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Study reveals top ten violence-inducing prescription drugs

By DmTryp, Jan 16, 2011 | | |
  1. DmTryp
    Study reveals top ten violence-inducing prescription drugs

    Ethan A. Huff
    Natural News
    January 16, 2011

    (NaturalNews) The Institute for Safe Medication Practices (ISMP) recently published a study in the journal PLoS One highlighting the worst prescription drug offenders that cause patients to become violent. Among the top-ten most dangerous are the antidepressants Pristiq (desvenlafaxine), Paxil (paroxetine) and Prozac (fluoxetine).

    Concerns about the extreme negative side effects of many popular antidepressant and antipsychotic drugs have been on the rise, as these drugs not only cause severe health problems to users, but also pose a significant threat to society. The ISMP report indicates that, according to the U.S. Food and Drug Administration’s (FDA) Adverse Event Reporting System, many popular drugs are linked even to homicides.

    Most of the drugs in the top ten most dangerous are antidepressants, but also included are an insomnia medication, an attention-deficit hyperactivity disorder (ADHD) drug, a malaria drug and an anti-smoking medication.
    As reported in Time, the top ten list is as follows:

    10. Desvenlafaxine (Pristiq) – An antidepressant that affects serotonin and noradrenaline. The drug is 7.9 times more likely to be associated with violence than other drugs.

    9. Venlafaxine (Effexor) – An antidepressant that treats anxiety disorders. The drug is 8.3 times more likely to be associated with violence than other drugs.

    8. Fluvoxamine (Luvox) – A selective serotonin reuptake inhibitor (SSRI) drug that is 8.4 times more likely to be associated with violence than other drugs.

    7. Triazolam (Halcion) – A benzodiazepine drug for insomnia that is 8.7 times more likely to be associated with violence than other drugs.

    6. Atomoxetine (Strattera) – An ADHD drug that is 9 times more likely to be associated with violence than other drugs.

    5. Mefoquine (Lariam) – A malaria drug that is 9.5 times more likely to be associated with violence than other drugs.

    4. Amphetamines – This general class of ADHD drug is 9.6 times more likely to be associated with violence than other drugs.

    3. Paroxetine (Paxil) – An SSRI antidepressant drug that is 10.3 times more likely to be associated with violence than other drugs. It is also linked to severe withdrawal symptoms and birth defects.

    2. Fluoxetine (Prozac) – A popular SSRI antidepressant drug that is 10.9 times more likely to be associated with violence than other drugs.

    1. Varenicline (Chantix) – An anti-smoking drug that is a shocking 18 times more likely to be associated with violence than other drugs.

    (I am unable to post the link until I have more than 50 posts)


  1. Killa Weigha
    SNAP! Why don't we have a thread for this? "What drug make you aggro?" or something. But that's EXACTLY why I ain't going on no psych drugs even though they MIGHT help. Not worth the risks.
  2. Crazy Insane Sanity
    Are these drugs causing violence, or is it that people with anxiety issues, or people who are under a lot of stress, are more likely to be violent? I see they put the anti-smoking drug at the top...no surprise there, these people are trying to quit smoking! :rolleyes:

    To me, it seems that the only one that makes any sense here is the amphetamines...the rest, perhaps, but I feel like they're trying to pass off correlation as causation, and I don't see the evidence.

    And they talk about the adverse effects of anti-psychotics, but I don't even see one listed?
  3. SlightlyBitter
  4. DmTryp
    My cat was placed on Effexor ptsd a few years ago. After a week or two my cat stopped sleeping except in half hour increments. When she complained to the psychiatrist who had prescribed it to her, he upped the dosage. This led to a full-blown manic episode with psychosis wherein my cat became uncharacteristically aggressive and violent. This resulted in hospitalization and withdraw from the horrendous medication.

