Dr. Langosta R21 ® 🇲🇽

Can a psychiatric medication make someone aggressive? Part of the answer is already printed on the label. This is a sensitive topic, and I want to handle it carefully. I don’t think medications are behind every act of violence. There’s a social contagion element to these tragedies too. But it’s a fair question, and it deserves an honest answer. The labels for antidepressants list agitation, aggression, and mania as possible side effects. Stimulant labels mention aggression and hostility. These are called paradoxical reactions, where a drug does the opposite of what it’s meant to do. Here’s an easy way to think about it. Put ten people in a room and give them all cannabis. Nine of them might relax and start laughing. One might become paranoid. Something about that one person’s biology makes them react the opposite way. Psychiatric medications can work the same way. These reactions are rare. But when millions of people are taking these drugs, rare side effects will still happen to real people. This has also been tested in court. In Tobin v. SmithKline Beecham, a jury heard the evidence and found that Paxil was a cause of a fatal family tragedy. The verdict held up on appeal. Now Tennessee has passed a law, with bipartisan support, that requires investigators to look at psychiatric medication use after school shootings. It’s the first state to try to collect this data. Better data helps everyone, including the families who’ve been affected. Most people will never have a reaction like this. But if you or your child notices new agitation, restlessness, hostility, or thoughts of harming yourself or others after starting, stopping, or changing the dose of a medication, call your prescriber right away. In a crisis, call or text 988, or call 911. If you’re looking to safely taper off a psychiatric medication, comment TAPER and I’ll send you my free tapering guide. It’s the exact protocol we use with our patients at TaperClinic. Please never stop a psychiatric medication abruptly. Talk to your prescriber before making any changes.