Tag: SSRIs

It seems Robert F. Kennedy Jr. has set his sights on a new wild goose to chase. The U.S. Secretary of Health and Human Services has made clear his intention to probe whether antidepressant drugs like selective serotonin reuptake inhibitors, or SSRIs, can be blamed for causing mass shootings.

Last week, Kennedy announced via a post on X that he would task the Centers for Disease Control and Prevention to study “the long-taboo question of whether SSRIs and other psychoactive drugs contribute to mass violence.” But while more research into this topic might be worthwhile, the data so far doesn’t support a causative link, many experts say.

“SSRIs are generally safe and effective medications, and there is no overwhelming evidence that these drugs alone would cause patients who are taking them to commit acts of violence,” Gregory Brown, Chair of the American Psychiatric Association’s Council on Communications, told Gizmodo.

SSRIs and mass violence

This isn’t the first time that RFK Jr. has brought up SSRIs as a possible factor causing mass violence.

In late August, following a school shooting in Minnesota that left two students dead and dozens injured, Kennedy went on Fox News and stated that he would launch studies looking into the role that SSRIs and other drugs used to treat mental illness might play in causing such incidents. In early September, during a conference announcing his “Make America Healthy Again” report on children, he made a similar promise, though he claimed the National Institutes of Health would be in charge of this planned research.

The idea that psychiatric medications can set off mass shooters certainly isn’t new. Nearly a decade ago, for instance, speculation arose that anti-anxiety drugs fueled Las Vegas shooter Stephen Paddock’s killing spree in 2017.

Contrary to Kennedy’s insinuation that scientists are afraid to study the topic, however, several studies have tried to look for a possible association between the use of these drugs and mass violence.

In a 2019 study, for instance, researchers combed through reports of school shootings recorded by the FBI between 2000 and 2017 (49 in total). They found that most school shooters had no documented history of taking psychotropic medications. And even in cases when they did, the researchers failed to find a “direct or causal association” with these medications.

In another 2019 report, which examined data from 167 mass shootings collected by The Violence Project, researchers found that about 20% of shooters had used psychotropic medications, comparable to the rate of use among the general public (around 17%, per a 2017 study).

And this September, a team of researchers led by Ragy Girgis, a professor of clinical psychiatry at Columbia University’s Vagelos College of Physicians and Surgeons, studied data from over 800 mass shootings in the U.S. They found that just 4% of shooters had any lifetime history of using antidepressants, well below the typical rate of use in the general public (12%), and that 6.6% had used any psychotropic drug at all.

The California State Association of Psychiatrists (CSAP) also issued an explicit rebuttal of RFK Jr.’s attempt to link SSRIs to mass shootings, following his comments in September.

“This is simply not true. What worries us most is that such statements can scare people away from getting the care they need and deserve,” the CSAP stated.

The role of suicidal intent

Mass shootings are a complex phenomenon, and for many who carry out these acts, there are likely to be several explanations why.

One of these explanations can be severe mental illness, such as psychosis, though probably not to the extent that many would assume. A 2022 study by the same Columbia team found that only about 5% of mass shootings might be linked to severe mental illness, such as psychosis.

What does seem to be a substantial mental health factor in mass shootings is suicidality. Roughly half of mass shooters will either kill themselves or try to provoke a lethal confrontation with law enforcement (“suicide by cop”), and perhaps around two-thirds express suicidal ideation before or during the shooting.

That factor could help explain why some research has found a potential relationship between antidepressant use and violence in general, according to Girgis.

“They find a close relationship because people who are suicidal or violent also have much worse depression. And people with worse depression are more likely to be treated with antidepressant medications. So that’s why we see this relationship,” Girgis told Gizmodo. “But it’s not causative.”

While SSRIs do carry a warning label claiming they might raise the risk of suicidal ideation and behaviors in people under 25, it’s a controversial one. Many researchers, including Girgis, now argue otherwise (or at least that the warning has done more harm than good), and some studies have actually found SSRIs can reduce suicide risk in younger people. Notably, Girgis’ study this September found no difference in the rate of mass shooters dying by suicide whether they were taking an antidepressant or not.

During the Fox News interview in August, RFK Jr. also appeared to claim SSRIs carry a black box warning that they can increase the risk of homicidal intent. Whether he misspoke or deliberately peddled a falsehood, that’s just flatly not true.

The search for a scapegoat

At least some of the reason why people might latch onto SSRIs as a factor behind mass shootings is sensationalism, Girgis argues.

“I think these sorts of events, when there are reports of a mass shooter taking a psychiatric medication or having a psychiatric condition, tend to make the event more of a headline and more attention grabbing. That’s one reason there’s this attention bias to it,” he said.

Still others might want to blame mental health or the drugs used to treat it for these incidents because it’ll deflect attention from more relevant factors, such as the wide proliferation of firearms in the U.S. or the ease with which someone can obtain them.

All that said, the experts I spoke to still welcome more research into this topic, provided that it’s done well.

“While I cannot predict results of any future research studies, ongoing research efforts—especially unbiased peer-reviewed research—can often provide useful information about the safety and efficacy of psychotropic medications,” Brown said.

The trouble is, we’re talking about RFK Jr. here. Since taking over HHS, Kennedy has repeatedly steamrolled over the scientific process to get his agenda across. He’s unilaterally dismissed outside experts on vaccine safety, installed allies sympathetic to the anti-vaccination movement, and allegedly fired former CDC chief Susan Monarez when she refused to rubberstamp policy changes recommended by the latter group.

More recently, he and President Donald Trump have tried to officially blame autism on the use of acetaminophen during pregnancy—an explanation that many experts and health authorities do not support. The FDA is trying to initiate a labeling change to acetaminophen products that would warn pregnant women about the supposed autism risk, even as Kennedy has admitted that they don’t yet have proof of a causative link.

The above could be the most illustrative example of what may happen if RFK Jr. gets his SSRI study off the ground. The overall evidence to date doesn’t point to these drugs being a major culprit in mass shootings. But that alone might not stop Kennedy and the Trump White House from claiming otherwise.