Prescription for Violence: The Corresponding Rise of Antidepressants, SSRIs & Mass Shootings

• As of 2021, 57.8 million adults in the U.S. experienced some form of mental illness, while 14.1 million adults suffered from a serious mental illness.
• In 2018, more than 34 million Americans were reported to be taking antidepressants.
• By 2023, over 3 million American children were receiving medication for behavioral issues.
• Over half of all mass shootings have occurred since the year 2000, with 20% taking place since 2014.
• Studies from Finland and Sweden suggest a possible link between prescription drug use and violent behavior.
• Between 2000 and 2013, 22% of mass shooters were reported to have used either prescription or illicit drugs.
• Official mental health diagnoses were found in 40% of individuals responsible for school attacks between 2008 and 2018.
• Prozac and Effexor were among the most commonly identified antidepressants in cases involving school shooters from 2000 to 2018.

Methodology

Unlike other countries around the globe, HIPAA laws make it challenging to investigate the relationship between mental illness, prescription drugs, and violence.

This article provides a comprehensive review of information sourced from global publications. We compiled data from news reports, peer-reviewed studies, and publications in other countries to deliver an accurate assessment of the effects of prescription drugs on criminality, violence, and mass shootings.

Sourcing information from various resources allows us to provide an unbiased report and highlight all possible underlying factors.

Ammo.com strives to provide fact-based information. You can view our sources HERE.

The History of Prescription Drugs and Mental Illness in the U.S.

In the 21st century, it seems like there’s medication for almost everything. Whether it’s Oppositional Defiance Disorder, ADHD, or clinical depression, there’s a pill designed to adjust brain chemistry and promote better behavioral outcomes.

Over the years, many people have questioned the impact of these medications on both individuals and society, wondering if we might be over-relying on them. The following sections will provide key insights into the use of prescription drugs in America.

Understanding the Role of Prescription Drugs in America

The 1950s marked the beginning of a new era with the introduction of “magical pills” designed to address various behavioral and mental health issues. One of the first breakthroughs was the introduction of MAOIs (monoamine oxidase inhibitors), which were highly effective as antidepressants. However, these medications came with significant side effects and required strict dietary restrictions. ¹²

Between the 1950s and 1980s, tricyclic antidepressants became widely popular despite their significant side effects, largely because they were effective in treating depression. During this period, Quaaludes also emerged but proved to be highly addictive, leading to numerous overdose deaths. Valium, a benzodiazepine that we’ll discuss further below, was another drug that gained popularity. Although it was also addictive, many in the medical community viewed it as a safer alternative to Quaaludes.

In December 1987, the FDA approved the first-ever SSRI (Selective Serotonin Reuptake Inhibitor), Fluoxetine, which quickly became known by its brand name, Prozac. Prozac soon became a household name, and since then, SSRIs have become a popular treatment option for various mental health conditions, including depression, anxiety, and PTSD.

By 2018, more than 34 million Americans were actively taking antidepressants. ⁵ Additionally, by 2023, over 3 million American children were being prescribed medication for ADHD. ⁶

Although antidepressants have been available for over half a century, it wasn’t until the 1980s that drug manufacturers started advertising directly to consumers. The first drug commercial aired on television in 1983, and today, pharmaceutical companies spend millions of dollars each year on advertising. ¹³

Understanding Mental Illness in the U.S.

In 2021, 57.8 million U.S. adults were reported to have some form of mental illness, with 14.1 million of them experiencing a serious mental illness. Additionally, nearly half (49.5%) of adolescents had some form of mental illness, and 22% experienced severe impairment or distress. ⁷

Despite more people seeking help for mental illnesses now than in previous decades, the prevalence of severe mental illnesses has actually increased in the 2020s compared to the 2010s.

According to the American Psychological Association, the rate of individuals reporting symptoms consistent with major depression increased significantly from 2005 to 2017. Among adolescents, the rate rose by 52%, while among young adults aged 18 to 25, it increased by 63% from 2009 to 2017. ⁸

Study authors attribute this sharp rise in mental health issues, including mood disorders and suicide-related concerns, to the influence of social media and broader societal changes. This has led many to believe that, despite better access to mental healthcare, mental health problems are more prevalent today than in the past.

