Questions remain about risk to public

The debate over whether antidepressants play a role in suicides and homicides has taken twists and turns over the years.

Drug company GlaxoSmithKline sent a letter in May 2006 to health care professionals warning them to take precautions with some Paxil patients with major depressive disorders who may become more depressed and/or have thoughts of suicide "whether or not they are taking antidepressant medications, and this risk may persist until significant remission occurs.”

And the Food and Drug Administration has heard complaints about antidepressants over the years and responded with increasingly stronger labeling for drug makers.

"I was making icing for a Father’s Day cake when suddenly, without warning, it seemed like a swell idea to kill myself,” Bonnie Leitsch, national director for the Prozac Survivors Support Group, testified before the FDA in September 1991. "Did I shoot myself? No, because a gun wasn’t handy. Had it been handy I’m sure I would have done that.”

The FDA issued a 2004 mandate to pharmacies to give patients a guide urging them to call a doctor if a patient who takes antidepressants begins acting aggressively, being angry or violent or acting on dangerous impulses.

Oklahoma psychologist Gail Poyner recommends considering testing in some cases to determine if an antidepressant might have influenced someone to commit a crime. The test identifies those, about 10 percent of Caucasians for example, who lack an enzyme and consequently could react violently to medication, she said.

The most dangerous times for people who have adverse effects are when the medication is first taken, when it is increased or when the person is withdrawing from the drug, she said.