Violent acts directed toward oneself are very complex behaviors with multiple factors influencing them. Before discussing whether antidepressants cause individuals to become violent, you should understand what it way to state there is a causal link between these medications and violence. One normally thinks of cause in terms of simple physics like a ball causing another ball to maneuver when it strikes it.
Obviously, this isn't the same type of causal relationship that exists between antidepressants and violence. In the physical respect of causality, the only definitive thing that can be said of antidepressants is that they block a transporter pump, causing it to fail to reuptake a neurotransmitter in the synaptic cleft. How this will cause an antidepressant effect after that is purely theoretical, although obviously depending on sound scientific reasoning.
If one reads the Physicians' Desk Reference regarding how antidepressants work, the written text rightly states that it is unknown. Thus, even providing a reason as to how antidepressants cause depression to lift is not definitively known. Another kind of causal relationship may be the relationship that exists when thinking about what causes people to behave in certain ways. For example, hunger causes anyone to eat or thirst causes anyone to drink.
They are apparently simple causal connections between feelings and acts. Other causal connections that are more complicated involve the problem of motives as in what's the motive behind someone committing a specific crime, for example revenge, jealousy, greed, etc. It is in these situations that people aim to understand the causal relationship from a violent act and the frame of mind from the perpetrator before committing the act.
Typically, when one seemingly cannot find any rational motive behind a particular violent act, then the act is related to a mental illness. If someone is on drugs or alcohol or some other allegedly "mind-altering" medication, then those might be implicated as well. Even though mentally ill are far more probably be victims of crimes instead of perpetrators of crimes, someone with mental illness tends to get more press when committing a crime. Many people with mental illnesses are on medication of some kind.
Sorting out the causal link from a particular violent act and the underlying causes is comparable to attempting to find the causal link between various genetic, physiological, and environmental factors that ultimately lead to disease however with the added complication of factoring in motive, intent, or one's frame of mind. Therefore, all that can definitely be established are correlations. Currently, seems like that overall, because the introduction of SSRI antidepressants, rates of suicide happen to be decreasing.
However, in many studies regarding particular SSRIs, it has been shown that a heightened rate of suicide and suicide attempts occurs at the outset of treatment. You should remember that these statistical analyses do not sort out the issues that are more pertinent as to whether an SSRI will influence the odds that any one individual will attempt or succeed at suicide. For that, one have to know the particular facts surrounding each particular attempt or completion.
Many possible reasons exist for there being increased violence throughout the initiation of antidepressant treatment. First, antidepressants have long been known to guide potentially to an increase in suicide during the initiation of treatment. This is attributed to the fact that there's generally an improvement in energy before it comes with an improvement in mood so that a depressed patient now has the drive to act on his or her thoughts of suicide. Second, it appears that SSRIs with shorter half-lives (i.e., SSRIs that are metabolized and eliminated through the body more rapidly) have the symptoms of a stronger correlation than SSRIs with longer half-lives.
This can be due to the fact that there is an association between half-life and the discontinuation syndrome one experiences when stopping these medications abruptly. The discontinuation syndrome can be hugely uncomfortable and anxiety provoking, prompting visitors to misinterpret their symptoms like a worsening of their depression.
At this time, this relationship is purely speculative. Third, the antidepressants themselves have unwanted effects associated with them, including agitation, restlessness, anxiety, insomnia, headaches, and indigestion. These side effects could be misinterpreted as a worsening of depression, despite the fact that they aren't. Finally, in some rare patients, antidepressants could cause a switch right into a manic state, where there might be irritability and poor impulse control in the presence of suicidal or homicidal ideation.
Statistically speaking, the elevated use of antidepressants in the population leads to a heightened probability that people subjected to antidepressants will endeavour or complete suicide merely by the fact that they'd have acted on these thoughts whether they were on the antidepressants or not.
If the entire population of the United States received antidepressant medications and the rates of violent acts increased slightly during the year that they received them (violent acts come with an annual statistical variability), the correlation between the medication and the acts will be 100%. This could have absolutely no meaning in terms of figuring out a causal link. Thus, at present, no clear causal links have established yourself between antidepressant use and violence.
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