Sandy Hook Massacre: The Unanswered Question

by Phil on January 6, 2014

On December 27, 2013, Connecticut State Police issued a 7,000-page, heavily redacted, report on the massacre that occurred at Sandy Hook Elementary School just over a year earlier (December 14, 2012).  For the record, I have not read the 7,000-page report, but I have read the Wikipedia article Sandy Hook Elementary School shooting, last updated January 4, 2013, and several media reports on the matter, including reports from the New York Times, the Hartford Courant, and the Washington Post.

Obviously there is an enormous volume of material in the official reports and in the various media reports and comments.  But there is still one major unanswered question.  Was Adam Lanza under the influence of a psychopharmaceutical product(s) at the time of the shooting or in the period immediately prior to the shooting?  There is a report in the record that he took Celexa (citalopram) for a short while in 2006, but no reports of psychiatric treatment since that time.  But there are some reasons for doubt.

ABLECHILD’S FREEDOM OF INFORMATION REQUEST

On August 22, 2013, Connecticut Assistant Attorney General, Patrick B. Kwanashie, during a freedom of information hearing on this matter, stated that releasing this information could “… cause a lot of people to stop taking their medications.”  He made his statement in response to AbleChild’s request for Adam Lanza’s medical records, especially with regards to any psychiatric drugs that he might have taken.  The hearing was videotaped.  Here is an excerpt, transcribed verbatim, from Mr. Kwanashie’s response.  The excerpt begins at about 1 hour 4 minutes into the tape.

“Therefore it is simply not sure that if you don’t fall into one of those categories, what you have to advance reasons that you actually do have a real interest in the [unclear] medical records.  The plaintiff, the complainant have not shown any such interest.  The complainant is proposing that they can make generalizations, generalized from one single incident, no matter how the uh outcome of the use of antidepressants, or thee thee thee causal link between the use of antidepressants and the kind of violence that took place in Newtown.  You just can’t, that’s not a legitimate use of information, of that information.  You can’t generalize just from one case.  Even if you can conclusively establish that Adam Lanza, his his uh his murderous actions, were caused by antidepressants, you can’t logically from that conclude that um um in others would uh, would uh commit the same actions as a result of taking antidepressants.  Um, um, so it’s simply not legitimate, and not only is it not the use to which they are proposing to put the information not legitimate, um it is harmful, because you can cause a lot of people um to stop taking their medications, stop cooperating with their treating physicians, um um just because of the heinousness of uh what Adam Lanza did.  As thee, as thee thee material, the FDA material that they submitted show, it would take a lot of studies uh over a long period of time and among, and within various demographic groups to even begin to uh establish causal links between antidepressants and uh uh aggressive actions or suicidal behavior.  And thee thee informed uh uh, the informed opinion has not quite reached that the point to to say definitively that there’s a causal link between uh between uh the use of antidepressants and uh and uh violent behavior.  Having correlations, there are correlations, but to say there are correlations doesn’t necessarily mean there is, the relationship is causal.  And uh uh this is an issue the FDA is still grappling with, and so far it’s been willing to do is is ask the drug makers to put warnings on their on their products and to advise physicians, treating physicians, to follow monitor their uh their  uh patients closely uh uh at the uh the beginning of uh uh the taking of antidepressants.  Um so it’s a complex issue, um and to pretend that you can just based on this one case make uh recommendations as to how people should uh uh how we should make judgment choices is a disservice to the public and illustrates why these types of reports should not be made available, because in the wrong hands they can be the source of the source of mischief.”

The hesitancies make the material a little difficult to read, but I think the message is clear:  AbleChild should be denied access to the documents in question because they are likely to draw and publicize unwarranted assumptions from these documents, and this might induce large numbers of people to stop taking the drugs in question.

Mr. Kwanashie’s statement is extraordinary for three reasons:

1.  The issue on the table was whether or not AbleChild had a “legitimate interest” (as defined by the statute and regulations) in the material.  This was essentially a legal/technical matter, and the complainant’s attorney Jonathan Emord had outlined various legal reasons in support of their right to the information.

What appeared to be expected from the Assistant Attorney General, who represented the State of Connecticut, was a rebuttal also based on legal issues and technicalities.  Instead, he launched gratuitously into these controversial waters, and provided, in my view, a glimpse of what seems to be going on behind the scenes.

It is of note that when he had finished these remarks, the hearing chairperson drew him back to the legal issues and asked him some clarificatory questions on those matters.

