Seite 4: Media are to slow?

But why do even important media such as the New York Times, the British Guardian or the German Spiegel that consider themselves as investigative not follow this antidepressant/amok track in the context of Lubitz and other cases where people have run amok?

David Healy: This is a very important question that needs answers. First, I would broadly point out that investigative journalism is slow to question the corporate establishment - on issues from lead poisoning to the food industry etc. The case has to be very compelling before some journalists will attempt to take the task on.

This holds especially for medical topics, not least journalists themselves are just ordinary people, and most ordinary people in today’s times have internalized the idea of drugs being a kind of "magic bullets", as Harvard scientist Allan Brandt outlined in his book "No Magic Bullet".

Is the mentioned BBC report about Paxil or Seroxat, respectively, to your knowledge the only of its kind from a major media?

David Healy: No. Just recently, on July 14, the German FAZ reported about the fact that most young men running amok in America, among them the mentioned "Batman" shooter James Holmes, have been under the influence of medications that can go along with severe side-effects such as antidepressants.

Another known example is the report of US neurosurgeon Sanjay Gupta in his capacity as CNN's Chief Medical Correspondent about Adam Lanza’s school shooting in 2012 with 28 being killed altogether. Gupta said:

There is something else to consider. What medication if any Adam Lanza was on? We are specifically talking about antidepressants. If you are looking at the studies and other shootings like this that have happened, medications like this were a common factor... [They] could lead to increased impulsivity, decreased judgment, making someone out of touch."

But in the context of shootings such as the one of Adam Lanza it is being argued that access to guns is the main problem. Doesn’t this sound plausible?

David Healy: Mass shootings are easier with a gun but antidepressants are also linked to some horrific murders with knives and other means. Apart from this, the number of gun homicides in the US at the beginning of the 1970s was the same as 2004, whereas at the beginning of the 1970s the US population was around 200 million and in 2010 about 300 million.

So finally, decades ago there have been even more gun homicides relative to today's times, but virtually no mass shootings. In this context, a 2013 study by the Pew Research Center showed that gun homicides and violence in the United States went down sharply in the past 20 years. But especially in the past 20 years the number of mass shootings without criminal background has risen sharply in America.

The U.S. Food and Drug Administration (FDA), though it has determined that antidepressants could cause suicide and as a consequence has issued a so-called black box warning that appears on the package insert of a prescription drug in 2004,8, hasn't enacted such black box warning for violence or homicide yet. And upon my request the FDA said they "have no such data for violence, or homicide, or aggression." Doesn’t this counter your view?

David Healy: Undoubtedly, the evidence is there.

But then, how is the missing FDA black box warning for violence or homicide to explain?

David Healy: The FDA probably concluded that it is politically impossible in the United States to hold a hearing on this risk. Apart from the clinical trial data, not least the FDA’s own voluntary reporting system for adverse events, the so-called MedWatch database, delivers solid evidence.

In which way?

David Healy: There are a large number of case reports of SSRI-associated violence that have been submitted to the FDA's own MedWatch program. In a review of that MedWatch data, Harvard psychiatrist Joseph Glenmullen and other researchers identified 31 drugs associated with case reports of violence towards other, which included 387 reports of homicides. Twenty-five of the 31 suspect drugs were psychiatric drugs, and 11 of the 31 were antidepressants.

The second most problematic drug on the list was the fluoxetine, known by the trade name Prozac. And paroxetine, known as Paxil, another SSRI, was number three. As a class, antidepressants were the most problematic drugs in the MedWatch data base So if the FDA would look at its own data, it would find a compelling scientific reason to issue a black box warning.

In this context, experts call attention to the fact that the FDA estimates that less than 1 percent of all serious events are ever reported to it. So can we seriously conclude from this that the real figures of violence and homicides associated with drugs such as SSRIs are in fact a hundred times or at least much higher than the statistics are indicating?

David Healy: It is true that the overwhelming majority of problems on drugs are not reported and it is also true that problems linked to violence and antisocial behavior may be even less likely to be reported because doctors do not make the link but it is not possible to say how much greater the problem in fact is in comparison with how it is reported.

But then, how can it be explained that recently experts even suggested to remove the FDA’s black box warning from 2004, saying that it is "extremely questionable and virtually meaningless"?

David Healy: The aggressive campaign to attempt to remove the black box warning from antidepressant drugs, determining that they could induce suicide, are reminiscent of the hazards of substances such as of lead, asbestos and tobacco that have been negated over decades by politicians and powerful scientists. In the case of asbestos , there have been first indications of its heavily sick-making or deadly potential already around 1900, but the carcinogenic silicate mineral - long celebrated as "miracle fiber" - has only been prohibited in Europe approximately 90 years later. The public will have to make their own mind up as to what is going on here.