Paul McCarron said his wife had seen a psychiatrist, but had stopped taking prescribed medication in the months prior to the May 13 death. He said she stopped taking it because it gave her suicidal thoughts.
—Peoria Journal Star, 1/8/2008“She was always crying,” the friend says. The friend asked McCarron if she might be suffering from depression. McCarron replied that she was taking anti-depressants , the friend says.
–Peoria Journal Star, 5/18/2006
I’ve been noticing a trend. Often when there’s a senseless homicide or suicide, there’s a mention somewhere in the article that the person is or has been on some sort of anti-depressant medication. Often it says they’ve just stopped taking it, had their dosage changed, or changed brands. The McCarron case is no exception, as you can see from the news article quoted above.
That got me thinking — is it just my imagination that I keep seeing this, or have other people noticed this, too? So I started doing a little research. I found out that not only have other people noticed it, there have been clinical studies to prove it, and there are many people who are concerned about the drug’s role in violent crimes.
The anti-depressants under scrutiny are medically described as “selective serotonin reuptake inhibitors,” or SSRIs for short. They’re marketed under brand names such as Prozac and Zoloft.
A website called SSRI Stories is a repository of news accounts of violent incidents where SSRIs played a part. Included are the Columbine shootings and Dr. McCarron’s case. In addition:
There are 34 cases of bizarre behavior, 28 school shootings/incidents, 46 road rage tragedies, 10 air rage incidents, 32 postpartum depression cases, over 500 murders (homicides), over 180 murder-suicides and other acts of violence including workplace violence on this site.
Just a few years ago, an article was published in the International Journal of Risk & Safety in Medicine by Dr. Peter Breggin called “Suicidality, violence and mania caused by selective serotonin reuptake inhibitors (SSRIs): A review and analysis.” The abstract explains the study’s findings:
Evidence from many sources confirms that selective serotonin reuptake inhibitors (SSRIs) commonly cause or exacerbate a wide range of abnormal mental and behavioral conditions. These adverse drug reactions include the following overlapping clinical phenomena: a stimulant profile that ranges from mild agitation to manic psychoses, agitated depression, obsessive preoccupations that are alien or uncharacteristic of the individual, and akathisia. Each of these reactions can worsen the individual’s mental condition and can result in suicidality, violence, and other forms of extreme abnormal behavior.
The two things that are particularly chilling in that abstract are the words “commonly cause” — in other words, these are not rare side effects, but common ones — and “obsessive preoccupations that are alien or uncharacteristic of the individual” — for instance, suicidal or homicidal thoughts and actions.
Do I think that the drugs made McCarron kill her autistic child? I don’t know; that’s up to the jury to decide, if the defense even uses that as an argument. My point is not to try McCarron in the court of public opinion here. I just want to bring attention to the serious, documented side-effects of anti-depressant drugs and wonder aloud, why are these drugs allowed to remain on the market?
With any medication there will be people who have a negative reaction – similar to the fact that, yes, some people will have a negative reaction to vaccines – but that doesn’t negate the worth of the drug.
It’s crazy that, as a society, we expect everything to be risk-free, when the best we can really do is eliminate unreasonable risk.
How many of those successfully treated with SSRI’s would have committed crimes due to their mental illness if they hadn’t received the medication?
Furthermore, the above cases are awful, but they are culled from news reports, not a peer reviewed study.
Moreover, was the person’s underlying mental illness the cause, or the medication? It’s not quantifiable.
Of course, I do think the drugs should be studied further. But, suggesting pulling SSRI’s, a measure that would greatly impact so many people’s lives, is unreasonable at this point.
Jennifer — Good points. I guess the question would be, how bad does the drug have to be before it’s pulled off the market? At what point do the cons outweigh the pros of a given medication? It would seem that a “common” side-effect of suicide and homicide might qualify. I don’t believe that everything should be without risk, but here we’re not just talking about risk to the drug taker, but risk to other people if the person becomes homicidal. That seems too risky to me.
As for whether a “person’s underlying mental illness [is] the cause, or the medication,” Dr. Breggin’s published report stated:
Note that these were healthy, non-depressed people. I think we can safely point our fingers at the drug.
“why are these drugs allowed to remain on the market?”
