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Peter R. Breggin, M.D.
Phone: 607-272-5328 www.breggin.com Fax: 607 272 5329
September 18, 2013
Violence and the Antidepressant Trazodone
by Peter R. Breggin, MD
This brief analysis is offered in response to information that the Navy Yard mass murderer, Aaron Alexis, was taking the antidepressant trazodone. Alexis was reportedly started on trazodone for sleep on August 23, 2013 at the Veterans Administration (VA) clinic in Providence and refilled on August 28 at the VA in Washington, DC. Twenty days later, on September 16, he committed the violent assaults. Severe adverse drug reactions such as suicide and violence typically occur in this relatively short time span after starting an antidepressant. Individuals with a known history of violence like Alexis are at even higher risk of being driven to more extreme violence by exposure to antidepressant drugs.
Antidepressants can cause a broad range of stimulating amphetamine-like adverse drug effects that will then cause or contribute to violence. The official FDA-approved label for trazodone lists the following stimulating effects: “anxiety, agitation, panic attacks, insomnia, irritability, hostility, aggressiveness, impulsivity, akathisia (psychomotor restlessness), hypomania and mania.”
Although commonly used as a sleeping pill, trazodone nonetheless can be very stimulating for some patients. It has higher reported rates than other antidepressants such as paroxetine (Paxil) and sertraline (Zoloft) for causing anxiety, nervousness, excitement, and hypomania, which are risk factors for causing violence. Trazodone blocks the removal of serotonin from the synapse in the same manner as the SSRIs (selective serotonin reuptake inhibitors) like Prozac (fluoxetine), Paxil and Zoloft; and therefore has similar dangerous effects.
The trazodone Medication Guide, found toward the back of the FDA-approved label, warns about patients “acting aggressive, being angry or violent.” It also warns about “Acting on dangerous impulses” while taking trazodone.
With the caveat that new information will continue to come forth about Aaron Alexis’ life, as well the caveat that I have no access to his medical records—trazodone must be weighed and considered as a possible if not probable cause or contributing factor to worsening Alexis’ violence tendencies and pushing him over into a murderous rampage.
Medication history taken from the New York Times (toward the end of the article):
The FDA-Approved Label (also called Complete Prescribing Information) for trazodone can be obtained on the Internet at Drugs.Com, FDA.gov, or other sources.
For scientific details and case studies concerning medication-induced violence, See Peter R. Breggin, MD. Medication Madness: The Role of Psychiatric Drugs in Cases of Violence, Suicide and Crime. New York: St. Martin’s Press, 2008.