Professors David Healy and David Menkes from Cardiff University in Britain, and Andrew Herxheimer from the Cochrane Centre, conducted the study to determine the risk of violent behavior in people taking SSRIs.
During their investigation, the researchers reviewed all available clinical data on SSRIs and summarized a series of what they refer to as "medico-legal" cases involving patients who became violent on SSRIs in which they have given evidence.
In addition, they analyzed 1,374 emails from patients on SSRIs sent in response to a British television program on Paxil featured on Panorama.
The authors focus mostly on Paxil because they had access to more medico-legal case material for Paxil patients than other drugs and because GlaxoSmithKline recently submitted data on the rates of "hostile" events for the review of SSRIs by the British regulatory Committee on Safety of Medicines Expert Working Group.
Dr Healy is one of the world's leading authorities on SSRIs. He is the author of over 120 articles and 12 books, including, Let Them Eat Prozac, The Antidepressant Era, and The Creation of Psychopharmacology.
His expert testimony at the trial of a Wyoming lawsuit involving violence associated with Paxil in 2001, was a deciding factor in the return of a favorable verdict for the plaintiffs. The trial involved the tragic case where 60-year-old, Donald Schell, shot and killed his wife, daughter and granddaughter and then himself after taking Paxil for only two days.
Mr Schell's surviving family members sued SmithKlineBeecham and won. Another decisive factor in the Wyoming case relevant to the results of the current study, is that the company's own internal clinical trial data revealed at trial showed that Glaxo knew prior to 1998, when the deaths occurred, that Paxil had caused some patients to become violent and suicidal.
The data included an unpublished study of incidents of serious aggression in 80 patients, 25 of which involved homicide. After weighing all the evidence, the jury said that Paxil "can cause some people to become homicidal and/or suicidal," and ordered Glaxo to pay the plaintiffs $8 million.
In the PLoS study, Dr Healy and his colleagues warn that, "The new issues highlighted by these cases need urgent examination jointly by jurists and psychiatrists in all countries where antidepressants are widely used."
However, that might be easier said than done because according to Dr Healy, "even though PLoS is braver than most journals and less influenced by industry than most, it still took close to 18 months for this article to appear."
"I have several articles that have taken this long," he reports. "The hold up," he says, "is the journal - whether PLoS or BMJ being terrified of industry and a legal action against them."
"This stands in contrast" Dr Healy points out, "to the good news about drugs which industry manages to get out rapidly in the best quality, highest impact factor journals, apparently authored by the biggest name academics in the field."
"But these articles," he advises, "are based on selected data and no-one has access to the full dataset and no-one makes a judgment based on full access."
Investigative reporter, Kelly Patricia O'Meara, author of, "Psyched Out, How Psychiatry Sells Mental Illness and Pushes Pills That Kill (2006)," is also painfully aware of the difficulties involved in getting the information published about SSRIs and violence that most experts have known about for years.
"It seems to me that the "new" study is an old issue," she says. "I don't believe there is anyone remotely familiar with these drugs who wouldn't admit a strong correlation between them and violence."