“She said that ‘my son is a real big problem of mine,’ ” Ms. Jefferson said in a telephone interview. “She said: ‘He has some psychological problems. Sometimes he takes his medication, sometimes he doesn’t. And that’s where the big problem is, when he doesn’t take his medication.’ ”

Typically if prescription drugs are even mentioned in association with bizarre behavior or criminal acts, the media will usually stress the medication-refusal correlation and will likely continue to do so despite recent revelations that young people on antidepressants are more likely to commit violence. From the Los Angeles Times: 

Researchers have identified a troubling side effect of a widely prescribed class of antidepressants -- they may make some patients more likely to commit violent crimes.

Data from Sweden show that young adults between the ages of 15 and 24 who had filled prescriptions for the drugs were more likely to be convicted of a homicide, assault, robbery, arson, kidnapping, sexual offense or other violent crime when they were taking the medications than when they weren’t. The researchers found no link between antidepressant use and criminal activity for older patients.

The findings, published Tuesday in the journal PLOS Medicine, build on other evidence that the antidepressants – known as selective serotonin reuptake inhibitors, or SSRIs – work differently in the brains of adolescents and adults. For instance, several studies have shown that the drugs actually boost the risk of suicidal thoughts in children, teens and young adults, but not in older adults.

The link between SSRIs and crime is less clear. One analysis of trends in the U.S. found that the “great American crime decline” that began in the 1990s coincided with the emergence of SSRIs, including Prozac, Celexa, Paxil and Zoloft. But reviews of safety data submitted to the Food and Drug Administration have found that SSRI use was associated with an increased risk of violent behavior.

Most sources that report on drug risks will end every article with the caveat that the risk for violence or suicide is greatest during withdrawal from psychiatric medications, though withdrawal effects may only amplify some individuals’ reactions. Columbine shooter Eric Harris wrote that he kept up with his doses of Luvox because it helped him “feel the rage.” And with the news that Chris Mercer could have abused his medication may come reassurances that sticking to prescribed doses is perfectly safe.  Although this may be true for many, several mass killers had clinically recommended doses in their systems at the time of their crimes according to reform psychiatrist and expert witness Dr. Peter Breggin, author of Medication Madness: The Role of Psychiatric Drugs in Violence, Suicide and Crime.  Breggin further points out that these reactions can occur among patient groups that are presumably carefully monitored:  a year after Medication Madness was published, Breggin testified before congress to present his paper Antidepressant-Induced Suicide, Violence, and Mania: Risks to Military Personnel on the potential connection between the practice of recycling combat-stressed troops with medications and the current 22-a-day suicide rate and rise in violent psychosis among members of the armed forces.

What independent whistleblowers like Breggin and others hope for in attempting to bring attention to the clinical association between prescription drugs and violence is mostly that these types of crimes might be prevented in the future, to stop the practice of forced treatment, to provide the public with truly informed consent as well as to prevent entire disabled populations from being framed for the crimes of a few.  Clearly victims of crime and their surviving families are not served when spin creates more victims, a predictable consequence in an age when the mentally disabled—even disabled veterans—are subjected to progressively abusive treatment; when three individuals with special needs—mostly children— die in schools and institutions every week due to restraint and seclusion; when the disabled are frequently dying in prisons where they are increasingly warehoused; when the FBI has repeatedly entrapped the mentally ill in various terrorist plots; when 50% of individuals killed by police are mentally disabled; and when the rate of mental disability has doubled among adults and has risen an estimated 35-fold among children in just two decades. Because of these bleak factors, it's become more destructive than ever to sew up the cause of all evil under certain diagnostic labels.

For instance, despite the fact that only a tiny fraction of individuals among the many hundreds who’ve perpetrated random mass violence have been diagnosed with autism, suppositions of  a general connection between the two things have run wild in the media and academia in the past several years. All of it effectively takes the onus off a much more compelling common denominator in modern mass assaults: that, according to drug expert and Pharmageddon author David Healy, about 90% of school shooters in North America and Europe were on prescription drugs.  

Sadly, what may give the correlation between disability and random violence staying power is the rate of drugging among the developmentally disabled with medications that carry black box warnings for violence and suicide. The rate may be as high as 90% according to Peter Breggin— a drugging rate approximately 1000% higher than the already high American average. This virtually ensures that a certain percentage of disabled individuals will periodically be in the news for violent acts.

