First of all, any real pharmacist knows that the PDR doesn’t stand for physician’s desk reference, it stands for poor drug reference. It’s useless. SSRIs increase the effect of serotonin in the brain. Atypical anti-psychotic medications do the reverse in terms of serotonin release. They are dopamine-2 and serotonin receptor antagonists which mean that instead of regulating the release of these chemicals to brain cells, they allow the release, but block the reaction of brain cells. In both cases, these drugs artificially manipulate the chemistry of the brain.
The black box warning on many of these drugs list side effects such as, akathisia, aggression, apathy, sexual dysfunction, even death in the elderly – to name a few. Another known side effect that the FDA does not require in the black box is suicidal tendencies. Drugs like that drive me nuts, mostly because of the overuse of them. Standard practice is to give patients a ‘drug-free holiday,’ meaning that psych patients and Ritalin patients should periodically be taken off their meds to see how they are doing without medication, but only under close medical supervision. In other words, don't try that at home.
A part of personality lives in the shadow of the psyche due to its perceived trauma. That creates anger and feel for the need of vengeance. A person with fractured identity personality disorder should not be given a drug that allows integration of personality through opening a path in the brain without proper therapy. Any trauma at a young age, however seemingly minor to adults, is extreme when away from the security base of parents and home, such as a school.
Drugs that integrate the psyche without a healing for that part of what it suffered do not heal anything – they bring that out, create insanity and are insanity. Patients need healing and therapy that is integrated with medication in order to prevent their violent personality from taking over. A personality put it in the shadow for so long is not controllable by any medication alone.
When I was in high school, I may have prevented a school shooting. I sat through a gym class with a misfit that had been incessantly picked on by boys and mostly girls. He was so distraught that all he could say was that he was going to bring a gun to school the next day and kill them all. I pleaded with him that it is not the solution and we can work it out in other ways. I insisted other students leave him alone as I talked to him. I convinced him not to bring a gun to school the next day. I then went to the gym teacher and told him that this guy is planning to bring a gun to school and kill people if the other students did not leave him alone. The gym teacher told me to 'go play in the street.' This was in 1987. Now I watch over patients that are overmedicated and I rarely have more than a few moments to speak with them.