The History of Mass Shootings in America

The history of mass shootings in the U.S. is often clouded by misinformation, confusion, and sensationalism. Recent studies indicate that over 50% of all mass shootings in the U.S. have occurred since 2000, with 20% of these incidents taking place between 2014 and 2019. ⁷

However, the definition of “mass shootings” has evolved over the past decade, making it crucial to clarify this terminology before distinguishing between mass shootings and other forms of targeted violence, such as gang-related or conflict-driven incidents.

Note: For the purposes of understanding mass shootings in America as they relate to public fear and terror, “mass shooting” in this article will refer to targeted attacks where an attacker shoots indiscriminately.

The Definition of Mass Shooting

A 2013 report on mass shootings defined them as incidents where an attacker indiscriminately shot at unsuspecting civilians in public places, resulting in the deaths of four or more people. By 2015, however, this definition was updated.

Today, the FBI classifies any public shooting that results in four or more deaths as a mass shooting. This change in definition is based on the understanding that all public shootings pose a significant public health crisis.

It’s important to note that conflict and gang-related mass shootings differ significantly from those carried out by targeted attackers. For instance, gang-related shootings are often spontaneous reactions to conflict, with little to no warning, whereas targeted mass shootings are typically premeditated. Preventative measures for these types of incidents are vastly different, involving approaches like policing for gang-related violence and community reporting for targeted attacks.

Following the change in the definition of mass shootings in 2013, the frequency of reported mass shootings appeared to increase, but this was largely due to the broader criteria being applied.

Understanding Mass Shootings in the U.S.

While definitions of mass shootings may vary, targeted attacks where the shooter indiscriminately fires at unsuspecting victims have increased over the past two decades. Despite the 1986 Firearm Owners Protection Act (FOPA), which restricted automatic firearms, mass shootings have become more lethal.

Sixteen of the twenty deadliest mass shootings from 1966 to 2019 occurred after 1999. Between 1982 and 1992, there were fourteen mass shootings as defined by the broader criteria. This number rose to twenty in the following decade (1993 to 2003) and then surged to 115 incidents between 2004 and 2023.

These statistics suggest that the type of firearm, its accessibility, and sweeping gun control legislation have had little impact on the frequency or severity of mass shootings in the United States. As a result, it is crucial to consider other contributing factors to mass shootings beyond just firearm regulations.

The Correlation Between Mass Shootings and Prescription Drugs

When examining graphs of mass shootings over the years alongside the approval of SSRIs, stimulants, and non-stimulants, a noticeable correlation emerges: mass shootings have increased as the prevalence of prescription drugs has risen.

However, it’s important to remember that correlation does not imply causation. To understand the true relationship between mass shooters and prescription drug use, we must carefully analyze all available data and consider multiple factors.

Occam’s Razor

Let’s address the central issue: Has the rise in mental illness led to an increase in mass shootings, or is there a direct correlation between prescription drug use and these tragic events in America?

Mass shootings are influenced by many factors, including opportunity, mental illness, and individual vulnerability, so it’s overly simplistic to place the blame solely on prescription drugs.

However, there is a notable correlation between the use of SSRIs, antidepressants, and benzodiazepines with increased aggression and, in some cases, homicide.

School shootings, for instance, saw a rise after the 1990 Gun-Free School Zones Act, which some argue made schools more vulnerable. The prevalence of mass shootings also increased as media coverage of these events became more frequent, a phenomenon known as the “contagion effect.” ¹¹

Additionally, these types of attacks have grown more common as the rate of mental health issues has risen.

The critical question isn’t whether prescription drugs are the sole cause of mass shootings but rather, what role do they play in these incidents? While many factors contribute to mass shootings, the correlation between prescription drug use and these events is significant and warrants closer examination.

Studies Around the Globe

In 1996, the Health Insurance Portability and Accountability Act (HIPAA) significantly restricted researchers’ access to medical records in the United States, making it particularly difficult to gather verifiable data on the relationship between mass shootings, prescription drugs, and criminal behavior.

However, studies from other countries have explored the effects of prescription drugs on crime and homicide.

For example, in 2007, the FDA advised that family members and caregivers of those taking antidepressants should be vigilant for emergency symptoms.