Nevertheless, as most in the autism arena understand, the disabled are still statistically far more likely to be victims of assault than to commit it; that, at a current rate of 1 in 34 boys being diagnosed with autism, autism is— again— greatly underrepresented among hundreds of modern mass killers; and that the vast majority of those with autism— the low- to nonverbal "babbling idiots" that Laurel Mercer differentiated from her high-functioning son in a NY Times quote— are far too disabled  to ever plan and carry out elaborate crimes. As AofA Managing Editor Kim Stagliano pointed out in Huffington Post at the time of the Virginia Tech massacre and speculations about whether the perpetrator had autism, there’s a “wide chasm” between the impulsive or defensive behaviors exhibited by some individuals with autism and mass murder.

There are many reasons that people are prescribed certain drugs, though those reasons may not be the direct cause of mass violence. Instead, these reasons and all the life stresses and misfortunes that fuel prescribing practices and industry profits may simply be the gateway to prescriptions that, in some instances, are themselves the cause.  Sometimes it’s just the drugs. Americans, with their love of magic bullet cures, may find this hard to accept. David Healy responded to a few typical arguments against the correlation:  

…most of us know people on antidepressants none of whom are violent. This makes it difficult to accept a link to prescription drugs. For many even raising the idea that [Aurora shooter James Holmes] may have been crazed by a prescription medicine is likely to sound deranged or the excuse of a bleeding heart liberal.

But in fact there is a great deal of publicly available clinical trial (Hammad 2004, p40-41) and other data highlighting the risks of violence from psychotropic drugs. There is far more hidden data. There is in fact no other area of medicine in which there is so much hidden data on a risk that has consequences for the lives of so many innocent third parties…

In the case of violence, the published trials show antidepressants cause it, probably at a greater rate than alcohol, cannabis, cocaine or speed would be linked to violence if put through the same trial protocols that brought the antidepressants on the market. The labels for the drugs in a number of countries say the drugs cause violence. And there is at least one clear and well-known factor, just like autopsy rates, that can account for the findings – young men. Violence is linked to young men, and episodes of lethal violence are falling in all countries where the numbers of young men are declining.

Shortly after Healy’s article was published, a study in the The American Journal of Public Health reported that suicides now outnumber car accidents. The old adage about suicide is that violence turned inward may sometimes turn out, though this risk seems particularly high when drugs are in the mix. For example, the German pilot who crashed a commercial plane into the French Alps in March, 2015 was reportedly suicidal. The reason he decided to take 149 people with him was considered a mystery, though his prescription for antidepressants was not.

One of the key arguments against focusing solely on preexisting mental conditions is that it isn’t merely psychiatric medications that can trigger radical personality change and violence in individuals with no history of it. David Healy listed 90 medications in ten separate classes of drugs that carry warnings and/or have clinical associations to these effects. On the list is the anti-malarial drug Lariam which was investigated several years ago by Age of Autism editor Dan Olmsted and UPI’s Mark Benjamin following a spate of murder-suicides on an American army base. Then antibiotics, antihypertensives and even some of the newer birth control medications have also been linked to violent psychosis.

What’s more, antidepressants and other psychiatric medications—the drug classes most often associated with violent adverse events— are no longer prescribed solely for mental affliction. A patient can walk into a doctor’s office with a stiff neck, migraines or fatigue from obvious cause (overwork, young children, etc.) and walk out with a prescription for Paxil, Prozac, Ritalin, Adderall or any number of drugs with explicit black box warnings for suicidality and violent psychosis. Roughly 8% of those patients will at some point be hospitalized for drug-induced psychosis and a fraction of that subset might go on to commit violence against themselves or others. The risk to each individual might be relatively low, but considering that 1 in 9 Americans currently take some type of mental health drug, often more than one, and when it’s factored that, in the rare instance that someone becomes murderously psychotic on the drugs, they may take ten, twenty or hundreds with them,  the statistical potential for fallout is enormous as journalist Robert Whitaker argues in Anatomy of an Epidemic.

