Oliver North’s Ritalin Myth

The incoming NRA President, Oliver North, recently offered his theory for the spate of school shootings in this country, blaming “a culture of violence“ and the drug methylphenidate (Ritalin). “If you look at what has happened to the young people, many of these young boys have been on Ritalin since they were in kindergarten,” North said. ¹

As a psychiatrist, I partly agree with North: there are cultural factors in the U.S. that may increase the risk for aggression or violence — including but not limited to bullying, gangs, and substances of abuse. But Col. North is way off base in blaming Ritalin for school shootings. This notion is part of a larger mythology that attributes mass shootings to psychiatric medications of various sorts, including antidepressants. But what is the evidence for such claims?

First off, there is very little evidence that Ritalin and related medications for ADHD (attention deficit/hyperactivity disorder) cause violent behavior, when properly prescribed and monitored. On the contrary, studies going back to the 1990s generally find that Ritalin-type medications actually reduce aggressiveness in children with ADHD. (It is important to note that aggression is not one of the “core” features of ADHD, according to current diagnostic criteria; and when aggression occurs, it is usually due to some co-occurring disorder).

Indeed, a 1990 study by Dr. Kenneth Gadow and colleagues stated, “One of the least documented ‘known’ effects of methylphenidate in hyperactive children is the suppression of peer aggression.” ² More recent studies in the U.S. and Europe have largely borne this out. ³ Of course, if a stimulant like methylphenidate is prescribed inappropriately — say, for a patient with unstable bipolar disorder — irritability or aggressive behaviors may sometimes emerge.

The larger myth that connects psychiatric medications with school shootings was meticulously debunked by psychologist Dr. Peter Langman in a 2016 study. ⁴ Langman pointed out the often-forgotten problem of “reverse causality”; that is, attributing violent behavior to a specific medication, when, in fact, the medication was initially prescribed because the person was already exhibiting aggressive or violent behaviors. Langman reviewed many recent cases of mass shootings in which the shooter was supposedly taking Ritalin or an antidepressant.

He found that in most cases, a causal link between the drug and the shooting could not be established. For example, in the 1998 Thurston High School shooting, Langman notes that the shooter “… had taken Prozac and Ritalin in the past but not anywhere near the time of his attack.”

Similarly, despite speculation in the media to the contrary, there was no evidence that the 23-year-old man responsible for the Virginia Tech shooting (2007) had recently used, or was withdrawing from, psychiatric medication. Langman found that out of 24 secondary school shooters, only two were taking psychiatric medication at the time of their attacks; or, as he puts it, “over 87% of the secondary school shooters were not on psychiatric medications at the time of their attacks.”

There are no simple explanations for why someone becomes a school shooter or carries out a mass shooting, though psychological “profiles” have revealed some common features among these individuals; for example, a history of having been bullied by peers; strong feelings of anger and resentment ⁵; or a history of morbid preoccupation with guns and violence. But it is wrong to heap blame, as Oliver North did, on medications prescribed for psychiatric illnesses.

 

References

1. Mele, C., & Caron, C. (2018, May 21). Oliver North Blames ‘Culture of Violence’ for Mass Shootings. Retrieved from https://ift.tt/2rZv8Vb
2. Gadow KD, Nolan EE, Sverd J et al. Methylphenidate in Aggressive-Hyperactive Boys: I. Effects on Peer Aggression in Public School Settings. Journal of the American Academy of Child & Adolescent Psychiatry , 1990; 29, Issue 5 , 710 – 718
3. Sinzig J, Dopfner M, Lehmkuhl G et al. Long-acting methylphenidate has an effect on aggressive behavior in children with attention-deficit/hyperactivity disorder. J Child Adolesc Psychopharmacol. 2007 Aug;17(4):421-32.
4. Langman P. Psychiatric medications and school shootings. Researchgate.net. Feb. 2016 https://ift.tt/2LtAobQ
5. Knoll JL 4th. The “pseudocommando” mass murderer: part I, the psychology of revenge and obliteration. J Am Acad Psychiatry Law. 2010;38(1):87-94. https://ift.tt/2GLnpic

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