This warning led to a 2017 review of 70 drug trials obtained from the European Medicines Agency. The review revealed that Duloxetine, an SSRI used to treat depression and nerve pain, was associated with a 4 – 5 times higher risk of suicide and aggression compared to those taking placebos. ⁹

A Swedish study released in 2020 found a correlation between SSRI treatment and increased rates of violent crime. The study examined SSRI use among individuals aged 15 – 60 between 2006 and 2013, revealing that 2.7% of participants went on to commit violent crimes. The risk of violent behavior appeared to be particularly elevated within twelve weeks of discontinuing SSRIs. ³

In 2015, researchers published a study examining 959 individuals who committed homicide in Finland between 2003 and 2011. The study found that those taking psychotropic medications—including antidepressants, benzodiazepines, and antipsychotics—had an elevated risk of committing homicide. Notably, the risk was higher for individuals taking benzodiazepines compared to those taking antidepressants. ¹⁰

How Many Mass Shooters Had Mental Health Issues?

It’s evident that anyone who indiscriminately shoots defenseless people likely has significant mental health issues. However, to move beyond assumptions, we delved into studies and scientific research to better understand the connection between mental health and mass shootings.

A 2021 study on mass murderers included incidents involving any type of weapon, not just firearms, and used the FBI’s definition of mass killings—four or more people killed, including in cases of gang and family violence.

The study found that 18% of the 1,315 mass killers examined had experienced lifetime psychotic symptoms. Among those, 8% used firearms to carry out their crimes. ¹⁹

Using the definition of indiscriminate mass shootings, out of 149 individuals, 72 exhibited prior symptoms of mental illness, 24 had unclear histories, 17 showed no signs of mental illness, and 36 cases are still awaiting further analysis. ²⁰

A third study found that suicidality was the most common mental health issue among perpetrators, present in 30% of cases. Additionally, 31% of perpetrators had experienced severe childhood trauma, and 80% were undergoing an active crisis at the time of the incident. ²¹

While we can’t determine exactly how many mass shooters had prior mental health issues, it is clear that those who indiscriminately target innocent people are more likely to have underlying mental health conditions.

How Many Mass Shooters Used Prescription Drugs?

The question of whether prescription drugs play a role in mass shootings remains unresolved. While some studies suggest there is no significant correlation, an FBI analysis of mass shootings from 2000 to 2013 found that 22% of shooters had used either illicit or prescription drugs. ²²

A study of 180 mass shooters conducted between 2016 and 2020 revealed patterns consistent with those discussed earlier in this article.

Although the study did not specifically examine the use of prescription drugs by mass shooters, it did analyze mental health and illicit drug use. The findings revealed that 34% of shooters had used illicit drugs, while 58% experienced significant mental health issues. Additionally, 34% had a history of depression, and 25% were actively experiencing depression at the time of the incident. ²⁷

Thirty-two percent of shooters received treatment from a mental health professional, which included medication, counseling, and/or involuntary hospitalization.

Although the study lacked complete evidence and included various types of shootings (such as dispute-related and family shootings), it still found that one-third of the individuals involved were using drugs, and another third had undergone mental health treatment, including the use of prescription medications.

Prescription Medication and School Shootings

With over 3 million children prescribed medication for behavioral issues, we questioned whether these drugs contribute to the rise in school shootings. Unfortunately, the answer is clouded by misleading terminology and HIPAA regulations.

While not all medicated children or adolescents commit acts of violence, those who do often have a history of mental illness and medication use.

The Secret Service began studying school shootings in the early 1990s, examining how multiple environmental factors contribute to targeted attacks. Their investigations consider the links between mental health history and the risks of school shootings.

Although these reports don’t specify how many attackers were on prescribed medications, they do provide insights into how many were receiving mental health treatment.

In 2002, it was found that 10% of school shooters were not taking their prescribed medications, 34% were receiving mental health treatment, and 17% were diagnosed with a behavioral disorder such as depression. ²⁵

In the agency’s 2019 report, which analyzed factors contributing to 35 targeted attacks on schools between 2008 and 2017, 54% of attackers had received mental health treatment before the attack. Additionally, 20% used drugs that were not prescribed to them, and 9% abused drugs that were prescribed. ²⁶

This study is particularly noteworthy because many of these students used weapons other than firearms. However, the vast majority of attackers came from broken homes, exhibited behaviors indicative of poor mental health, and had a history of drug use, whether recreational or prescribed.