Because they are life-saving drugs for many people who suffer from crippling mental illnesses, and because they are worlds better, in terms of safety and side effects, than the last generation of drugs.
These studies have been getting a lot of press because they’re sexy, but the majority of (peer-reviewed, scientifically-valid) studies show these drugs are quite safe for the majority of people who are properly prescribed them. (And 20 individuals is hardly a study; that’s a collection of anecdotes.)
One serious and legitimate problem is that people who are so severely depressed they can barely act/move/get out of bed who begin on SSRIs may come up out of the depression enough to be motivated to act … before they get undepressed enough NOT to be suicidal. (Hence the black-box warning on prescribing SSRIs to teenagers in particular, who seem more prone to this particular problem.) But that’s why these drugs should be prescribed under the *close* supervision of a doctor during the induction phase. That’s a fault in procedure, not the drugs.
Spreading scare-mongering about an already-stigmatized disease and already-poorly-understood drugs isn’t helpful in ensuring people with mental illness get necessary medical treatment, whether that treatment is psychological, pharmaceutical, or a combination.
Eyebrows, you and Jennifer have both now mentioned these “peer-reviewed, scientifically-valid studies” — can you please provide me with some references so I can read up on them? Healy, who was quoted in Dr. Breggin’s paper, is listed on this site as having been “peer reviewed.” Am I missing something?
Here’s another interesting link regarding an FDA hearing on SSRIs.
Knight in Dragonland would probably be the way faster guy to find them. 🙂
Certainly SSRIs are overprescribed, and I personally have noticed an alarming trend in inadequate medical supervision. When I was first diagnosed 13 years ago, beginning on SSRIs meant literally 24-hour supervision by a family member and seeing the prescribing psychiatrist twice a week until the induction phase was over. Now you can just go to the GP, get pills, and they don’t even say, “Have your family keep an eye on you for side effects.” That’s a problem.
But seriously, CJ, I find your post upsetting. Mental illness doesn’t need more stigma, and there’s enough resistance to seeking appropriate treatment as it is, enough feeling of “If you were just a stronger person you wouldn’t need medicine” or “the meds hurt more than they help.” I feel like you’re adding to that stigmatization of both the illness and the drugs.
Why would anyone give prozac or another SSRI to a healthy person? I mean, I can give a healthy person digitalis and stop their heart – doesn’t mean the medication doesn’t work!
Yes, the drugs are a lot like doing brain surgery with a chemical sledgehammer. There’s a lot of risk involved. The question isn’t is there risk. The question is: is the risk worth it?
It isn’t perfect. But is it worth it to the people suffering to wait until something “perfect” does come along, and leave them suffering until then?
(also, well known psychological fact is that the MOST likely time for suicide for someone depressed is when you first start to come out of it. That’s a common problem with medication or without it. That’s where you look at the pit behind you and go “NEVER going back” and are most likely to slide back in).
“Note that these were healthy, non-depressed people. I think we can safely point our fingers at the drug.”
What’s the point of showing the side effects of an anti-depressant on people who don’t need it? Sorta silly if you ask me.
These drugs are quite powerful but should only be used in conjunction with and under the close watch of a good therapist. Maybe whoever subscribed the drug should be under investigation in cases like these because it isn’t a sugar pill and I would suggest that sometimes they’re handed out a bit too freely.
Eyebrows, I guess I just don’t see my post as stigmatizing mental illness. Rather, I’m questioning the safety of drugs that are being used to treat mental illness. I’m not discounting that they work on some people, or that they’re embraced by many in medical science. However, medical science is not infallible (witness the barbaric but, at the time, accepted, Nobel-prize-winning medical practice in the mid-20th-century of performing lobotomies on the mentally ill). Obviously, SSRIs are not as bad as lobotomies, but nevertheless, if it turns out that these drugs are indeed harmful — too risky for use by the mentally ill — don’t you think they should be withdrawn?
I’m not criticizing/stigmatizing the ill, but questioning the doctors/drug companies/FDA. No stigma intended.
Perhaps you’re right that they’re overprescribed and too often unsupervised — maybe it’s a malpractice issue rather than a drug issue. I don’t know, but that’s what I’m asking. When you see these drugs involved in so many violent acts, you have to wonder whether these drugs are safe. Can’t that be questioned without stigmatizing the patients who are merely relying on their doctors’ advice?
