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Specific Groups Of Prescription Drugs Are Associated Of Serious Acts Of Violence

Prescription MedicationViolence towards others is a seldom-studied adverse drug event and a difficult one to study because the risk of injury extends to others. Researchers sought to identify the primary suspects in adverse drug event reports that included thoughts or acts of violence towards others. Check the end of this report for a link to download this open access study.

From the Food and Drug Administration (FDA) Adverse Event Reporting System (AERS) data, researchers extracted all serious adverse event reports for drugs with 200 or more cases recorded from 2004 through September 2009. Case reports were then classified as including homicide, homicidal ideation, physical assault, physical abuse, or violence related symptoms.

Researchers identified 1527 cases of violence disproportionally* reported for 31 drugs. Primary suspect drugs included varenicline (an aid to smoking cessation), 11 antidepressants, 6 sedative/hypnotics and 3 drugs for attention deficit hyperactivity disorder. The evidence of an association was weaker and mixed for antipsychotic drugs and absent for all but 1 anticonvulsant/mood stabilizer. Two or fewer violence cases were reported for 435/484 (84.7%) of all evaluable drugs suggesting that an association with this adverse event is unlikely for these drugs.

In conclusion, acts of violence towards others are a genuine and serious adverse drug event associated with a relatively small group of drugs. Varenicline, which increases the availability of dopamine, and antidepressants with serotonergic effects were the most strongly and consistently implicated drugs. Prospective studies to evaluate systematically this troublesome side effect are needed to establish the incidence, confirm differences among drugs, and identify additional common features.

Material adapted from PloS One.

Download / Reference
Moore TJ, Glenmullen J, Furberg CD, 2010. Prescription Drugs Associated with Reports of Violence Towards Others. PLoS ONE 5(12): e15337. doi:10.1371/journal.pone.0015337

*Disproportionality in reporting was defined as a) 5 or more violence case reports, b) at least twice the number of reports expected given the volume of overall reports for that drug, c) a χ2 statistic indicating the violence cases were unlikely to have occurred by chance (p<0.01).

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