2.  Mr. Kwanashie has unquestionably conveyed the impression that there is some information that is being suppressed, and that it is being suppressed for the reasons that he outlined; i.e. so that people would not stop taking their pills.

3.  Mr. Kwanashie was not speaking as a private individual, but rather as the representative of the State of Connecticut.  He had almost certainly been authorized by his superiors to make the statement in question, and presumably the statement reflects the state’s stance on this issue generally, i.e. not just in the Adam Lanza case.

It’s possible, of course, that Mr. Kwanashie was confused or inadequately prepared for the hearing.  But that seems unlikely.  He is 59 years old, has been licensed to practice law in Connecticut since 1988, and draws a salary of $142,000.  Denying a freedom of information request is not a trivial matter, and the notion that he would go to such a hearing unprepared is hard to credit.  This is especially the case in that the Lanza shooting is probably the highest profile case that the State of Connecticut has encountered in decades.

So what we have is a credible indication that Adam Lanza was taking psychoactive “medication” around the time of the murders.  But the State of Connecticut will not release this information because such a release might induce large numbers of people to stop taking antidepressants.

A MINNESOTA TOWN HALL MEETING

A December 13, 2013, article called Newtown One Year Later, The Missing Link on the AbleChild site contained a link to a video.  The video is of a town hall meeting that Minnesota Congresswoman Betty McCollum held with some of her constituents in Oakdale, Minnesota eleven months earlier, on January 26, 2013.  At about 39 minutes and 30 seconds into the video, a member of the audience made the following comments:

“…I agree with Congresswoman McCollum that we need to have a dialogue with what’s going on with these gun issues.  I’m, we’re blindly running into gun control and a violation of the second amendment – but we’re not even sure if we have a  gun control problem.  I’ve been reading things where a lot of these kids – the Sandy Hook kid and the kid up in Red Lake Minnesota and Aurora – they’re all on Prozac and Ritalin and is this a psychopharmaceutical issue that’s causing these kids to do. – I mean – I think we need to have a,  I think we need to bring not only with both sides of the aisle but both sides of the issue together and examine exactly what’s going on here.  Is this a gun problem or is it a – you know – it could be anything.  But I think before we jump into legislating one portion of this we need to examine the entire issue and find out what’s going on.  Thank you very much.”

Here’s Congresswoman McCollum’s verbatim response:

“To that, let me tell you something: that, to quote my grandmother (so I use nice words here), frosted my cookies.  We can’t study, federally – we’re prohibited from studying the effects of some of the drugs that you were just talking about as it relates to people who go out and commit violent acts with guns.  We’re prohibited from studying that.  It’s an NRA square bolt.  That’s why I’d never be at 100%.  I think we have an obligation to study those kinds of issues.  So that’s why we need a dialogue.  It is prohibited from the CDC – the Centers of Disease Control – to study this.  It’s wrong!  And that’s why we need to get the lobbying efforts out of the discussion, just saying here’s your scorecard and they only highlight certain issues.  And they don’t give you everything else that they’re involved in. And that’s why I’m here and that’s why I’m glad you’re here.  So that we can talk and listen to one another.  And so I really am feeling very good that you’re here today.”

In the December 13 article, AbleChild describe their unsuccessful attempts to obtain additional information from Congresswoman McCollum concerning the CDC “rule.”

My interpretation of the Congresswoman’s words in the town hall meeting is that there is some kind of prohibition within the government on researching this topic, and that this prohibition is connected to lobbying – presumably by the pharmaceutical industry.

According to Wikipedia, Congresswoman Betty Louise McCollum is 59 years old, and is the U.S. Representative for Minnesota’s 4th congressional district, serving since 2001. She is a member of the Democratic-Farmer-Labor Party (DFL).  She currently serves on the United States House Appropriations Committee and the following subcommittees:  Subcommittee on Interior, Environment and Related Agencies, United States House Appropriations Subcommittee on Defense.   She also previously served on the House Committee Education and the Workforce; House Committee on Government Reform; House Committee on Resources; and House Committee on the Budget.  So she is mature and not, I imagine, given to flights of fancy.  She appears credible; she seems to have some personal knowledge of the “rule”; and there is nothing to suggest that she is making this stuff up.

Why is the media not all over this?  The town hall meeting was held almost a year ago.  To date the video has had only 307 hits.

WHITE HOUSE PETITION

And let’s not forget that a petition to formally investigate the link between psychopharmaceutical products and violence was removed from the White House petition website in December of 2012 without explanation, even though it was well on the way to obtaining the requisite number of signatures.