    My cat has a MUCH better psychiatrist now. Her current doctor, when she expressed a desire to quit smoking, informed her that Chantix is also known to produce psychosis in some patients and is not worth the risk.
  5. Potter
    Source for above posted article

    Abstract Top

    Violence towards others is a seldom-studied adverse drug event and an atypical one because the risk of injury extends to others.

    To identify the primary suspects in adverse drug event reports describing thoughts or acts of violence towards others, and assess the strength of the association.

    From the Food and Drug Administration (FDA) Adverse Event Reporting System (AERS) data, we extracted all serious adverse event reports for drugs with 200 or more cases received from 2004 through September 2009. We identified any case report indicating homicide, homicidal ideation, physical assault, physical abuse or violence related symptoms.
    Main Outcome Measures

    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).

    We 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.

    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 side effect are needed to establish the incidence, confirm differences among drugs and identify additional common features.

    Citation: 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

    Editor: Joseph S. Ross, Yale University School of Medicine, United States of America

    Received: October 9, 2010; Accepted: November 7, 2010; Published: December 15, 2010

    Copyright: © 2010 Moore et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

    Funding: The authors have no support or funding to report.

    Competing interests: Mr. Moore has received consulting fees from litigators in cases involving paroxetine, and was an expert witness in a criminal case involving varenicline. Dr. Glenmullen has been retained as an expert witness in cases involving varenicline and psychiatric drugs including antidepressants, antipsychotics, benzodiazepines, mood stablizers, and ADHD drugs. Dr. Furberg has received consulting fees from litigators in cases involving gabapentin. This does not alter the authors' adherence to the PLoS ONE policies on sharing data and materials.

    * E-mail: tmoore@ismp.org
    Introduction Top

    Violent thoughts and acts towards others area common occurrence in our society but rarely studied as an adverse drug event. Increased risk of suicidal behaviors—but not violence— associated with antidepressants has been examined through meta-analysis of clinical trials for approval by the U.S. Food and Drug Administration. [1], [2]

    Despite limited clinical study, numerous drugs contain FDA-required warnings to doctors or patients about the possibility of aggressive or violent acts. Among the drugs with warnings about aggressive behaviors are varenicline, zolpidem, montelukast, and all antidepressant drugs. [3]–[6] The mandatory patient Medication Guide for varenicline, the antidepressants and quetiapine warn patients to contact a healthcare provider immediately if they start “acting aggressive, being angry or violent.” [3], [7]–[9]

    In this study we summarize and evaluate the evidence about reported acts of violence associated with therapeutic drugs among all serious adverse drug events reported to the FDA from 2004 through the third quarter of 2009.
    Methods Top

    The cases for this study were selected from the Institute for Safe Medication Practices (ISMP) QuarterWatch database of all adverse drug events reported to the FDA since 1968. [10] The FDA publishes for research use computer extracts of all adverse drug event reports that it receives, [11] and all such cases are included in the QuarterWatch database. While best known to medical professionals as “MedWatch Reports,” the FDA's adverse event database also includes serious foreign cases from international drug companies who market the drugs in the United States. We limited this study to cases with serious outcome as defined by the FDA, and which includes death, disability, hospitalization, a life threatening event, an event that required medical intervention to prevent harm, or other medically serious conditions. The latest version of all cases with an initial report date from 2004 through the third quarter of 2009 was included. To qualify for inclusion in this study as an evaluable drug, it had to have wide enough clinical use and sufficient post marketing surveillance to have generated 200 or more case reports for any serious adverse event in the study period. Drug names were standardized from the QuarterWatch dictionary, which is in turn based on standardized ingredient names in the National Library of Medicine RxNorm database. [12]
    Identification of Violence Reports

