Can Domestic Violence be Triggered by a Reaction to Medication?

You’re not exactly sure how you got here. It’s not uncommon for you to get into a disagreement with your spouse or partner, but this time, things got out of hand. You felt an unusual sense of rage, and before you realized it, things had escalated into violence. Perhaps you felt like you were standing outside yourself, watching yourself do something you never believed you were capable of doing. Now, you’re facing domestic violence charges (and possibly a protective order), and you’re devastated. How did this happen?

Then a thought crosses your mind: Could this have been a reaction caused by my medication?

Depending on the medication(s) you’re taking, the answer might be yes. In fact, research has identified at least 31 medications that have been linked to violent behavior in a disproportionate number of patients. While it’s impossible to say for certain whether any given person will become violent while taking these medications, the connection between certain drugs and violence is significant enough that it merits further discussion.

Which Drugs Are Linked to Violent Behavior?

The list of medications studied that are linked to an increased risk of violence includes mainly prescription drugs, the majority of which are psychotropic drugs (meaning their primary goal is to affect brain function). Commonly prescribed drugs like antidepressants, antipsychotics, and stimulants have all been associated with violent behavior. We won’t go into every drug on the list by name, but the drugs most likely to evoke violence tend to fall into certain categories, as follows:

• Antidepressants. At least 11 antidepressants have been linked to an increased risk of violence. The most notable culprits are those of the Selective Seratonin Reuptake Inhibitor (SSRI) class, meaning they work by regulating serotonin levels in the brain. Popular drugs like fluoxetine (Prozac), paroxetine (Paxil), and sertraline (Zoloft), as well as fluvoxamine (Luvox), venlafaxine (Effexor), and desvenlafaxine (Pristiq).
• Benzodiazepines. Typically used as sedatives used to treat conditions like anxiety and insomnia, benzodiazepines are psychotropic medications that slow brain activity. Drugs in this class that have been associated with aggression include triazolam (Halcion), alprazolam (Xanax), and clonazepam (Klonopin).
• Amphetamines. These stimulant drugs work by stimulating the central nervous system. Stimulants most often associated with violence are those which are often used to treat attention-deficit/hyperactivity disorder (ADHD). One non-amphetamine drug used to treat ADHD is also on the “risk list”: atomoxetine (Strattera), which is a noradrenaline reuptake inhibitor.
• Anti-infectives. Drugs used to treat infections, like antibiotics and antifungals, are not typically thought of as having any connection to violence. However, a few have been linked to an increased risk, including efavirenz, atazanavir, ribavirin, alfa interferons, and in particular, mefloquine (Lariam), which is 9.5 times more likely to cause violence than the average medication.
• Antipsychotics. These drugs are used to manage psychosis and schizophrenia, and atypical antipsychotics have been linked with violence more than older, “traditional” antipsychotic drugs. However, the data is less definitive as to whether these drugs actually evoke violence because they are so often used to treat patients who are already prone to violent behavior.
• Varenicline (Chantix). When it comes to drugs linked with violence, this specific smoking cessation aid deserves to be mentioned separately. Among the drugs studied, it tops the list in the number of violent incidents documented. Researchers estimate this drug is 18 times more likely to trigger violent behavior than the average medication.

How Do These Drugs Increase the Risk for Domestic Violence?

Even for medications that are not specifically psychotropic, it’s important to note that nearly all medications affect the brain in some way. While not all drugs will cause violent behavior (and while not everyone will become violent by taking a drug where violence is a known side effect), it’s believed that the drugs most likely to do so act on the brain in a way that increases impulsive and aggressive tendencies. 

As the most complex organ in the body, the brain operates with a highly complicated (and delicate) balance of chemicals, hormones, and electrical impulses. Any drug we take has the potential to interfere with this balance, and some are more affected by these changes than others. When the level of one chemical (such as serotonin) is restricted or regulated by the presence of medication, for example, it may reduce the normal inhibitions a person might feel–those impulses that restrict a person from becoming aggressive or violent. In other cases, certain chemicals inciting agitation might be elevated in the brain. In still other cases, the brain’s centers of logic and reason might be adversely affected, causing the person’s sense of perception to be off. Whatever the case, if the drugs (or a combination of drugs) being taken disrupts the balance in too much of one direction, the person may be more likely to commit violence–including violence against partners, spouses, or family members.

Can My Medications Be Used as a Defense Against Domestic Violence Charges?

This is, at best, a slippery slope. If your defense is geared around blaming your actions on your medications, that logic taken to its full conclusion might be to plead “not guilty by reason of insanity,” which could open the door to some unwanted consequences. However, given the current research, if you were on a prescription medication where violence is a known side effect at the time of your domestic violence incident, a good attorney may be able to use this as a mitigating factor to have your charges reduced or dropped, or at least to argue for more lenient penalties. If you believe your medications may have been a contributing factor in your domestic battery case, it’s important to speak with an experienced criminal defense attorney about your legal options. For compassionate legal representation, call our offices today to schedule a consultation.