Antidepressant Drugs Scientific Resources
(1) Antidepressants Cause or Worsen Activation (Over-stimulation) and Mania
In 2003/2004 (below), I wrote about the stimulant or activation syndrome of adverse drug reactions caused by SSRI antidepressants that are very dangerous and closely resemble amphetamine- and cocaine-like effects. The FDA then included this syndrome in its class warning for all antidepressants, including, for example, Zoloft where it states : “The following symptoms, anxiety, agitation, panic attacks, insomnia, irritability, hostility, aggressiveness, impulsivity, akathisia (psychomotor restlessness), hypomania, and mania, have been reported in adult and pediatric patients being treated with antidepressants for major depressive disorder as well as for other indications, both psychiatric and non-psychiatric” (below, pp. 12-13). The scientific literature confirms that this syndrome is very common in adults and even more common in children, afflicting up to 50%, and causes or contributes to a whole array of behavioral abnormalities including harm to self and to others, and bizarre out-of-character antisocial behaviors (see this Section and Sections 2 and 3 below).
A. Adults
- Breggin 2003/2004, SSRI activation, mania violence & suicide
- Dumlu 2011, Anti-depressant discontinuation syndrome and bipolarity
- Effexor all adverse reports to FDA 2003-2008. Search for items like homicide, homicidal ideation, aggression, irritability, violence, hostility, mania, depression, depressed mood, suicide & suicidal ideation, intentional overdose, self injurious behavior, anxiety, agitation, etc.
- FDA 2004 Talk paper says antidepressants “known” to cause activation and worsening of condition
- Ghaemi 1999, Schizoaffective bipolar antidepressants
- Goldberg 2003, Overview of current controversies
- Henry 2001, Bipolar SSRI mania risk
- Howland 1996, Induction of mania
- Leverich 2005, Bipolar switch Effexor, Zoloft and Wellbutrin
- Maund, Guski & Gøtzsche, 2016. Duloxetine (Cymbalta), even for urinary incontinence, causes activation and abnormal behavior related to violence, suicide, and personality change.
- McElroy 2006, Bipolar antidepressant combo suicide needs lithium
- Morishita 2003, Paxil mania high rate
- Mundo 1993, Drug induced mania
- Okada 2001, Violent acts on fluvoxamine
- Pacchiarotti 2013, The International Society for Bipolar Disorders (ISBD) Task Force Report finds grave risk of inducing severe mania by giving antidepressants to patients with a past history of manic symptoms.
- Preda 2001, Antidepressant mania and psychosis
- Ramasubbu 2004, Age effects on antidepressant
- Schneck 2011, Bipolar mania rapid cycling and antidepressants
- Sparhawk 2011, Antidepressant bipolar
- Spiget 1999, Adverse reactions selective serotonin reuptake inhibitors
- Tondo 2010, Mania review
- Vázquez 2011, Mania
- Viktorin 2014, Risk of manic switch
- Zoloft Label 2014 with highlights
B. Children
- Aggarwal 2011, Antidepressant child-mania report
- Amitai 2015, important: SSRI activation and mania very severe in children and adolescents
- Ameen 2003, SSRIs during pregnancy cause serotonin syndrome in newborns
- Breggin 2003/2004, SSRI activation, mania violence & suicide
- Effexor all adverse reports to FDA 2003-2008. Search for items like homicide, homicidal ideation, aggression, irritability, violence, hostility, mania, depression, depressed mood, suicide & suicidal ideation, intentional overdose, self injurious behavior, anxiety, agitation, etc.
- FAEDA 2003, SSRI child mania in bipolar
- FDA 2004 Talk paper says antidepressants “known” to cause activation and worsening of condition
- Goodman 2007, Child activation suicide
- Gould 1996, Child suicide psychosocial risk factors
- Joseph 2009, SSRI childhood mania
- Pravin 2004, SSRI-induced mani in children
- Safer 2006, Activation age related underreported
- Schirman 2009, SSRI hypo-mania in children
- Shirazi 2005, SSRIs have high-mania-switch rate
- Viktorin 2014, Risk of manic switch
C. Serotonin Syndrome (SS). SS is a toxic reaction caused by drugs that stimulate serotonin. It varies from minimal to deadly and can be acute or chronic. Recovery can seem complete or it can leave neurological disability consistent with brain damage, including cognitive decline, emotional instability, and hyperactive reflexes. It is easily confused with neuroleptic malignant syndrome (NMS) (antipsychotic drugs and tardive dyskinesia resources center); but characteristically reflexes are subdued in NMS and hyperactive in SS.