School Shootings, Prescriptions, and Definitions

The K-12 Shooting Database reported 349 school shootings in 2023. David Riedman, the founder, included a wide range of incidents in this count, such as gang-related shootings, those occurring outside school hours, and off-campus shootings.

Using this broad dataset to explore a correlation between prescription medication and school shootings could distort the findings, as the motivations behind these shootings vary greatly. However, by focusing on the Secret Service and FBI’s definitions of targeted school shootings, we can more accurately assess the role of prescription medications in adolescent behavior and targeted attacks on schools.

In research, broad definitions can inflate the number of unmedicated attackers and lead to misleading conclusions, underscoring the importance of precise criteria when studying the impact of prescription drugs on school shootings.

Correlation Between Antidepressants and School Shootings

There has been a 384% increase in school shootings since 1990, prompting us to question whether this rise is linked to the increased use of antidepressants. Between 2008 and 2017, 40% of school attackers had an official mental health diagnosis, with suicide often being a significant factor.

From 1998 to 2012, there were seventy targeted attacks on American schools. Among the attackers, twelve were confirmed to have been prescribed medication, with two taking Ritalin and all twelve on some form of antidepressant. The most commonly prescribed antidepressants were Prozac and Effexor.

In another study, focusing on averted school shootings from 2006 to 2018, 63% of plotters (those who planned but did not carry out an attack) exhibited psychological symptoms related to depression and suicidality. Of the fifty-seven individuals studied, fifteen were receiving mental health treatment. ²⁴

Violence Cases Linked to Prescription Drugs

Over the years, some notable shootings and gruesome killings have been attributed to prescription drug use. We’ll cover many of those in this section.

• 1989: Joseph T. Wesbecker shot twenty co-workers, killing eight. Wesbecker began using Prozac (SSRI) one month before the shooting.
• 1995: Jarred Viktor was 15 when he began taking Paxil (SSRI). Ten days after he began taking the drug, he stabbed his grandmother 61 times.
• 1996: Kurt Danysh murdered his father seventeen days after he began taking Paxil (SSRI). He was only eighteen years old, and his doctor performed no psychological evaluations. Danysh told the police that the medication made him feel odd, saying, “I just act differently. I don’t have the energy or personality I used to. I spend half the time in a trance.”
• 1997: Luke Woodham stabbed his mother and traveled to Pearl High School, where he killed two students and injured six others with a 30-06. The assistant principal shot Woodham with his personal .45 ACP. Woodham was taking Prozac (SSRI).
• 1998: Kip Kinkel, aged fifteen, shot both parents and murdered two classmates, injuring 22 others. Kinkel was taking Prozac at the time of the shootings (SSRI).
• 1999: Eric Harris and Dylan Klebold killed 12 classmates and one teacher, injuring 23 others during the Columbine school shooting. Harris was prescribed Zoloft (SSRI) and Luvox (SSRI) before the shooting.
• 2001: Christopher Pittman killed his grandparents with a .410 shotgun at age 12. Pittman was prescribed Zoloft (SSRI) and told his psychiatrist, Dr. Lanette Atkins, that he heard voices telling him to “Kill, kill, do it, do it.”
• 2001: Andrea Yates killed all five of her children while taking Effexor (SSRI). After the gruesome tragedy, Effexor added homicidal thoughts to its list of side effects. It is estimated that 19,000 of the 19 million people prescribed Effexor up to 2005 experienced homicidal thoughts.
• 2001: Cory Baadsgaard walked into his high school with a rifle taking twenty-three classmates hostage. Fortunately, no one was injured, but Baadsgaard’s doctor recently switched him from Paxil (SSRI) to Effexor (SSRI) before the incident. The popular honor student has no recollection of the event.
• 2005: Jeff Weise shot his grandfather, his grandfather’s girlfriend, and murdered 10 students at Red Lake School. He wounded twelve more and eventually shot himself. Weise was taking an adult dose of Prozac (SSRI).
• 2008: Steven Kazmierczack killed six people and wounded twenty-one others at Northern Illinois University. Kazmierczack was prescribed Prozac (SSRI), Xanax (Benzodiazepine), and Ambien (Sedative) three weeks before the mass shooting.
• 2009: Robert Stewart killed eight elderly patients and injured three others at his estranged wife’s work (Pinelake Health and Rehab). The killings occurred two weeks after Stewart began taking Lexapro (SSRI).
• 2012: James Holmes killed twelve people and wounded seventy others during a screening of The Dark Night. Holmes was taking Sertraline (SSRI). Holmes sent a notebook to his psychiatrist, claiming that the medication decreased his anxiety and he lost his fear of consequences. As the dosage became higher, his thoughts became more obsessive.
• 2012: Adam Lanza murdered his mother before killing twenty young students and six teachers at the school where his mother worked. Lanza’s uncle confirmed that he was taking Fanapt, a controversial antipsychotic.
• 2014: Ivan Lopez shot fifteen of his fellow soldiers, killing three of them at Fort Hood. He was being treated at the VA (which notoriously overmedicates soldiers). The VA confirmed that Lopez was taking antidepressants (SSRIs) at the time of the shooting.
• 2015: Dylann Roof killed nine churchgoers and injured one more in the Charleston Church Shooting. While largely attributed to racism, Roof was taking antidepressants when he committed the massacre.
• 2016: Arcan Cetin killed four females and one man at the Cascade Mall when he was twenty years old. Cetin was seeing a psychiatrist and prescribed medication for ADHD and depression. Prozac (SSRI) was one of the medications he was taking.
• 2017: Nikolas Cruz killed seventeen people at his former high school. Cruz’s mother stated he had ADHD and Autism. The Florida DCF confirmed that Cruz was medicated for behavioral issues but did not confirm the prescription.
• 2017: Stephen Paddock killed fifty-eight and wounded many more at a music festival in Las Vegas. Paddock was prescribed Valium (Benzodiazepine) and did have it in his system at the time of his autopsy.
• 2019: Patrick Crucius killed twenty-three at an El Paso Walmart. Crucius’ lawyers confirmed that the shooter was taking antipsychotic medication at the time of the shooting but did not reveal which medication.