Perhaps a better example would be Vioxx. How many people were helped by that medication, yet it was pulled off the market because of the increased risk of heart attack. Isn’t increased risk of drug-induced suicide/homicide a little more serious?
PI asked, “What’s the point of showing the side effects of an anti-depressant on people who don’t need it?”
To show whether the side effects are caused by the underlying illness or the drug itself. These were clinical drug tests, as I understand it.
there are 3 fundamental problems:
1. The drug/medical industry by and large treats symptoms, not causes. And the side effects of many “treatments” create more symptoms, that require more treatments, and so on in an ever-growing chain of dependence.
2. Too many people think that they need to take a pill for every pain or discomforture in life. We all know people who almost brag about how many prescriptions they take.
3. There’s big money to be had in pushing drugs to people. Lobbyists see to it that legislators are well taken care of if they vote for more vaccines; more drugs for kids and old and “sick” people who “need” them. And the media, which makes big money from advertising drugs, portrays skeptics as idiots and neanderthals.
Now, before I get accused of being a neanderthal, I did NOT say we should do away with all drugs. I am saying, that many (perhaps most) are overused, overhyped, and not looked at critically enough.
“PI asked, “What’s the point of showing the side effects of an anti-depressant on people who don’t need it?”
To show whether the side effects are caused by the underlying illness or the drug itself. These were clinical drug tests, as I understand it.”
Isn’t that a little like giving someone without diabetes insulin to see what negative side effects it might have? It just doesn’t make sense.
Amen to Mouse’s comments.
CJ: I agree that your questions are valid about the drugs and I do not feel that you stagmitizing those with mental illness.
No disrespect intended — each inidividual is a different ‘petri’ dish at different hours on the same day, different days, weeks and months. Our mental process alters our chemical balance, along with diet, exercise, sleep, whatever substances we put into our bodies and oh so many other factors.
After delivering my second son, I was so overtired and exhausted from delivery, I finally relented to the lowest dosage of a drug, Halcion, prescribed to induce sleep. It was a frightening experience, hallucinations and suicidal thoughts of the blackest kind, almost instantly. Within two weeks, I saw a prerecorded news show about this very drug and how people had killed family members while using this drug. They were shunned and told it just couldn’t be true. I knew otherwise. That was the first indication about the possible dangers of drugs on a personal level. Since that time, almost every drug I have had prescribed has had a negative effect on my body so I have opted for a natural remedy.
As a society, many of us are severely dehydrated which causes many health symtoms — the importance to find a cure rather than just something to mask a problem. Drinking water is essential for proper body functioning.
In addition to prescribed medications, there are natural methods for depression, anxiety and other physical ailments that can also be effective — people can decide to pursue. I recall reading informative articles and studies about depression with cognitive bahavior therapy vs. depression medication and the results were startling (In the WSJ — the Dali Lama participates in an annual conference regarding brain functions.) For example, cognitive behavior therapy may require significant personal effort and change with long term effective results.
Each of us needs to decide what method or methods will work best for us and our families and those around us.
The exchange and discussion of ideas is important.
Turn on the television and count how many commercials push pills on the general public. You can get a pill for anything and it will cure anything from crooked toenails to flat hair. They are drowning us in pills, pills, pills. For those of us that have to take pills they are a pain in the neck and costly. No prescription should be given out without regular checkups on the results before they are allowed to be refilled. Many just need the strength to be adjusted to make them effective without being overwhelming. Anti-depressants are only as good as the hands they are in.
Mr. Summers – If you have seen the pattern with such drug use, so have her defense attorneys. I read the articles about the trial in the PJS and it seems to be some textbook defense they are putting on and some things just do not ring true.
If she was driven to her actions due to the drug influence or lack there of, she was certainly coherent before and after she committed the crime. I have never been around someone suffering from mental illness (that I know of). I guess I need someone to explain how she could be so depressed and crying all the time and yet make a plan to remove her daughter from the home and commit the act and then attempt to cover her tracks.
Also, it is always hard from me to understand where all the rest of the adults are when situations like this happen. I guess her husband was working out of town but her parents were actively involved in her life. She was employed in a professional capacity. Did no one notice she was teetering on the brink of disaster?
