In the wake of yet another mass killing—the tragic event at Annunciation Catholic School in Minneapolis on August 27, 2025, where two children were murdered and 17 others injured—the public discourse often zeroes in on guns, manifestos, and societal failures.
But amid the clamor, a critical question seems to have faded from view: What role might legal and illegal drugs, and toxic exposures play in the volatile mix that drives some individuals to violence?
For years, reporters routinely probed the medical histories of perpetrators, revealing patterns of psychiatric drug use. Today, that line of inquiry has largely vanished, even as evidence mounts that certain medications carry warnings for suicidal thoughts and aggressive behavior, and environmental toxins disrupt brain function. Ignoring these factors not only overlooks potential triggers but also misses opportunities to prevent future tragedies through better data collection and analysis.
When Medications Were Front and Center
In the late 1990s and early 2000s, mass killings prompted immediate questions about the perpetrators’ mental health treatments, including any prescribed drugs. This was partly because many suspects exhibited clear signs of mental illness, and their medications often came under the microscope.
For instance, in the 1999 Columbine High School shooting, where Eric Harris and Dylan Klebold killed 13 people, Harris had been prescribed the antidepressant Luvox (fluvoxamine), an SSRI known for potential side effects like agitation.
Similarly, in the 2005 Red Lake Senior High School shooting, 16-year-old Jeff Weise, who killed nine others before taking his own life, was on Prozac (fluoxetine), another SSRI.
Kip Kinkel, the 15-year-old behind the 1998 Thurston High School shooting in Oregon that left two dead and 25 injured, had also been prescribed Prozac.
These cases weren’t anomalies.
A compilation by advocacy groups like AbleChild lists over a dozen similar incidents, including the 2007 Virginia Tech massacre, where Seung-Hui Cho, who killed 32 people, had a history of mental health treatment and was prescribed antidepressants, though details on his actual compliance history was spotty.
In the 2012 Aurora theater shooting, James Holmes, who murdered 12 and injured 70, was under psychiatric care and had been prescribed sertraline (Zoloft), an antidepressant linked to manic episodes in some users.
Reporting at the time often highlighted these details, fueling debates about whether the drugs—intended to alleviate depression, anxiety, or bipolar disorder—could instead exacerbate violent impulses in vulnerable individuals.
This scrutiny aligned with emerging FDA warnings. In 2004, the agency mandated black-box labels on antidepressants, alerting users to increased risks of suicidal thoughts and behavior, particularly in young people. Some experts, like psychiatrist Peter Breggin, have long argued that SSRIs can induce violence and mania in a subset of patients, citing akathisia—a state of severe restlessness—as a potential trigger. A 2015 Swedish study of over 850,000 people found that antidepressants were associated with violent crime in 11,225 cases, though causality remains debated.