    In the published computer extracts, the adverse event narrative description is replaced by one or more standardized medical terms selected from Version 11.1 of the Medical Dictionary for Regulatory Affairs (MedDRA). [13] We defined a violence event as any case report containing one or more of the following MedDRA terms: Homicide, Physical assault, Physical abuse, Homicidal ideation or Violence-related symptom. If a case report contained more than one of these terms, it was assigned to the most severe event term in the order listed above. In selecting terms from the MedDRA dictionary, we sacrificed some degree of sensitivity in case identification to achieve greater specificity. Thus, from the High Level Term group “Criminal Activity” we selected Homicide and Physical assault but omitted more ambiguous descriptors such as “Crime” or “Spousal Abuse.” Similarly from the High Level Term group Behavioral and Social Disturbances we selected Violence-related Symptom and Homicidal ideation but omitted the more general terms Aggression, Belligerence and Hostility. To assure an accurate count of widely used drugs for which no violence cases were reported we included all evaluable drugs in our data set.
    Proportional Reporting Ratio

    The null hypothesis for this study assumed that a violence case could be attributed to a drug by pure chance, and that drugs with a greater total number of adverse event reports might be exposed to greater risk of accruing a violence case. A drug might have a larger total number of adverse events reported for several reasons unrelated to safety, including more widespread clinical use, a higher reporting rate, the patient population treated, and more extensive international sales by the pharmaceutical sponsor.

    To assess the null hypothesis we calculated the proportional reporting ratio (PRR) for each evaluable drug using the method of Evans. [14] With this method we compare the proportion of violence cases for each drug (drug violence events/all drug events) to the proportion of all other violence events for all other evaluable drugs (all other violence events/all other drugs events). For example, violence cases accounted for 35/3689 (0.95%) of all cases for the drug bupropion. For all the other drugs, violence cases accounted for 1902/776480 (0.2%) PRR = 3.9. In other words, the number of violence cases was 3.9 times greater for bupropion than for all other drugs combined after adjusting for the volume of reports. Using the χ2 test for independence, we assessed the strength of the relationship, and the probability that that the PRR could have occurred by chance. In the bupropion example, χ2 = 70.6 df = 1 p<0.01. To allow for the fact that some drugs might have as few as 5 index cases we applied the Yates correction to the χ2 statistic.
    Study Criteria

    To be identified as disproportionally associated with violence cases, an evaluable drug had to have a PRR≥2, a χ2≥4.0, and 5 or more violence cases attributed. These are the Evans criteria except that our minimum threshold was 5 cases rather than the 3 cases specified in Evans. As a practical matter a χ2≥4 with 1 degree of freedom produces a sample estimate with p<0.01 but p values are provided to assess borderline cases.

    The data for this study were maintained in an open source MySQL database (Oracle, www.mysql.com) and analyzed with open source software from the R-Project for Statistical Computing (www.r-project.org), version 2-11-0.
    Results Top

    In the 69-month reporting period we identified 484 evaluable drugs that accounted for 780,169 serious adverse event reports of all kinds. This total included 1,937 (0.25%) cases meeting the violence criteria. The violence cases included 387 reports of homicide, 404 physical assaults, 27 cases indicating physical abuse, 896 homicidal ideation reports, and 223 cases described as violence-related symptoms. The patients were 41% female and 59% male with a mean age of 36 years (SD = 17.9) Consumers reported 651/1937 (38%) of the cases, foreign and domestic health professionals were the source for 967/1937 (49.9%) and the remainder were missing (217), from lawyers (67) or clinical studies (34).
    Drugs Identified

    Among 484 evaluable drugs, 31 drugs met the study criteria for a disproportionate association with violence, and accounted for 1527/1937 (79%) of the violence cases. The drugs are listed in Table 1. They include varenicline (a smoking cessation aid), 11 antidepressant drugs, 3 drugs for attention deficit hyperactivity disorder, and 5 hypnotic/sedatives. No violence cases were reported for 324/484 (66.9%) of all evaluable drugs, and 1 or 2 cases were reported for an additional 86/484 (17.8%). Thus, for 84.7% of all evaluable drugs in widespread clinical use, an association with violence appeared highly unlikely.

