Here we go again. I have written extensively in FmH in the past about scurrilous and scientifically unwarranted attempts to link antidepressant use to violent crimes. This case invloves a minor, and is fueled by the FDA’s recently mandating a ‘black box warning’ that antidepressants may cause increased suicide risk in children. The defense, contending that sertraline (Zoloft) transformed ‘a “nice, shy Christian boy” to a violent predator’, is attempting to use an “involuntary intoxication” defense, which requires
Antidepressants can rarely induce acute mania, sometimes psychotic, which can possibly meet these criteria, but short of that I cannot think of a way in which an antidepressant can ‘intoxicate’ or obscure distinguishing right from wrong. Adverse events occurring while someone is being treated with an antidepressant are far far more likely to be consequences of the patient’s underlying psychological distress than the effects of the drug. The scurrilous publicity to the contrary steers many patients, or parents of minor patients, away from agreeing to urgently needed and hugely effective therapeutic options for their suffering.