(2) Antidepressant-induced Suicide
Antidepressant-induced suicidality is among the most scientifically established facts about antidepressants. Ironically, it is much better established that any claims for antidepressant effectiveness as a treatment (see Section 8 below). It is not surprising that children appear to be more vulnerable than adults to antidepressant-induced suicidality. Because of the immaturity of their brains and minds, their relative inexperience in life, and their dependent status, they are more vulnerable to all neurotoxins, which is why we prohibit their use of other strong psychoactive substances, such as alcohol and marijuana.
I have been writing about antidepressant-induced suicide for many years in books and scientific articles. My book that focuses most intensively on the subject is Medication Madness: The Role of Psychiatric Drugs in Cases of Violence, Suicide and Crime. Many of the individuals in the book are taken from malpractice and product liability cases in which I have testified. Most of my scientific articles in Section 7 of this Resource Center also deal with this subject, including Breggin, 1992, 2001, 2003/2004, 2006a-d, 2010, 2014, and 2016. The following material was originated by other scientists and clinicians:
A. Adults
- Aursnes 2005, Paxil adult suicide
- Aursnes 2006, Paxil adult suicide
- Bielefeldt 2016, SSRI-induced suicidality in healthy subjects
- Bloch 1995, Paxil suicide
- Breggin 2003/2004, SSRI violence suicide review
- Breggin 2006a, Paxil GSK Special Report Part I
- Breggin 2006b, Paxil GSK Special Report Part II
- Breggin 2006c, Paxil GSK Special Report Part III
- Breggin 2006d, Regulation of antidepressants
- Breggin 2007, Medication spellbinding
- Breggin 2010, Antidepressants military suicides
- Breggin 2017, How FDA avoided finding adult antidepressant suicidality
- Dasgupta 1990, Violent suicidality cases
- Donovan 2010, Self-harm epidemiology suicide study
- DSM IV TR 2000 akathisia
- Fava 2015, suicide withdrawal
- FDA 2004 Talk paper says antidepressants “known” to cause activation and worsening of condition
- FDA 2006 drug companies allowed to hide adult suicide data
- Effexor all adverse reports to FDA 2003-2008. Search for items like homicide, homicidal ideation, aggression, irritability, violence, hostility, mania, depression, depressed mood, suicide & suicidal ideation, intentional overdose, self injurious behavior, anxiety, agitation, etc.
- Fergusson 2005, suicide SSRIs
- Feuerstein 1986, Pre-SSRI research shows antidepressants cause suicide
- Frankenfield 1994, Prozac suicides more violent
- Fridell 1996, Five year suicide followup
- Gøtzsche 2016, Antidepressants increase suicide and violence at all ages
- Grounds 1995, Antidepressant suicides especially violent
- GSK Paxil May 2006 suicide adults dear doctor letter
- GSK Paxil May 2006 suicide adults dear doctor letter highlight
- Healy 2000, Zoloft suicidality
- Hengartner 2019, A definitive new study showing antidepressants cause suicide in adults
- Hoover 1990, Violent suicidality cases
- Jakobsen 2017, Meta-analysis shows antidepressants do more harm than good
- Juurlink 2006, suicide in elders
- Lancet Editor 1990, SSRIs & Suicide
- Ljung 2008, ethnic suicide differences
- Makris 2012, SSRI suicides violent in study
- Maund, Guski & Gøtzsche, 2016. Duloxetine (Cymbalta), even for urinary incontinence, causes activation and abnormal behavior related to violence, suicide, and personality change.
- Medawar 2003/2004, Paxil suicides under-reported in Great Britain
- Paxil 2006 Adult Suicide Label Warning before being dropped (highlighted p. 12)
- Paxil 2006 Adult Suicide Warning excerpt from 2007 PDR before being dropped
- Paxil 2008, full prescribing info and medication guide
- Perroud 2012
- Pompili 2010, No difference among antidepressants for suicide completed rates
- Raja 2009, suicide SSRIs hospital admissions
- Rothschild 1991, Fluoxetine re-exposure after suicide attempts
- Rubino 2006, Venlafaxine (Effexor) highest rate of suicide
- Ruengorn 2011, suicide SSRIs after hospitalization
- Sheehan 2015, SSRI violent suicides
- Soloff 1986, Amitriptyline violence and suicide
- Stone & Jones, 2006 Paxil
- Teicher 1990, Cases of Prozac suicidality
- Teicher 1993, Suicide overview antidepressants
- Tint 2008, Withdrawal suicide
- Valenstein 2009, suicide VA veterans
- Valenstein 2009, suicide VA veterans highlighted
- Valuck 2009, Antidepressant suicide risk increased during both initiation and withdrawal
- Viktorin 2014, Risk of manic switch
- Wirshing 1992, Akathisia and suicide clinical reports
- Zoloft Label 2014 with highlights
B. Children
- Aggarwal 2011, Antidepressant child-mania report
- Amitai 2015, SSRI child activation and mania in children and adolescents
- Breggin 2003/2004, SSRI violence suicide review
- Christiansen 2016, increasing suicidality in low risk youth
- Effexor all adverse reports to FDA 2003-2008. Search for items like homicide, homicidal ideation, aggression, irritability, violence, hostility, mania, depression, depressed mood, suicide & suicidal ideation, intentional overdose, self injurious behavior, anxiety, agitation, etc.
