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SSRIs and violence/violent thoughts?


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Hi all,

 

I've been on Prozac on varying doses since late July. It has helped me come out of a deep depression. But I am having some concerns.

 

I have been struggling a lot with violent intrusive thoughts, and they started a couple of weeks after I started the Prozac. I've been doing a lot of research online about Prozac (and SSRIs in general) being linked to violent thoughts and violent behavior. I've been diagnosed with anxiety with "obsessive tendencies", so I don't know if these are just OCD type intrusive thoughts, or if they could be being caused by the Prozac. It's really freaking me out.

 

In looking for alternatives, I was reading up on Luvox. It seemed OK until I read that one of the Columbine shooters had been on Luvox before the rampage. Now I can't help but be afraid that the SSRI is doing this to me.

 

The counter-point to that, though - I was on Paxil for about 10 years, from 2002-early 2013. During that time I wasn't violent and didn't really have intrusive thoughts, other than a few now and then. I switched to Celexa in early 2013, and similarly, was not violent and didn't have violent thoughts. After being on the Celexa for about 6 months I had a breakdown and ended up in a deep, major depression - this is when they put me on Prozac. 

 

As I said, I'm struggling trying to figure out if these thoughts are just classic intrusive thoughts, or could be brought on by the Prozac. If I were susceptible to the violent behavior I've read about, would it have already manifested itself during my 10 years of Paxil? Does the fact that it didn't manifest itself, and that I didn't really have any major side effects, mean that I tolerate SSRIs pretty well?

 

I'm just completely at a loss for what my next move should be. The Prozac has helped, but I still am depressed and having issues (the intrusive thoughts, dulled emotions, doubting my feelings, etc.) so I don't know if I should stay on it. I'm meeting with my pnurse tomorrow but wanted to see what others' experiences were.

 

Thanks.

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The fact that you are worried about these intrusive thoughts, would suggest to me that you're not liable to go out and act on them.  Everyone gets sick thoughts from time to time, they get brushed off and that's that.  If everyone who had violent thoughts went out and acted on them, humans (and probably every other known creature) would be long gone.  I get worried when people have them and think they're somehow O.K. or worth following through on.

 

I'd guess it's a manifestation of your obsessive tendencies which may suggest that Prozac is not adequate for you.  Why did you stop the Paxil in the first place?

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I think (And its just my opinion) that getting settled down on medication that works takes a lot of back and forth with the Doctor.   The way thats worked for me was to take a drug.  Give it a proper time to get going.   With Celexa I think it was 6 weeks.  Then adjust the dose up and down until you are at the minimum that works.  All the while reporting side effects which maybe a quick (Lets change drugs you don't want to live with _______)

 

If I had the same issue (Violent thoughts) I would report in with my Doctor and say that I wanted a visit asap because of worseining symptoms.    Be upfront and spell out whats going on.  You might just be on a drug that doesn't work for you.   And I think all SSRIs have a black box warning about suicidal thought or actions.

 

The Colorado mass murders - why is it assumed it was mental illness?   I think too many people think that all violent crime MUST be because they must be "crazy"  

How else would anyone do such things? 

I think the answer to that is that we live in a world with good and evil people.  A lot of the people that do evil think they are good but they aren't insane.   Stupid?  Mean?  Creepy?  All of the above?

 

I know Hitler is such an easy target but somewhere I have a book that was published in the 1930s by one of Hitler's cohorts who bailed out when he saw the real Adolf.  He said he left because Hitler was a criminal whose only rule was "don't get caught"   And a lot of crime is from people who have zero morals or scruples.   But its not because they have Anxiety or Depression.   Anyway I think its an insult to lump murderers and other criminals with mental illness.    Am I wrong?

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The fact that you are worried about these intrusive thoughts, would suggest to me that you're not liable to go out and act on them.  Everyone gets sick thoughts from time to time, they get brushed off and that's that.  If everyone who had violent thoughts went out and acted on them, humans (and probably every other known creature) would be long gone.  I get worried when people have them and think they're somehow O.K. or worth following through on.

 

I'd guess it's a manifestation of your obsessive tendencies which may suggest that Prozac is not adequate for you.  Why did you stop the Paxil in the first place?

 

The Paxil had helped with some of my anxiety, but it was not helping at all in other areas. For example, when I bought my house I couldn't stop obsessively worrying about all kinds of catastrophic things happening with the house. My anxiety was still interfering with my life, and my family even staged a mini "intervention" to get me to go back to therapy, which I did. I wanted to try something different, and my wife and sister had both had fantastic results with Celexa, so I tried that route. 

 

I felt about the same on the Celexa as I did on the Paxil. For a while I thought I was getting better, then I got much worse, and fell into the depression.