BMW
I just want to say it is so hard reading this story on the news every night. As the grandmothers describe what happened leading up to Kathryn’s death, tears well up into my eyes. I just feel so bad for that family.
I agree, NewsAnchorMom. It’s hard for me to read about, too.
BMW — I’ve never been a big believer in the “insanity” defense. To me, that’s an aggravating, rather than mitigating, factor. Still, if certain drugs have been clinically proven to cause some people to act in ways “alien or uncharacteristic of the individual,” and if she was following her doctor’s advice, that’s something to consider. It wouldn’t absolve her of responsibility, but it could be a mitigating factor, if proven.
“To show whether the side effects are caused by the underlying illness or the drug itself. ”
Some drugs cannot be tested in this fashion (insulin is a good example) because on a healthy body they will CAUSE illness whereas on a sick body they will CURE it.
“To me, that’s an aggravating, rather than mitigating, factor.”
WOAH. Someone who’s incapable of telling right from wrong is an AGGRAVATING factor? If people DON’T know what their actions are or can’t control them, that’s AGGRAVATING? CJ, that throws out an entire category of jurisprudence dating back to God knows when. That would suggest that children’s childhood is an aggravating factor, because they also suffer from diminished capacity. Mental retardation would be an aggravating factor. You must be meaning something different from the legal definition, because I can’t imagine that you seriously consider diminished capacity an aggravating factor that makes someone MORE responsible for a crime.
BMW, “I have never been around someone suffering from mental illness (that I know of).”
You almost certainly have been. Most of us function quite well, many of us thanks to livesaving drugs such as SSRIs. If you’ve met me, you’ve been around someone mentally ill. Congrats.
“Did no one notice she was teetering on the brink of disaster?”
That is frequently the case. You apparently have never noticed the mentally ill people in your life. And stigma keeps many people who are mentally ill from seeking treatment, and keeps many of their family and friends from being willing to believe the person is “mentally ill” rather than just “going through a rough patch” — and, frankly, from knowing enough about the symptoms to know when to help someone seek help.
BMW, you ask where “all the rest of the adults were” in this situation.
It’s not mentioned in the story, but Katie lived with her father in North Carolina for 18 months and attended a special school prior to her death. (He worked for Cat and was transferred there)Katie and her father moved back to Morton only 3 weeks before she died. Also not mentioned in these stories is that Katie had a younger sister who was not autistic and had lived with the mother all this time without apparent incident.
There have been posts over at the Journal Star site repeatedly bashing the father on the false assumption that he divorced Karen long before this happened and abandoned Katie to his mentally ill wife’s care. For the record, he did not file for divorce until AFTER Katie died.
Frequently families realize that there is something wrong with one of the family members but because of the way laws are structured they cannot do anything about it. Their hands are tied. You can’t just go to the authorities and say this person is mentally ill and needs to be locked up. The only one out in this case would have been child services to declare the mother dangerous to her child. But often the choice are not simple and require a lot of proof to get anything done and then it is too late.
Wow! I appreciate all the feedback. I did not mean in anyway to fault the father. I was familiar with the “rest of the story” and that he was living out of town and caring for Katie. I guess I was questioning why, if her mental health was in such a state that it led to the death of her own child, that other adults that were in contact with her, like her parents, did not take action. As Eyebrows explains, perhaps they did (or did not) and that is one of the difficulties of dealing with this disease.
I guess what I failed to make clear in my previous post is that based on the facts presented in the PJS, I am not convinced insanity drove her to her actions.
I’m going to have to sit down and take some time to do this topic justice, but I’ll make a few quick points.
My experience, of course, is mostly with children. I have some experience with SSRIs, although I certainly do not use them frequently. Of course I am often left managing psychiatric issues in children because our mental health system is so completely abysmal. There is literally no one else to do it, so it falls on the shoulders of primary care physicians who have very little training in this area. That’s part of the problem, I’m sure.
first, on mccarron: i am not trying the case, but i am in the office that is. i have watched much of the trial and prior motion hearings and observed the defendant often. i realize her claim is not that she is now ‘insane,’ but that she was at the time of the offense. a defense expert is to testify monday and a rebuttal expert the day following. my layman opinion (i am a lawyer, not a psychiatrist) is this:
sorry, have to repost the whole kit-and-kaboodle:
first, on mccarron: i am not trying the case, but i am in the office that is. i have watched much of the trial and prior motion hearings and observed the defendant often. i realize her claim is not that she is now ‘insane,'(that is irrelevant) but that she was at the time of the offense. McFarland has attempted to release her, however, she threatens suicide if she is released and otherwise refuses to leave their care, despite their claims that she is able to live outside the facility. a defense expert is to testify monday and a rebuttal expert the day following. my layman opinion (i am a lawyer, not a psychiatrist) is this: she was legally sane when she killed her daughter.
