Suicide and Homicidal thought, anger agitation aggression irritability from Antidepressants, Anti-anxiety anti-depressants, ADHD
by Donald H. Marks, M.D., Ph.D.
Physician, scientist and 3rd generation veteran
Emeritus Fellow, American College of Physicians
updated 6 Sept 2026
It should be generally accepted knowledge that prescription medications, for medical or psychiatric problems, can actually make an individual's psychiatric situation unstable. The following discussion is taken from my publications on the subject of medication-induced psychological adverse effects, referenced below.
New or worsening (psychiatric) symptoms can represent adverse effects AE of prescribed medications, rather than a progression of the underlying disease state. Patients and their families should be informed and warned, as I have urged (cited ref below).
It is well-known in the medical literature, and also well-described in the prescribing information for Central nervous system CNS active medications, that medications can be capable of causing Adverse Events, in addition to being therapeutically, beneficial. These are often described as substance-induced mood disorder SIMD. The treating / prescribing physician of medications that Can cause psychiatric adverse events should perform an adequate medical and psychiatric history and evaluation to ascertain the risk for using these medications in each patient. Professional help should be sought from psychiatrists with a good knowledge of psychopharmacology and SIMD. Consideration should be given to the consequences in each patient of the prescribed medications inducing increased anxiety, aggression, agitation, anger, depression, hallucinations, impulsivity, irritability, paranoia, or suicidal or homicidal ideation. In my opinion, all patients who receive psych drugs, and their immediate family and caregivers, must receive specific warning about potential induction of central nervous system adverse events, including anxiety, aggression, agitation, anger, depression, hallucinations, impulsivity, irritability, paranoia, suicidal or homicidal ideation (Marks et al 2008)
Patients receiving CNS-active medications should be queried at regular intervals for the development of CNS adverse events, and appropriate follow-up should be performed. If a person receiving these medications develops new or heightened suicidal or homicidal thoughts, it is important for the treating / prescribing physician to determine whether the medication should be discontinued. Patients developing CNS / psychiatric adverse events should be questioned concerning their degree of risk to themselves and to others, and they should be requested to notify anyone who may be at risk from their actions. Professional psychiatric input should be considered by someone aware of SIMD and medication AE. All these actions should be documented in the medical records. Above all else, do no harm.
References
Marks DH, Breggin PR. Braslow D. Homicidal Ideation Causally Related to Therapeutic Medications https://bit.ly/3x7yjtw Ethical Human Psychology and Psychiatry, Volume 10, Number 3, 2008
Marks DH. Depression leading to suicide as an adverse effect of metoclopramide. ISP Gastroenterology 2006 (5.2) https://bit.ly/3x8dYEs
Top Medical Journals including JAMA and NEJM Challenged by Department Of Justice. Fraud vs clever and misleading deception, by Donald H. Marks.