    Table 1. Drugs associated with violence adverse drug events.
    Smoking Cessation

    Table 2 shows the results for three drugs available as an aid to smoking cessation programs: varenicline, bupropion and nicotine replacement products. Bupropion is indicated for both depression and as an aid to smoking cessation, so those results are not limited to the smoking cessation population. Varenicline has the largest number of reported violence cases, the highest proportion of violence cases (PRR = 18.0) and the highest χ2 statistic (χ2 = 5172 df = 1 p<0.01) of any of the 484 evaluable drugs. Comparing reports of violence in the patient population seeking to discontinue smoking provides adjustment for the possibility that the side effects might be caused by stopping smoking rather than the drug.

    Table 2. Drugs prescribed for smoking cessation.
    Psychoactive Drugs

    Since psychoactive drugs accounted for most of the drugs identified we further analyzed them by class, including other drugs in the class that did not meet the criteria for an association. The results by drug class are shown in Table 3. These data indicate marked differences between drug classes. All the antidepressants were associated with violence cases, except for two tricyclics, trazodone and amitriptyline, which had a similarly elevated PRR that was statistically significant, but fewer than 5 required cases to qualify as suspect under our criteria. The PRR for all antidepressants combined was 8.4, higher than for any other class of psychoactive drugs. At the other extreme, mood stabilizers/anticonvulsants were not implicated with the exception of levetiracetam and overall the group did not indicate an elevated risk. Results for the antipsychotics were mixed, ranging from a PRR = 4.2 for aripiprazole to a low of PRR = 0.6 for clozapine indicating fewer than expected reports (χ 2 = 1.6 p = 0.203). Grouped together the antipsychotics were borderline with a PRR of 1.9, slightly less than the 2.0 required, and χ2 = 68.5 p<0.01. The results for hypnotics/sedatives were also mixed with strong signals for zolpidem and triazolam, and little or no evidence for lorazepam and midazolam. Among the opioids, only oxycodone showed an association.

    Table 3. Psychoactive drugs by drug class and association with violence.*
    Discussion Top

    These data show that serious acts of violence towards others were regularly reported as an adverse drug event, and that marked differences were observed among drugs. Varenicline had the strongest association with violence by every measure used in this study. In addition, antidepressant drugs showed consistently elevated risk, even when compared with antipsychotics and mood stabilizers, which are used in psychiatric patients populations in which violent acts may occur. Violence cases as defined here were infrequently reported, accounting for 0.25% of all serious adverse drug events, and confined to a relatively small number of drugs.

    This analysis shares many limitations common to studies based on spontaneously reported adverse drug events. The submission of an individual adverse event report does not itself establish causality, only that a reporting individual suspected a relationship existed. However, such reports frequently contribute to a broader assessment of causality. In the computer excerpts, the narrative description of each event is replaced by a series of standardized medical terms, as are adverse events in clinical studies. The quality and detail in each report varies, and the reporting rate for adverse drug events is unknown and believed to vary among types of event, among drugs and over periods of time. [15]

    This study, however, contains numerous features intended to minimize the limitations of adverse event data from postmarketing surveillance. The proportional reporting ratio takes into account two possibilities: a) that wider use or a higher reporting rate exposes a drug to a greater chance of having a violence case attributed, and b) that a higher number of reports might have occurred by chance. The varying results among drugs for smoking cessation and the mood stabilizers show it is unlikely that the violence events are attributed to existing problems in the patient populations treated. Also, the focus of this study was on specific event terms that unequivocally described a violent act or thought – such as homicide or physical assault. By excluding more general adverse event terms such as “aggression” or “anger” many thousands of less specific cases were eliminated under the study criteria. While this means that the study did not count many possible cases of violence towards others (a loss of sensitivity) the restrictive criteria increased specificity. However, given that violent thoughts or actions are not typically attributed to drug therapy or recorded in medical records, the reporting rate for violence cases could be very low. The selected violence cases do not provide a reliable estimate of how often they might occur.
    Common and Unusual Features

    These events were reported in a patient population that was 41% female and one-half older than age 36. In addition a majority of reports were submitted either by health professionals (primarily MDs) or from foreign sources where reporting is normally limited to health professionals.

