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Antidepressant use and interpersonal violence perpetration: a protocol for a systematic review and meta-analysis
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  • Published on: 22 September 2021
    More high quality data are needed
    • Peter Schofield, Clinical Director, Neuropsychiatry Service; Conjoint Professor Hunter New England Local Health District; University of Newcastle, NSW, Australialaia
    • Other Contributors:
      • Tony Butler, Professor

    The recent article by Keen et al. describes a protocol to systematically explore the literature relating to the use of antidepressants as a possible means of reducing interpersonal violence. 1 This is a worthwhile exercise for which the investigators can be applauded. The existing literature points to the importance of serotonin in the neurobiology of impulsive violence and benefits have been suggested in some small studies of SSRIs in impulsive aggressive individuals 2. We have been particularly interested in this issue and, some years ago, published a small pilot study to determine possible benefits of sertraline with respect to reducing subjectively-reported measures of impulsivity, anger, and aggression-related constructs in repeat-violent offenders. 3 Highlighting the heterogeneous findings, and the poor methodology of many studies relevant to the possible benefits of antidepressants in the literature, Keen et al. state their planned review is ‘made more urgent by emerging recommendations for antidepressants to be used as a treatment for violent behaviour’. Their citation for this claim is a more recent article of ours (their citation 17). 4 We are disappointed in the suggestion that our cited article represented ‘a recommendation for antidepressants to be used as a treatment for violent behaviour’. We wish to highlight that we made no such recommendation. Indeed, key points of the article were the need for more and better data and the evidence we had collected that...

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    Conflict of Interest:
    None declared.