Is the US government, or any branch, or agency, of the US government deliberately suppressing research into the widely-suspected link between psychopharmaceutical products and mass shootings?  And if so, is this suppression the result of pharmaceutical lobbying?

If in fact, as many of us suspect, there is a causal link between the mass shootings and psychopharma products, shouldn’t this be a matter of urgent national importance?  Whose interests would be served by the suppression of this information?  Has the constitutional supremacy of We The People been usurped by They The Drug Companies?  By what distorted “logic” can a government collude with the notion of keeping people in the dark concerning a devastating drug effect in order to ensure that individuals keep taking these drugs?  I encourage my readers to check out both videos, and perhaps recommend that your friends and contacts do the same.  Perhaps there’s an innocent interpretation to all this.  If so, I’d be very grateful if someone could explain it to me.

FINALLY

In 2000, Joseph Glenmullen, MD, a psychiatrist, published Prozac Backlash – a critical look at the adverse effects of Prozac and other serotonin boosters.  Here’s a quote from the final chapter:

“We do know, from documented clinical experience and research, that these drugs have led to suicidal and violent urges in some patients.  We desperately need warnings for patients and doctors, together with information on prevention and coping with suicidal and violent impulses when they occur.  Additional research to help us understand the phenomenon is desirable but should not be merely a ploy to delay such warnings and preventive steps.” (p 336)

And that was more than 13 years ago!

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  • Francesca Allan

    Good article as usual, Phil. When the official said the information wouldn’t be released as that would cause people to go off their medications, that was tantamount to saying that Lanza was *on* medication.

    Thank you for talking about AbleChild. I was not aware of this organization.

    BTW, I ran into another psych student recently and we were discussing SSRI disasters. She assured me that SSRI suicides only occurred in the already suicidal who just didn’t have enough energy to act until medicated. I found this a ridiculous argument but didn’t say so. After all, how much energy does it take to swallow a bottle of pills or jump off a bridge. So I asked her, even if we accept this as true, how would that explain SSRI homicidal ideation? She had never heard of this phenomenon and she’s an honours student in a masters program.

  • Phil_Hickey

    Francesca,

    There is good evidence that the suicidal/violent impulses are triggered in people who had no prior experiences of this sort. For instance, Teicher and Cole, Am J Psych 1990:

    “Six depressed patients free of recent serious suicidal ideation developed intense, violent suicidal preoccupation after 2-7 weeks of fluoxetine treatment. This state persisted for as little as 3 days to as long as 3 months after discontinuation of fluoxetine. None of these patients had ever experienced a similar state during treatment with any other psychotropic drug.”

    Also, here’s a quote from Joseph Glenmullen’s book Prozac Backlash, Simon and Schuster, 2000:

    “But the key elements in these stories appeared to be the ‘dramatic change’ observed in these people after starting Prozac, how ‘out of character’ their behavior was on the drug, and the often extraordinary degree of violence not only toward themselves but toward others.” (p 138).

    You can get a used copy of the book from Amazon for just a few dollars, and it contains a great deal of evidence on these sorts of issues.

    Best wishes.

  • Francesca Allan

    Hi, Phil. I don’t think I worded my comment very well because you’re making my point: there should be no assumption that some sort of an underlying predisposition was somehow triggered. Same with developing mania on SSRIs – the assumption is invariably that you were predisposed to bipolar disorder. Suicidality, homicidality, mania — whatever disastrous effect there is will always be attributed to the patient rather than to the drug.

  • Phil_Hickey

    Francesca,

    I agree. Preconceived assumptions, especially when they’re self-serving, are the royal road to error.

  • cannotsay

    Another outstanding post Phil.

    Something that has not been duly covered is that Adam Lanza had been given the SSRI for treatment of OCD. For those who don’t know, high dose of SSRIs or TCAs, particularly clomipramine, are the treatment of choice for OCD. I stress “high dose” because they are administered in higher doses than what is normal for depression.

    Now, when I read this, almost by accident, during the holidays, I thought that my life was about to become extremely difficult if the shrinks got out to the street aggressively asking for increasing powers to commit those diagnosed with OCD, as they usually do with the voice hearers. Alas, that hasn’t happened. In fact, the Adam Lanza / OCD connection is even hard to find and you don’t even mention it here. While that is reassuring for me, in the sense that it is unlikely that people will use my past psychiatric abuse against me, it begs the question of why this double standard.

    Why the anti freedom shrinks waste no time to ask for the involuntary incarceration of voice hearers when one of them goes to do something horrible, while they are now silent about OCD. This is unequal treatment under the law which is explicitly forbidden by the XIVth amendment!

