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Lawrenceville, NJ (Dr Simone) – A study using the FDA Adverse Event Reporting System data identified 31 prescription drugs that induced violent behavior (http://www.plosone.org/…/info%3Adoi%2F10.1371%2Fjournal.pon…). These 31 drugs accounted for 1527 of 1937 (79%) violence cases. This number is probably higher since some doctors do not report violent actions. The search words included homicide, physical assault, physical abuse, homicidal ideation, and violence-related symptom.

Varenicline (Chantix), the smoking cessation aid, leads the list and was 18 times greater than all the other drugs combined; #2 fluoxetine (Prozac); #3 paroxetine (Paxil). Next are nine more anti-depressants, six sedative/hypnotics, and three attention deficit/hyperactivity disorder prescription drugs. Anti-depressant drugs as a group had a higher risk of violent thoughts/actions than any other class of psychoactive drugs, including mood stabilizers, anticonvulsants, antipsychotics, and hypnotics/sedatives.

The gene CYP450 breaks down some of these drugs. However, if a person has a mutation CYP450 gene, the drugs are not broken down efficiently. Some practitioners argue that people who are on these drugs should have their CYP450 checked. Also there are some inhibitors of this gene: alcohol, cannabis, citalopram (Celexa), escitalopram (Lexapro), estrogen, fluoxetine (Prozac), fluvoxamine (Luvox), nortriptyline (Pamelor, Aventyl), paroxetine (Paxil), sertraline (Zoloft) and valerian.

Should the FDA remove drugs that are this harmful? Send me your comments.

(c) 2017 Charles B. Simone, M.MS., M.D.