Unfortunately, this is not a comprehensive list because prescription drug use data is largely unavailable for many others. However, it should be noted that other mass murderers have not taken prescription drugs, but most were exhibiting some type of concerning behavior before they carried out their attacks.

Correlation Between Violence and Prescription Drugs

Black box labels on prescription drugs serve as critical warnings to patients and healthcare providers about potential severe side effects. These warnings are typically added after clinical trials or reports of adverse reactions from patients who have experienced issues with the medication.

SSRIs, benzodiazepines, and antipsychotics carry multiple warning labels, including the risk of increased suicidal thoughts and behaviors. However, despite the evidence outlined above, pharmaceutical companies are generally more reluctant to include warnings related to violence on these labels.

Unfortunately, pharmaceutical companies wield significant influence within the FDA, even going so far as to pay FDA panelists tens of thousands of dollars (NIMH). ¹⁴

Representatives from these companies have expressed concerns that black box warnings might discourage doctors from prescribing their medications. ¹⁵

Despite interference from pharmaceutical companies, the Food and Drug Administration (FDA) eventually began issuing black box warnings on antidepressants. This decision came after clinical trials revealed that 4% of patients taking these medications committed suicide, compared to only 2% of those taking placebos.

Following the introduction of these warnings, prescription rates declined, with a 31% reduction among adolescents, a 24.3% decrease among young adults, and a 14.5% drop among adults. ¹⁸

The Missing Link: Drugs and Mass Shootings

Prescription drugs designed to balance brain chemistry and treat mental health conditions undeniably have adverse effects. However, the extent of these effects is often overlooked when studying their potential link to criminality and violent behavior, such as mass shootings. To better address and prevent such violence, it’s crucial to consider the correlation between prescription drug use and violent behavior in the context of other contributing factors.

While proponents of these medications often highlight their benefits over potential drawbacks, it’s essential to fully understand and evaluate all possible causes and underlying factors involved in these tragic incidents. By doing so, we can develop a more comprehensive approach to combating mass shootings and other forms of violence, ensuring that all aspects—including the impact of prescription drugs—are thoroughly examined and addressed.

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