I'm sure everyone is as stunned as I was yesterday to hear about the murders at Va-Tech. Today we learn more about what happened and some about those involved. The young 18 year old girl that the killer was obsessed with, the Israeli professor that blocked the doorway after he was shot so his students could escape, and a 23 year old South Korean student on Anti-depressants. Not to get me wrong here, I'm a firm believer in poly-pharmacy, I'm an Internist after all and I don't get started until I'm using at least 3 drugs.My mentor in my residency Dr. Bill Rebhun would always chastise me by saying " Weldon, if you have to use 3 medications, you don't know what the hell is going on with your patient". I think he may have been right. Neurochemistry has always been a complex topic for me to try and get my head around and I feel that the complex interactions of various drugs may be something that we need to be aware of in these cases. There is a link(although small) between SSRI (Selective Serotonin Re uptake Inhibitors) anti-depressants and increased suicides published in the American Journal of Psychiatry . Some Doctors have suggested that these kids just weren't medicated enough and it was under dosing in those cases. It used to be that when people were suffering from depression they went on suicide watch.....not killing sprees. Yesterday, another kid on Prozac kills a large group of people and then himself, not the other way around. A look back at some of the more notorious cases may show us something......
1989 – Joseph Wesbecker walked into a printing plant in Louisville, Kentucky and killed eight co-workers and then himself. Mr. Wesbecker was taking Prozac, which had recently been approved.
1998 – 14-year-old Kip Kinkle, who was on Ritalin and Prozac, killed his parents and then went on a shooting spree at his Springfield, Oregon, high school, killing two and injuring 22
1999 – Eric Harris, one of the teen gunmen in the infamous Columbine massacre in 1999, had been prescribed Luvox, an antidepressant similar to Prozac. The two boys entered the school with an arsenal of weaponry killed 12 people with many more injured before taking their own lives.
2001 – Christopher Pittman killed his grandparents while taking Zoloft, another antidepressant similar to Prozac. His lawyers faulted the drug, but a jury in Charleston, S.C., convicted him of murder in February.This could be a chicken or the egg scenario......is it the mental illness or the mental illness+meds. I recently read that one concern about anti-depressant therapy may be a partial dissociation from reality and perhaps a loss of a feeling of consequence. It may also be that these people were just evil or it was just the mental illness . I worry that there could be an unintended consequence to our wide use of some of these meds. It's something to think about.