There’s another argument against framing preexisting conditions for mass murder—that the specific adverse effects that lead to violence may not be occurring directly through the brain but through the immune and mitochondrial systems. Psychopharmaceutical expert Grace Jackson’s Drug Induced Dementia: The Perfect Crime cites hundreds of studies demonstrating that certain medications have a compounded effect on mitochondrial health aside from inducing brain swelling and mass brain cell death that mark the larval stages of dementia. What Jackson’s research suggests is that, though individuals already suffering from organic brain diseases (which are rare and do not include so called “brain chemical imbalances” promoted by the drug industry) or previous toxic injuries that effect these relevant cellular systems may succumb all the more quickly to the effects of certain drugs, the drugs can also induce these effects without any help.

This could explain the documented cases of violence committed by individuals who were given psychiatric medications by pharmacy mistake—say, Celexa instead of Celebrex—though they lacked any criminal history or history of mental illness. Susceptibility to side effects may eventually boil down to otherwise benign or even beneficial immune alleles (associated with natural defenses against some cancers or infections) or mitochondrial polymorphisms (associated with high IQ) that do not on their own manifest as mental health disorders—that is, if anyone would investigate vulnerable subsets. As with vaccine injuries, there seems to be official resistance to researching drug-susceptible subsets when the very pursuit may stand as an admission that something is wrong with a profitable product line.

The final argument for taking a closer look at the effects of certain modern medications is history. Nonideological mass murder is a relatively new phenomenon. To clarify, “nonideological” is meant as a reference to perpetrators who act without ties to militant organizations, lack financial or other pragmatic motive or whose motives are senselessly convoluted and in direct conflict with the identity of the killer (i.e., a Jewish Dylan Klebold suddenly identifying with Nazis; a mixed-race individual identifying with Nazis and the IRA; disproportionately petty grievances; someone irreligious who suddenly hears the voice of God or who sends victims off to “meet God,” etc.).

There has always been ideological mass violence associated with militant hierarchies, whether religious or political or connected to organized crime. There have been serial killers for as long as anyone remembers, and Americans have always been heavily armed.  But despite all the brutality and harshness and gun-totingness of past eras that— under the theory that trauma or violent video games and access to fire arms cause modern mass violence— would certainly have spurred something similar to present horrors,  it’s nearly impossible to find cases that genuinely resemble today’s high profile peacetime mass murders prior to 1966.

1966 was the date of the Bell Tower massacre committed by Charles Whitman, who had been taking amphetamines and possibly one of the then-new MAO inhibitors for his migraines— a combination known to cause psychosis.  But before 1966, reported cases of nonideological random mass murder were vanishingly rare around the world. Even the extent to which these few ideologically ambiguous instances are hashed over and argued about only highlights their scarceness. And the only historic “rash” of motiveless mass murders that existed before the 1980s were 19^th century Javan knife rampages, though these weren’t actually a departure from the med madness theory. The latter were associated with the first and lesser known Opium War and the killers were widely reported to be drugged out of their minds.

All the same, despite history, clinical evidence and basic humanity, the media correlation between diagnostic categories and mass violence continues, ironically increasing the drum beat for mandated treatment. This certainly benefits the media’s corporate sponsors, since the pharmaceutical industry spends upward of $4.5 billion on direct-to-consumer advertising alone, not to mention the $57.5 billion and rising that industry spends on drug promotion (an old figure that's likely been doubled over the past 12 years as a reader points out).

The inquisitorial environment created by omission of preventable, man-made factors in modern mass murder and default conclusions that natural born mass killers are all around us certainly benefits psychiatric institutions held by the massive private prison industry that consumes taxpayer dollars. It benefits the private security industry that makes up 80% of the NSA and is largely responsible for the country’s current Orwellian trajectory. And these associations also feed misleading information into a public need for devils to wear horns—for mass killers to be endowed with supposedly inherent traits that are easily identifiable: just turn that age-old witch-hunting hysteria lens on special education departments, group homes and the odd kid next door.  

The bogeyman construct of the autistic killer may make people feel safer, though in the end the red herring will make us all doubly unsafe. Not only have these random mass crimes killed hundreds of innocent people within a few decades and stand to kill hundreds more in the coming years, they spread the kind of terror that—in the absence of clear answers on cause— can brutalize society and easily double back as rationales to make further incursions on everyone’s civil rights.

Adriana Gamondes is a contributing editor to Age of Autism and one of the blog’s Facebook administrators.