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I think you need to call / consult / visit your psychiatrist immediately.  This is a serious side effect.  And if it is NOT a side effect it is just as serious.  Please go talk with your doctor.

 

I have an appointment tomorrow afternoon. She's not a psychiatrist but a psychiatric clinical nurse specialist, and she's supervised by a psychiatrist. 

 

I started the Prozac when I went to a partial hospitalization program, and it was the psychiatrist that put me on it. He gradually increased my dose over the course of 6 weeks. I had told him about the violent thoughts, but he didn't think it was because of the Prozac. He said it sounded like intrusive thoughts, and that's when I started on Geodon to try to stop the obsessive thinking. The Geodon didn't seem to make any difference, so they raised the dose. At the higher dose, I was having tremors and muscle weakness, and I could hardly stay awake, so I dropped back down to the lower dose.

 

This has been a roller coaster nightmare for me. In the past 6 months I have been on Celexa, Risperidone, Ativan, Seroquel, Klonopin, Geodon, and Prozac. 

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Can you see how you have made a link from having an intrusive violent thought to what you later talk about in the post, which is violent behaviour? By reading up on AD's a violence, you have gone from experiencing an intrusive thought to assuming that having that thought proves a kind of behaviour in you that is out of your control, either because it is innate/your med is causing it?

 

Intrusive thoughts can be part of a mental illness, they can be a reaction to stress or change, they can come when taking some medications. What is guaranteed to increase the frequency and severity of the thoughts is being frightened by them and trying to think your way out of them. There are techniques to work with intrusive thoughts to allow them to cross your mind without feeling shocked by them or needing to block them, cognitive behavioural therapy is a great resource for that.

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I just feel like I have to be extra vigilant about these thoughts after reading about SSRIs and violent behavior.

The problem is, I don't know if these thoughts are (1) being caused by the prozac, (2) are warning signs that I'm going to snap and do something terrible, or (3) are just OCD type obsessive intrusive thoughts.

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If you have never had these thoughts before and they are casing you distress, then you should mention them to whoever prescribed you, it can be the case that AD's have these thoughts as a rare side effect.

 

That said, having a thought doesn't mean you will act on it. The fact that you fear acting it a sign that it is highly unlikely you will act on it, if you lacked insight and were dangerous, would it occur to you to get help? The more time you spend trying to figure out the significant of the thoughts, the more you will have and the more you will feel frightened by them, it tends to be a cycle.

 

My advice is ask a doctor today and see what happens.

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So I saw my nurse practitioner today and talked about my concerns. She says it's clear that the high dose of Prozac is not working well for me. So for now the plan is for me to gradually lower my dosage back down again. At that point we will look at other SSRI options. She also gave me some Klonopin to take daily for the short term to help alleviate the anxiety and fear I've been having.

So tomorrow I am stepping down to 40mg of Prozac, and see how that goes for a week.

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I think you need to call / consult / visit your psychiatrist immediately.  This is a serious side effect.  And if it is NOT a side effect it is just as serious.  Please go talk with your doctor.

 

I have an appointment tomorrow afternoon. She's not a psychiatrist but a psychiatric clinical nurse specialist, and she's supervised by a psychiatrist. 

 

I started the Prozac when I went to a partial hospitalization program, and it was the psychiatrist that put me on it. He gradually increased my dose over the course of 6 weeks. I had told him about the violent thoughts, but he didn't think it was because of the Prozac. He said it sounded like intrusive thoughts, and that's when I started on Geodon to try to stop the obsessive thinking. The Geodon didn't seem to make any difference, so they raised the dose. At the higher dose, I was having tremors and muscle weakness, and I could hardly stay awake, so I dropped back down to the lower dose.

 

This has been a roller coaster nightmare for me. In the past 6 months I have been on Celexa, Risperidone, Ativan, Seroquel, Klonopin, Geodon, and Prozac. 

 

This is going to sound weird but I took my Ambien a while ago and it might really be weird.   All I want to say is that finding the right drug (Even the correct diagnosis) can take a lot of time and effort.   How doctors are able to do this mystifies me.  But they DO succeed.    When you talk to your doc & therapist you should tell them your symptoms are worse.  

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  • 2 months later...

I know I've been away for a while, but I wanted to post an update on this topic.

 

I've been off Prozac for almost 2 months now. I'm on 100mg of Zoloft now. It doesn't seem to be helping much as far as my anxiety and depression, but one big positive is that I am not having violent thoughts anymore! Every once in a while, I will think about how I used to have them, and that will cause me to have some. But I recognize what it is, and I can focus my mind elsewhere.

 

I'm still struggling every day, mostly depression and fears about losing my job, but I am glad to be rid of those violent thoughts.

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