    While the reported events occurred among drugs used in widely different patient populations, the list of suspects was dominated by drugs that increase the availability of serotonin or dopamine in the brain. Most of the antidepressants increase the availability of serotonin through reuptake inhibition. Varenicline increases the availability of dopamine through partial antagonism of acetylcholine nicotinic receptors. [16] Sodium oxybate is a dopamine agonist indicated for narcolepsy. [17] Amphetamines increase concentrations of dopamine and serotonin. [18] On the other hand, no signal was seen for many common mood stabilizers such valproic acid, carbamazepine, and phenytoin, even though these drugs are used in bipolar patients who may experience psychosis in the acute manic phase and therefore be more prone to violence.

    The proportional reporting ratio—our primary measure of elevated risk—showed consistency among drugs with the most similar mechanisms of action. As shown in Table 3, for example, venlafaxine had a PRR of 8.3 and desvenlafaxine a PRR of 7.9 even though the number of total cases and violence cases were different. Similarly citalopram had a PRR of 4.3 and escitalopram a PRR of 5.0. We believe it is also noteworthy that no signal whatever was seen for an overwhelming majority of drugs.
    Additional Questions for Study

    We have previously examined varenicline's association with serious psychiatric symptoms including aggression/violence. [19]–[22] The aggression/violence case series for varenicline was consistent with these data but revealed other features that may or may not occur in cases attributed to other drugs. These features include early onset of psychiatric symptoms (usually within a few days), a senseless act of aggression/violence directed at anyone who happened to be near by, and resolution of the symptoms upon discontinuation. A more detailed case series of several hundred cases involving different classes of drugs would greatly improve scientific understanding of this drug adverse event and possibly lead the way towards identifying an at-risk patient population.

    These data provide new evidence that acts of violence towards others are a genuine and serious adverse drug event that is associated with a relatively small group of drugs. Varenicline, which increases the availability of dopamine, and serotonin reuptake inhibitors were the most strongly and consistently implicated drugs. Prospective studies to evaluate systematically this side effect are needed to establish the incidence, confirm differences among drugs and identify additional common features.
    Author Contributions Top

    Conceived and designed the experiments: TJM JG CDF. Performed the experiments: TJM. Analyzed the data: TJM JG CDF. Wrote the paper: TJM JG CDF.
    References Top