Reasons: she spoke openly to her husband and others about ‘adopting out’ Katie, she spoke to others about having Katie institutionalized, she spoke to others about Katie being better off dead. 3 days prior, she put a pillow over katie’s face but withdrew it before death. No one, save her and Katie were aware of this incident. The asphyxiation took at least one minute and as much as four, after the girl stopped breathing to accomplish. She witnessed and knew the signs of death: Katie defecated and had no heartbeat, which she checked. She brought Katie home and put her in her bed for a nap, as a ruse, waited two hours, got ice cream and disposed of the bag, which she conceded could be damaging to her, then played out a ‘finding Katie dead’ scenario including screaming, performing useless CPR and allowing paramedics and doctors to attempt resuscitation for at least an hour.
Doubts: in my experience, all facts are a double-edged sword. Everything heterogeneous; good and bad jumbled. there was a clear decline in McCarron’s condition in the year leading to katie’s death. Significant weight loss. Verbalizing her wishes to rid herself of Katie through (somewhat, at least non-violent) acceptable, then unacceptable means. Clearly, she was and still is a troubled woman. I cannot say if she is troubled, or troubled by her actions. But she is a husk of a person, unable to look anyone in the eye. It is unlikely she will ever do so.
I do not blame the family. And no one wants his/her private life judged so publicly, but there were some disturbing signs leading up to the death. I cannot imagine having to ask my spouse whether she would harm our child. To feel the question necessary should be a signal there are foul things afoot. Maybe not murder, but bad tidings.
McCarron was raised by strict, immigrant, german-catholics. As was I. I understand that imperfection and family problems (as in other families, as well) are often buried or unspoken. I understand that physical displays of affection may be verboten. Do not talk of ‘it’ and ‘it’ will go away. And I am aware that this approach exacerbates rather than solves problems. This post is getting too far afield…
Summation: the defense will make much of her unsupervised cessation of SSRI’s, namely Cymbalta. (or maybe they won’t – her attorneys are hacks, as anyone who has watched the trial can attest to). My next post will talk about SSRI’s, but if she is ‘insane,’ the drugs had little to do with it. The jury will decide her fate, but any ‘insanity,’ found or not, is a result of her own childhood and the impact that had on raising her own children.
Just one person’s opinion.
SSRI’s.
I think it’s important to note that this person had recently stopped taking SSRI medications. Without very close supervision from a doctor, stopping medications that help regulate chemical production in the brain is extremely dangerous. Because SSRIs work so well for some people, they become convinced that they are cured, and will stop taking the medication cold turkey without a doctor’s knowledge or supervision. All of these things are noted in strong warnings on the medication itself, and people considering taking such drugs should also be warned by their doctor.
To say that SSRIs are not safe is sort of ridiculous. There are lots of medications that are extremely unsafe if not taken properly, from commonly used ones like antibiotics to more heavily regulated painkillers. Hell, compare the numbers to that of alcohol-related incidents, which I am sure far outweigh SSRI-related incidents 10 to 1.
Mental illness is perhaps the leprosy of our day, and to stigmatize the drugs that help those people who benefit from them is short-sighted. After there was a great deal of press about how SSRIs can affect children adversely (end of 2006, beginning of 2007), doctors and psychiatrists became reluctant to prescribe them. In 2007, suicides among children rose dramatically. While decreased use of SSRIs in treating mentally ill children may not be the only factor, it would certainly seem to be partially at fault.
A jury will decide the fate of Ms. McCarron, and whether irresponsible drug use played any part in her daughter’s murder.
However, fearmongering about available drugs for mental illnesses (which are little understood as it is) will only serve to deter people who may need them.