According to Steven Kazmierczak's girlfriend, about three weeks before he shot students and then himself at Northern Illinois University, he stopped taking the antidepressant medication (Prozac) prescribed for him by a psychiatrist.
It's not clear that discontinuing his medication led to Kazmierczak's shooting rampage. But stopping antidepressants can lead to suicidal thoughts and behavioral changes that can result in violence.
You may have read, too, that Prozac can increase the risk of suicides, especially in children and adolescents. And it is true that, as deep depression lifts while taking an antidepressant, an individual may regain enough energy to attempt suicide.
Overall, however, suicide is less likely when depression is treated by antidepressants. Violent behavior is also uncommon in the vast majority of people with schizophrenia, depression, and bipolar disorder, whether they are taking medications or not.
Failure to take antidepressant medications is a common problem. Some studies have shown that about one quarter of patients stop taking antidepressant medications within three months after they have started taking them, and that less than half are still taking their medication at the end of six months. Many others go on and off their medications over a period of years.
Side effects are frequently the reason why people stop taking their drugs. Side effects of the selective serotonin reuptake inhibitors (SSRIs) like Prozac, Zoloft, Paxil, and others include insomnia, restlessness, agitation, excessive sweating, weight changes, headaches, and sexual dysfunction — diminished sexual desire and loss of the ability to achieve an orgasm.
Still other depressed people stop their medications because they can't afford the cost of the drugs, or believe they no longer need the drugs once they start to feel better.
Individuals should stop taking an antidepressant only after discussing it with their doctor. While violent behavior is unlikely from stopping these medications, the depression may worsen, their mood may switch from depression to manic symptoms, and suicidal thoughts may emerge.
If you know that a friend or family member has stopped taking his or her antidepressant, or if they begin to demonstrate unusual or erratic behavior, urge them to see their doctor. Another medication or a lower dose may alleviate the troublesome side effects, or be less expensive. And they may get advice from their doctor on how to successfully stay on their medications.
