Chasing the Epidemiology of Mass Murder
WE CAN ALL READ THE STORIES, ADD UP THE CLUES AND REACH THE SUMMARY THAT Stephen P. Kazmierczak was just an unlucky soul born with bad genes. We can shake our heads at the loss, the waste, the pain, and then go back to our lives knowing that the Illinois man who opened fire on a roomful of college students only became violent when he stopped taking his meds.
Yet the discordant images of the gunman leave us unsettled. He was "brilliant," "gentle," "even," "sweet," "soft-spoken''-- characterizations of teachers and students who knew him in high school and college. But he also was kicked out of the Army, hospitalized in a mental facility, accused of self-mutilating himself. He recently had gotten a disturbingly violent tatoo inked onto his arm, and he began to collect guns. His brave girlfriend, determined to challenge the picture of a demented man, gave a moving interview to CNN because, she said, Kazmierczak "cannot be defined by his last actions. There was so much more than that."
Of her boyfriend, she said, "The Stephen I know and love was not the man that walked into that building. He was anything but a monster."
There's not many roads left to follow in this news story. The biggest unaswered question about the tragedy of Steve Kazmierczak is, "Can we ever truly know anyone?" And to that I say, 'Good luck finding the answer." Mankind has spent history chasing that query. But here's one narrower avenue that ought to be traveled: antidepressant discontinuation syndrome. What, if anything, does withdrawal have to do with Kazmierczak's final crazy act? During a press conference after the assault, NIU officials revealed that Kazmierczak had recently become "erratic" after stopping his medicine, but they declined to name which one. His girlfriend told CNN that he had quit his antidepressant because it was making him feel like a "zombie," and while she denied he was erratic, she said "he was just a little quicker to get annoyed."
Yet the medical literature is clear: "Discontinuation reactions are clinically important for several reasons. Firstly, although most are mild and short lived, a minority are severe or chronic and cause considerable morbidity." Among SSRI (selective serotonin reuptake inhibitor) antidepressants, Prozac has the least withdrawal symptoms, while Paxil and Luvox have been associated with increased risks of withdrawal symptoms. In fact, QuitPaxil.info exits solely to warn the public about the risks of quitting Paxil too quickly. Dr. Peter Breggin, the best-selling author of "Talking Back to Prozac" who has become an outspoken sentinel on the risks of antidepressants, also has a page exploring SSRIs' "induced violence and abnormal behavior." And one outdated site seems to have made it its business to list each individual associated with antidepressants and violence or suicide.
There's few newspapers remaining that are willing to donate the resources to investigate big questions like this one. Here's my hope that one will accept the challenge.
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Posted February 18, 2008
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