- Example of all SSRI Black Box Warnings for child suicide
- FAEDA 2003, SSRI child mania in bipolar
- FDA 2004 Talk paper says antidepressants “known” to cause activation and worsening of condition
- FDA 2005, Public Health Advisory
- Goodman 2006, SSRI suicidality inchildren.pdf
- Goodman 2007, Child activation suicide
- Gøtzsche 2016, Antidepressants increase suicide and violence at all ages
- Gould 1996, Child suicide psychosocial risk factors
- Hammad 2006, SSRI suicidality in children
- Jureidini 2004
- Lancet Editor 1990, SSRIs & Suicide
- Leslie 2005
- Newman 2004, FDA summary
- Safer 2006, Activation age related underreported
- Sharma 2016, SSRIs doubles risk of aggression & suicide
- Umetsu 2015, Large epidemiological study based on FDA reports
- Viktorin 2014, Risk of manic switch
- Whittington 2004, SSRIs children metaanalysis
C. SSRIs Cause Especially Violent Suicides
(3) Antidepressant Violence, Aggression, Hostility, Irritability and Antisocial Behavior
I have been writing about antidepressant-induced violence for many years in books and scientific articles. My book that focuses most intensively on the subject is Medication Madness: The Role of Psychiatric Drugs in Cases of Violence, Suicide and Crime. Many of the cases in the book involve criminal cases in which I have testified. Most of my scientific articles in Section 7 also deal with this subject, including Breggin, 1992, 2001, 2003/2004, 2006d, 2010, 2014, and 2016. The following material was originated by other scientists and clinicians:
A. Adults
- Bielefeldt 2016, SSRI-induced violent suicidality in healthy subjects
- Dr. Breggin’s Paxil Product Liability Report in the Lacuzong Case
- Effexor all adverse reports to FDA 2003-2008. Search for items like homicide, homicidal ideation, aggression, irritability, violence, hostility, mania, depression, depressed mood, suicide & suicidal ideation, intentional overdose, self injurious behavior, anxiety, agitation, etc.
- Eikelenboom Schieveld Lucire 2016, genetic vulnerability to suicide & violence on antidepressants
- FDA 2004 Talk paper says antidepressants “known” to cause activation and worsening of condition
- Gøtzsche 2016, Antidepressants increase suicide and violence at all ages
- Grounds 1995, Antidepressant suicides especially violent
- Healy 2006, Antidepressants and violence
- Judicial Opinion 2011, Breggin expert in Prozac Murder Case
- Lucire & Crotty 2011, genetic vulnerability akathisia, suicide & violence
- Moore 2010, Violence rates all drugs FDA
- Okada 2001, Luvox violence
- Proof Eric Harris, Columbine shooter, taking antidepressant
- Rouve 2011, Violence-causing drugs, French database
- Slashinski 2003, Sexual violence, SSRIs and other drugs
- Soloff 1986, Amitriptyline violence and suicide
- Trois 1995, 47% of retarded subjects on Prozac show increased aggression
- Viktorin 2014, Risk of manic switch
- Zoloft label 2012
B. Children
- Also see Scientific Sections 4 & 5
- Amitai 2015, SSRI child activation and mania in children and adolescents
- Effexor all adverse reports to FDA 2003-2008. Search for items like homicide, homicidal ideation, aggression, irritability, violence, hostility, mania, depression, depressed mood, suicide & suicidal ideation, intentional overdose, self injurious behavior, anxiety, agitation, etc.
- FDA 2004 Talk paper says antidepressants “known” to cause activation and worsening of condition
- Gøtzsche 2016, Antidepressants increase suicide and violence at all ages
- Healy 2006, Antidepressants and violence
- Hemminki 2017, youth violence increased by antidepressants
- Jain 1992
- Judicial Opinion 2011, Breggin expert in Prozac Murder Case
- Jureidini 2004
- Karanges, 2011, developmental neurotoxicity and brain damage in children (large review)
- King 1991
- Molero 2015, antidepressant-induced violence crime in children and youth
- Proof Eric Harris, Columbine shooter, taking antidepressant
- Riddle 1990
- Sharma 2016, SSRIs doubles risk of aggression & suicide
- Viktorin 2014, Risk of manic switch.
