SSRIs Do Not Contribute to Violence
Antidepressants are a mainstay of psychiatric care, and for good reason.
Posted September 9, 2025 | Reviewed by Lybi Ma
Do antidepressants contribute to school shootings ? Even under harsh criticism , the US Department of Health and Human Services thinks so, and the current administration has included a directive to “assess the prevalence of and threat posed by the prescription of selective serotonin reuptake inhibitors, antipsychotics , mood stabilizers, stimulants, and weight loss drugs." Following the recent Minnesota school shooting, plans were announced for an NIH study to evaluate the contribution of SSRIs to violence, including mass shootings .
Ample existing research supports that SSRIs are not instrumental in mass violence, however. For example, among patients with post- traumatic stress disorder with established aggressive tendencies, double-blind, placebo -controlled studies have demonstrated that fluoxetine (Prozac)—an SSRI introduced decades ago— reduces impulsive aggressive behaviors.
Similarly, a 2020 study of 785,337 individuals in a Swedish registry showed that a small percentage of high-risk individuals may incur a greater risk of violent ideation when treated with SSRIs; however, the overwhelming majority of SSRI users (97 percent in the study cohort) did not commit violent offenses. A more recent 2025 Danish study of 167,319 individuals with personality disorders , among whom 12 percent were prescribed antidepressants, showed no consistent association in either direction between antidepressant treatment and police-recorded charges of violent crimes, although risk of suicide was lower during periods of antidepressant treatment.
The assertion that antidepressants increase the likelihood of mass shootings risks further stigmatization of individuals struggling with mental illness, branding those who may need care as perhaps inherently at risk for violence. But data suggest most school shooters have not been treated with psychotropic medications. Analyses of mass shootings spanning 1966-2023 by the Violence Project indicate that only 22.7 percent of perpetrators had taken psychiatric medication in the past.
The pathway to violence is multifactorial; violent offenders frequently feel aggrieved by their experiences with societal institutions and others around them (“injustice collectors”), may become intolerant of difference, and find social media audiences that amplify their perceived grievances (so-called “echo chambers”). In the specific case of school shooters, findings from the Violence Project indicate that over 62.5 percent of those analyzed had a history of playing violent video games. Ninety percent showed interest in guns or proficiency with firearms. This is a complex interplay of factors.
As an emergency psychiatrist, I certainly welcome a greater emphasis on treating mental illness and the debility that these disorders may cause. Many who work in my field gladly welcome attention and funding to help support substance use prevention, increased access to mental health treatments, and programs that identify those at risk for threatening behavior. Advancing this cause requires steady focus on evidence-based outcomes rather than conjecture.
After decades of use in clinical psychiatry, the utility of SSRIs is well-known and established. Concerns that these potentially life-saving treatments spur the majority of mass shootings are unvalidated by existing data. For individuals who struggle with mental illness, discounting the value of treatment can run contrary to the hope that patients need and deserve.
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Charles Hebert, M.D . is the Medical Director of Emergency Psychiatric Services and Visiting Associate Professor of Psychiatry at the University of Colorado Hospital.
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This article is part of the Bringwise Psychology Journal — daily insights on human behavior, mental health, and personal growth.