A possible link between SSRIs and antisocial behaviours

The use of selective serotonin reuptake inhibitors (SSRIs) has spearheaded recent advances in the psychopharmacology of depression and other disorders. Two patients with major depressive episodes reported repetitive insistent urges to commit antisocial acts which they ultimately carried out, 2–8 weeks after starting treatment with selective serotonin reuptake inhibitors. Neither patient had a previous history of antisocial behaviours. I postulate that this phenomenon may be analogous to the emergence of intense suicidal preoccupation during treatment with one of these agents. Forensic psychiatrists should be aware of and alert to this relatively rare phenomenon as a possible aetiological factor in the assessment of violent and criminal behaviours.