Murder, minors, selective serotonin reuptake inhibitors, and the involuntary intoxication defense

This article examines the clinical and legal aspects of the involuntary intoxication defense, primarily as it relates to violent acts perpetrated by minor and adult patients who have been prescribed selective serotonin reuptake inhibitors (SSRIs) and related psychoactive medications in a therapeutic context. The Model Penal Code recognizes the involuntary intoxication defense and its potential applicability to cases in which the defendant's criminal behavior is believed to be associated with prescription medication use. Two case reports of juvenile murderers who attributed their violent behavior to SSRI treatment are presented. Selected pertinent case law is reviewed. Currently there is a lack of convincing scientific evidence that clearly confirms or negates the postulated relationship between antidepressant agents and violent behavior. However, the use of the involuntary intoxication defense will likely continue to increase due to the growing number of novel psychotropic medications being developed and marketed along with advances in the scientific understanding of their actions and side effects.