    1. Mosholder AD, Pamer CA (2006) Postmarketing surveillance of suicidal adverse events with pediatric use of antidepressants. J Child Adolesc Psychopharmacol 16: 33–36. 10.1089/cap.2006.16.33 [doi]. Find this article online
    2. Mosholder AD, Willy M (2006) Suicidal adverse events in pediatric randomized, controlled clinical trials of antidepressant drugs are associated with active drug treatment: a meta-analysis. J Child Adolesc Psychopharmacol 16: 25–32. 10.1089/cap.2006.16.25 [doi]. Find this article online
    3. Pfizer Inc (2010) CHANTIX (varenicline tartrate) tablet, film coated [package insert]. Find this article online
    4. Sanofi-Adventis US (2009) AMBIEN (zolpidem tartrate) tablet, film coated [package insert]. Find this article online
    5. Merck & Co. I (2010) SINGULAIR (montelukast sodium) tablet, film coated [package insert]. Find this article online
    6. U.S.Food and Drug Administration (2007) New Warnings Proposed for Antidepressants. http://anonym.to/?http://www.fda.gov/ForConsumers/Consumer​Updates/ucm048950.htm.
    7. GlaxoSmithKline (2009) PAXIL (paroxetine hydrochloride) tablet, film coated [package insert]. Find this article online
    8. Pfizer Inc (2008) ZOLOFT (sertraline hydrochloride) tablet, film coated [package insert]. Find this article online
    9. AstraZeneca Pharmaceuticals LP (2010) SEROQUEL (quetiapine fumarate) tablet, film coated [package insert]. Find this article online
    10. Moore T, Cohen M, Furberg C (2008) QuarterWatch: 2008 Quarter 1. http://www.ismp.org/QuarterWatch/2008Q1.​pdf.
    11. U.S.Food and Drug Administraton (2010) The Adverse Event Reporting System (AERS): Latest Quarterly Data File. http://anonym.to/?http://www.fda.go...RegulatoryInformation/Surveillance/uc​m082193.
    12. National Library of Medicine (2010) Unified Medical Language System (UMLS): RxNorm. http://anonym.to/?http://www.nlm.nih.gov/research/umls/rxn​orm/.
    13. MedDRA Maintenance and Support Organization (2009) Introductory Guide: MedDRA Version 12.1. Chantilly, VA: MedDRA Maintenance and Support and Service Organization (MSSO).
    14. Evans SJ, Waller PC, Davis S (2001) Use of proportional reporting ratios (PRRs) for signal generation from spontaneous adverse drug reaction reports. Pharmacoepidemiol Drug Saf 10: 483–486. 10.1002/pds.677 [doi]. Find this article online
    15. Moore TJ, Cohen MR, Furberg CD (2010) QuarterWatch: 2009 Quarter 4. http://www.ismp.org/QuarterWatch/2009Q4.​pdf.
    16. Coe JW, Brooks PR, Vetelino MG, Wirtz MC, Arnold EP, et al. (2005) Varenicline: an alpha4beta2 nicotinic receptor partial agonist for smoking cessation. J Med Chem 48: 3474–3477. 10.1021/jm050069n [doi]. Find this article online
    17. Jazz Pharmaceuticals (2009) XYREM (sodium oxybate) solution [package insert]. Find this article online
    18. Goodman LS, Hardman JG, Limbird LE, Gilman AG (2001) Goodman & Gilman's the Pharmacological Basis of Therapeutics. New York: McGraw-Hill.
    19. (2008) Varenicline: a British review. Unfavorable risk-benefit balance. Prescrire Int 17: 199. Find this article online
    20. Moore TJ, Furberg CD (2009) Varenicline and suicide. Risk of psychiatric side effects with varenicline. BMJ 339: b4964. Find this article online
    21. Moore TJ, Glenmullen J, Furberg CD (2010) Thoughts and acts of aggression/violence toward others reported in association with varenicline. Ann Pharmacother 44: 1389–1394. aph.1P172 [pii];10.1345/aph.1P172 [doi]. Find this article online
    22. Moore TJ, Cohen MR, Furberg CD (2008) Strong Signal Seen for New Varenicline Risks. http://ismp.org/QuarterWatch/chantixRepo​rt.asp.

    Source for journal article
  6. Heretic.Ape.
    The basis for comparison it mentions is other meds: people using this drug are x times more likely to show violent behavior. Thus simple issues of mistaken correlation seems minimized as it's not just "people who take antianxiety drugs are violent".

    Concerning the anti-anxiety vs anti-depressant issue, some of these drugs are used for treatment of both.

    I do however wish that journalists would have the decency to cite their material.

    Edit: thanks potter, lol
  7. Potter
    That original article was hardy written by a journalist, but rather just stolen from Time magazine and dumbed down.
  8. DmTryp
    My apologies. When I was I was shown this article, I was unaware that it was a dumbed-down version of a Time article, otherwise I would have posted that one instead.
  9. DmTryp
    Here's the Time article:

    Top Ten Legal Drugs Linked to Violence
    Related Topics:Body & Mind, Mental Health, prescription drugs, violence

    When people consider the connections between drugs and violence, what typically comes to mind are illegal drugs like crack cocaine. However, certain medications — most notably, some antidepressants like Prozac — have also been linked to increase risk for violent, even homicidal behavior.