- Wilens 2003
- Zoloft Label 2014 with highlights
C. Animal Studies
- Bienkowski 2012, Prozac makes fish violent
- Karanges, 2011, developmental neurotoxicity and brain damage in young animals (large review)
- Kiryanova 2014, Increased aggression in adult male mice exposed to Prozac in early in life
- Lovett 2012, fish on Prozac “the males start killing the females”
- Martin 2019, Prozac pollution alters group behavior of mosquitofish
- Parolini 2019, Prozac pollution alters behavior of zebrafish
- Ricci 2012, Prozac causes violence in adolescent hamsters
- Slater 1978, Prozac turns gentle cats into hostile ones
- Svirsky 2016, Prenatal exposure to Prozac causes aggression in mice offspring
- Weinberger 2014, Prozac makes fish disturbed and violent.
(4) Antidepressant-Induced Apathy, Indifference, Lack of Caring or Empathy in Children and Adults
- APA Textbook of Psychiatry 2010, SSRI apathy
- Barnhart 2004, SSRI apathy syndrome
- Breggin 2007, Medication spellbinding
- Cartright 2016, long term deterioration
- El Mallak 2011, chronic depression dysphoria caused by antidepressants
- Garland 2001, SSRI apathy syndrome in child
- Goldsmith 2001
- Makris 2012
- Marin 1990, Diagnosis of apathy
- Moret 2009, Apathy, lack of motivation, frontal lobe syndrome
- Perroud 2012
- Read 2014, Antidepressant-induced apathy and indifference
- Reinblatt 2006, SSRI-induced apathy
- Reinblatt 2009, SSRI adverse activation in children
- Rütgen 2019, Corroborates one of Dr Breggin’s basic scientific observations, that all psychoactive drugs suppress empathy for self and others and antidepressants very potently.
- Sansone 2010, Apathy and indifference
- Wongpakaran 2007, SSRI-induced apathy in elderly.
(5) Persistent Sexual Dysfunction
- Csonka & Shipko, sexual dysfunction
- FDA 2018, Citizen-petition-sexual-side-effects
- Fisher & Thomson 2006, SSRIs disrupt love, sex, family
- Healy 2017, Enduring sexual dysfunction
- Hogan 2014, 120 cases of enduring sexual dysfunction
- Serretti 2009, Treatment-emergent sexual dysfunction
- Simonsen 2016, animals persistent sexual dysfunction
- Stockmann 2018, SSRI and SNRI withdrawal.
(6) Antidepressants Full Prescribing Information (the Label) with Assorted Dates
(7) Selection of Dr. Breggin’s Antidepressant-Related Articles
- Breggin 1992, Prozac suicidality and withdrawal
- Breggin 2001, Luvox mania and aggression
- Breggin 2003/2004, SSRI violence suicide review
- Breggin 2003, Regulatory agencies and SSRI suicidality
- Breggin 2006a, Paxil GSK Special Report Part I
- Breggin 2006b, Paxil GSK Special Report Part II
- Breggin 2006c, Paxil GSK Special Report Part III
- Breggin 2006d, Regulation of antidepressants
- Breggin 2007, Medication spellbinding
- Breggin 2008, SSRIs cause birth defects
- Breggin 2010, Antidepressants military suicides
- Breggin 2014, Rights of children and parents
- Breggin 2014, TBI PTSD psychiatric drugs
- Breggin 2016, Drug overview rational principles.
(8) Antidepressant Ineffectiveness
A. Adults
B. Children
C. Antidepressants Make People Worse
(9) Antidepressant Increase the Death Rate in Humans, and Damage the Fetus, Newborn, Nursing Infant, and Animals
A. Animals: Damage to Fetus and Young Animals
- Ansorge 2004, Prozac brain damage in rats
- Cabrera 1998, Brain damage animals
- Gaspar 2003, SSRI brain damage review
- Ghaemi 2013, Antidepressants carcinogenic in animals
- Holmes 2003, Brain damage serotonin mutation genetic
- Karanges, 2011, developmental neurotoxicity and brain damage in children (large review)
- Moiseiwitsch 1995, SSRIs embryonic brain damage
- Svirsky 2016, Prenatal exposure to Prozac causes aggression in mice offspring
- Xu 2004, Paxil brain damage
B. Humans: Damage to Fetus and Infants
- Bérard 2017, Congenital malformation
- Breggin & Breggin 2008, SSRI in-utero harms
- Casper 2003: “The findings that SSRIs during fetal development might have subtle effects on motor development and motor control are consistent with the pharmacologic properties of the drugs.”
