The authors trawled the French records of drug side effects from 1985 to 2008. By law, doctors in France must report any adverse event which is either serious, or unexpected, to the authorities.
They found a total of 540 reports mentioning "violence", but only 56 of these were clear-cut incidents of physical aggression towards others. Suicide and self-harm were not included, unless they also involved violence to other people.
There were 76 suspect drugs (because some reports included one or more). Here's the Hall of Shame:
16 reports involved benzodiazepines (Valium) or similar drugs.
13 implicated dopamine-boosting drugs used to treat Parkinson's disease.
4 were caused by serotonin-based antidepressants like Prozac. Older antidepressants were not associated.
Antipsychotics and anti-epileptics were also high on the list.
There were also reports involving and the antiviral drugs interferon (3), ribavarin(2), and efavirenz (3); the stop-smoking aid varenicline (4); anti-acne drug isotretinoin (4); and the banned weight-loss drug rimonabant (2). All of these can also cause depression, and I've blogged about some of them before for that reason.
Of the perpetrators, 86% were men. Nearly half had a prior psychiatric history, but that's not surprising because many of these drugs are prescribed to people with mental illness.
In terms of the number of reports of violence relative to the total number of adverse events for each drug, Parkinson's drugs were "worst". However, this doesn't mean much, because it might just mean that these drugs are generally mild in terms of side effects.
So it's an interesting dataset, but it's impossible to come to any firm conclusions as to how common these effects really are. Cases might go unreported if they're thought to be "normal" violence; and regular violence could also get wrongly blamed on a drug - criminals get sick too.
Finally, we ought to remember while these effects are inherently attention-grabbing (and Parkinson's drugs in particular have given rise to some tabloid-friendly stories), the overall rate was tiny - less than 3 cases per year, for all prescribed drugs, in a nation of over 60 million people.
Rouve N, Bagheri H, Telmon N, Pathak A, Franchitto N, Schmitt L, Rougé D, Lapeyre-Mestre M, Montastruc JL, & the French Association of Regional PharmacoVigilance Centres (2011). Prescribed drugs and violence: a case/noncase study in the French PharmacoVigilance Database. European journal of clinical pharmacology PMID: 21655992
4 comments:
That's weird that benzodiazepines would be one of the drug categories most often associated with violence; I would've thought they'd just put you to *sleep*, not make you violent!
Lyndsay,
Having worked with dementia clients in a care home were PRN lorazepam was used liberally, I can attest to the paradoxical side-effects of benzodiazepines.
Also, benzos are rather like alcohol pharmacologically. And if you counted alcohol as a prescription drug (it's legal after all...) it would dwarf all the others in terms of violence.
The results are so tiny to actually be inconsequential. And living in france i can tell you their idea of administration is something from another epoch. And hardly any doctor speaks any language except french and their mother tongue.
To name something. The land registry gets updated once a year and solely depends on the good will of the notaries to send in the data.
My house took 3 years before it was registered to my name in the books.
In my block there is a floor that's actually in the next street according to them.
I could fill a huge post with all the quirks of french administration.
So i wouldn't attach much meaning to this.
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