Warn patients
Commenting on the study, Eduard Vieta, MD, PhD, professor of psychiatry, Institute of Neuroscience, University of Barcelona, Spain, and author of an accompanying editorial, said it’s still not known if the mediating factor in the increased risk of violent crime was the SSRI or the underlying mental condition that prompted the prescription.
Dr. Vieta, who was not involved with the study, added that the results “raise a note of caution in terms of making a very accurate diagnosis and treatment in patients with a history of conviction, violence, or criminality, and opting ideally for psychosocial therapies whenever possible in this population.”
Also commenting on the study, Michael Thase, MD, professor of psychiatry, University of Pennsylvania, Philadelphia, said the findings are “not easy to brush away or explain away.”
Dr. Thase, who was not involved with the study, continued, “although it is a small finding, it is also a serious problem.”
He suggested the risk should be treated in a similar way to the risk for suicidal thoughts or behaviors.
“Just as you might caution patients [initiating treatment with SSRIs] regarding that risk, you might broaden your counsel to include other types of violent behavior because the same process that provokes the risk of self-harm for a given person may be externalized and provoke harm or violence toward others.”
Ms. Lagerberg added that further research is needed to confirm their findings and “inform whether – and if so, how – clinical practice should change.”
The study was supported by the Swedish Research Council, Horizon 2020 ACTION project, Stockholm County Council, and Thurings Foundation. Ms. Lagerberg has reported no relevant financial relationships. Other author disclosures are listed in the article. Dr. Vieta and coauthors have reported no relevant financial relationships. Dr. Thase has reported consulting with and receiving research funding from many of the companies that manufacture/sell antidepressants.
This article first appeared on Medscape.com.