- Croen 2011, Autism in offspring of mothers exposed to antidepressants
- Domar 2013, SSRI risks in infertile women: a review of the impact on fertility, pregnancy, neonatal health and beyond
- Nordeng 2017, Danish epidemiological study: children of mothers treated with antidepressants have increased in variety of mental disorders (Abstract Only).
- Urato 2013-2015, physician Adam Urato writes feature columns with multiple scientific references concerning the dangers of SSRIs to the mother, the fetus, and the newborn child.
- Zeskind 2004, Fetal exposure to SSRIs causes developmental abnormalities
C. Damage to Brain in Adult Animals and Humans
D. Neurogenesis (growth of new neurons) Antidepressant-induced neurogenesis is touted as proof of the good physical effects of antidepressants, but neurogenesis is typically the brain’s reaction to brain damage. This section has articles about antidepressant neurogenesis and about neurogenesis in general as an expression of brain damage from stroke, seizures and electroshocks.
E. Death and Other Harms to Human Anatomy and Function (Non-CNS)
- Bartholoma 2002, Causing cell death in lab
- Bouwer 1996, Lexapro increases carbohydrate intake
- Cloonan 2011, Causing death of cancer cells in lab
- Cohen 2000, Tricyclic antidepressants cause myocardial infarction
- Cosgrove 2011, Causing breast and ovarian cancer
- Kim 2017, SSRI cardiotoxicity
- Leong 2017, SNRI antidepressants higher risk of nonfatal stroke than SSRIs
- Maslej 2017, Antidepressants Increase All-Cause Mortality by One-Third
- Moret 2009 Survey of long-term effects
- Mueller 2017, Antidepressants increase death rate among dementia patients
- Shively 2016, Paxil increase coronary and carotid atherosclerosis in monkeys
- Tanrikut 2010, Paxil kills sperm, threatens sterilization
- Trifiro 2010, Antidepressants cause stroke.
(10) Discontinuation or Withdrawal Syndrome
My book Psychiatric Drug Withdrawal is the most extensive source available for information on why and how to stop taking psychiatric drugs. It discusses the toxicity and withdrawal problems associated with every class of psychiatric drug. It then provides a patient-centered team approach with the prescriber, therapist, and family working cooperatively with the individual withdrawing from the medication. Below is a sample of the psychiatric literature on the hazards of psychiatric drug withdrawal.
- Ayd 1996, Paxil withdrawal and suicidal
- Black 1995, SSRI suicide and violence
- Black 1999, SSRI withdrawal includes suicidality (see Table 1)
- Bloch 1995, Paxil withdrawal suicide and violence
- Davis & Read 2018, The available research indicates that antidepressant withdrawal reactions are widespread, with incidence rates ranging from 27% to 86% (weighted average of 56%), and with nearly half (46%) of those experiencing withdrawal describing these reactions as severe.
- QuarterWatch 2012, Duloxetine (Cymbalta) withdrawal reactions
- Tonk 2002, Paxil withdrawal severe
- Fava 2015, Paxil withdrawal and suicidal chart
- Haddad 1997, Paxil suicide akathisia
- Keuthen 1994, Paxil withdrawal 1 to 3 days longer
- Milliken 1998, Paxil withdrawal depression akathisia
- Phillips 1995, Paxil withdrawal agitation
- Stockmann 2019, What it was like to stop an antidepressant
- Tamam 2002, Antidepressants discontinuation syndrom
- Tint 2008, Antidepressants withdrawal suicide
- Valuck 2009, Antidepressant suicide risk increased during both initiation and withdrawal
- Zajeck 1998, Prozac withdrawal.
(11) Miscellaneous FDA Documents
(12) Psychotherapy and Other Effective and Less Harmful Approaches to Depression
(13) Head Injury Worsens Drug Reactions
(14) SSRI-induced Abnormal Movements, TD, Dystonia (also see Akathisia above)
(15) No Long-Term Placebo-Controlled Clinical Trials that Determine Safety. There are many long-term clinical studies that confirm harmful effects such as apathy, brain damage, and sexual dysfunction. However, there are no adequate long-term randomized placebo-controlled clinical trials that shed light on the risks or safety of the drugs. Therefore, while there is evidence for a variety of long-term harms, there is no evidence to the contrary demonstrating their safety.
Antidepressant Drugs Resource Center
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