    A new study from the Institute for Safe Medication Practices published in the journal PloS One and based on data from the FDA's Adverse Event Reporting System has identified 31 drugs that are disproportionately linked with reports of violent behavior towards others. (More on Time.com: New Hope For An Anti-Cocaine Vaccine)

    Please note that this does not necessarily mean that these drugs cause violent behavior. For example, in the case of opioid pain medications like Oxycontin, people with a prior history of violent behavior may seek drugs in order to sustain an addiction, which they support via predatory crime. In the case of antipsychotics, the drugs may be given in an attempt to reduce violence by people suffering from schizophrenia and other psychotic disorders — so the drugs here might not be causing violence, but could be linked with it because they're used to try to stop it.

    Nonetheless, when one particular drug in a class of nonaddictive drugs used to treat the same problem stands out, that suggests caution: unless the drug is being used to treat radically different groups of people, that drug may actually be the problem. Researchers calculated a ratio of risk for each drug compared to the others in the database, adjusting for various relevant factors that could create misleading comparisons. Here are the top ten offenders:

    10. Desvenlafaxine (Pristiq) An antidepressant which affects both serotonin and noradrenaline, this drug is 7.9 times more likely to be associated with violence than other drugs.

    9. Venlafaxine (Effexor) A drug related to Pristiq in the same class of antidepressants, both are also used to treat anxiety disorders. Effexor is 8.3 times more likely than other drugs to be related to violent behavior. (More on Time.com: Adderall May Not Make You Smarter, But It Makes You Think You Are)

    8. Fluvoxamine (Luvox) An antidepressant that affects serotonin (SSRI), Luvox is 8.4 times more likely than other medications to be linked with violence

    7. Triazolam (Halcion) A benzodiazepine which can be addictive, used to treat insomnia. Halcion is 8.7 times more likely to be linked with violence than other drugs, according to the study.

    6) Atomoxetine (Strattera) Used to treat attention-deficit hyperactivity disorder (ADHD), Strattera affects the neurotransmitter noradrenaline and is 9 times more likely to be linked with violence compared to the average medication.

    5) Mefoquine (Lariam) A treatment for malaria, Lariam has long been linked with reports of bizarre behavior. It is 9.5 times more likely to be linked with violence than other drugs.

    4) Amphetamines: (Various) Amphetamines are used to treat ADHD and affect the brain's dopamine and noradrenaline systems. They are 9.6 times more likely to be linked to violence, compared to other drugs.

    3) Paroxetine (Paxil) An SSRI antidepressant, Paxil is also linked with more severe withdrawal symptoms and a greater risk of birth defects compared to other medications in that class. It is 10.3 times more likely to be linked with violence compared to other drugs. (More on Time.com: Healthland's Guide to Life 2011)

    2) Fluoxetine (Prozac) The first well-known SSRI antidepressant, Prozac is 10.9 times more likely to be linked with violence in comparison with other medications.

    1) Varenicline (Chantix) The anti-smoking medication Chantix affects the nicotinic acetylcholine receptor, which helps reduce craving for smoking. Unfortunately, it's 18 times more likely to be linked with violence compared to other drugs — by comparison, that number for Xyban is 3.9 and just 1.9 for nicotine replacement. Because Chantix is slightly superior in terms of quit rates in comparison to other drugs, it shouldn't necessarily be ruled out as an option for those trying to quit, however.
  10. EscapeDummy
    This was a correlational study, not an experimental study. Meaning they looked at prescription trends and violent incidents, which means all the data points in the study were prescribed their meds by a doctor. It's not like they got a bunch of people in a room, gave them a pill, and watched how they reacted.
  11. mrMarco
    I would have to say from personal experience my

    #1 Xanax/alcohol very dangerous combo, can turn anyone into the incredible Hulk
    Swim does have several scars to prove it.
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