  • Phil_Hickey

    Francesca,

    I realize, belatedly, the source of yesterday’s confusion. The miscommunication was mine. I had realized what you were saying, and was providing corroboration, not rebuttal, but I see now that it wasn’t clear. Your writing was perfectly clear.

    Best wishes.

  • Phil_Hickey

    cannotsay,

    Thanks for coming in. As you say, information about Adam Lanza is still sketchy, and may remain so if the facts continue to be suppressed.

    One thing that did strike me: According to the various reports I have read, about 2007, his mother took him to the Yale Clinic where he was given a
    prescription for Celexa (citalopram). He reportedly took this for a short time.
    His mother called the nurse and told her that her son “couldn’t raise his arm.” The nurse assured the mother that this had nothing to do with the Celexa, but mother took him off the drug anyway.

    The PDR lists arthralgia (joint pain) and myalgia (muscle pain) as adverse effects of Celexa, both with a prevalence of 2% during trials. Possibly Adam Lanza was experiencing something of this sort, but the notion was dismissed summarily by the nurse, who reportedly described the mother as “non-compliant” – a frequently used term!

    This is all ancient history by now, of course. The real question is: has there been psychiatric “treatment” since that time?

    AbleChild is still pursuing this matter, and the fact that the State is stonewalling so determinedly suggest that there is information that is being suppressed.

  • cannotsay

    Hi Phil,

    According to this report, the Celexa prescription was for OCD: http://www.courant.com/news/connecticut/hc-lanza-sandy-hook-report1228-20131227,0,6970854.story

    “Koenig said that Lanza’s obsessive compulsive disorder “severely limited his ability to lead a normal, well-adjusted life.”

    She described him as “emotionally paralyzed” and said that he would participate in multiple daily rituals like repeated hand washing and showering and obsessively changing the blue polo shirts and khaki pants that he wore exclusively — behavior that forced Nancy Lanza to do up to three loads of laundry a day.

    The report said that Adam Lanza would change socks 20 times a day.

    She said that Adam Lanza was also sensitive to light and was unable to touch doorknobs with his bare hands.

    Koenig prescribed Celexa and recommended that he have follow-up visits at her office.”

    As I said above, the APA recommends TCA/SSRIs for OCD http://psychiatryonline.org/content.aspx?bookID=28&sectionID=1678180#149475 . The dosage is usually higher than what is recommended for depression.

    When I learned about this during the holidays I was afraid that OCD -because the story of my own abuse- would be pushed as the “new schizophrenia” or the “new bipolar” but I haven’t heard anything in the news to suggest that shrinks are about to add OCD to the list of what they think are the so called “disorders” that make people prone to violence. I don’t know why.

    This is all very fishy, I think.

  • Laura B

    The probibition that Congresswoman McCollum was referring is that public health research on firearms is disallowed. The prohibition she is referring to is not about psychopharm research.

  • Phil_Hickey

    Laura B,

    Thanks for coming in.

    I’m aware of the 1996 initiative that effectively prohibited the CDC from researching gun violence.

    But it seems a bit of a stretch that this is what Betty McCollum was referring to, especially since the questioner had identified himself as an NRA member, and was essentially asking – could we look at other things besides guns.

    Also, the Congresswoman’s words:

    “We can’t study, federally – we’re prohibited from studying the effects of some of the drugs that you were just talking about as it relates to people who go out and commit violent acts with guns.” [emphasis added]

    And: why didn’t she issue a clarificatory statement? Or did she? I haven’t been able to find anything.

    And: I think the NRA would welcome a study of the link between these shootings and psychopharma products.

    And: Why was the petition removed from the White House website in December 2012? I actually wrote to the White House at the time, and received a rather weak response to the effect that the need for better mental health services would be thoroughly reviewed in the near future. I can’t remember the exact words, and I must have junked the email, but it was along those lines. It was clear that there was no intention of researching the issue in question.

    Please note that I’m not saying you’re wrong. You may well be correct as to the Congresswoman’s remarks. I’m not a conspiracy theorist sort of person, and am very open to a benign interpretation. But at present, all I see are questions.

    The ban on research into gun violence was obviously effected by the NRA. Given that that kind of dynamic exists within our governmental framework, isn’t it plausible that the psychopharma bloc – a much larger and more powerful lobby than the NRA – has managed to install a similar ban on research into the link between the mass shootings and pharma’s drugs?

    I would be very interested in any additional thoughts or information that you might have on this matter – or other sources to which you might point me.

    Best wishes.

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