"The implication that diazepam caused someone to go on a murderous rampage is improbable at best and highly irresponsible at worst."
What would motivate someone to do this? And as many scramble to figure out the motive, some are stretching to link his anti-anxiety meds to the shooting.
The Las Vegas Review-Journal reported that Paddock was prescribed diazepam (also known as Valium), a common sedative often used to treat anxiety, on June 21, 2017. They added that the drug "is known to cause violent outbursts." The article even goes on to cite a study that finds teens who had been convicted for homicides were more likely to have been on benzodiazepines—a class of psychoactive drugs that includes diazepam—when they committed their crimes.
There's a big problem here, though. "The idea that diazepam would trigger this event is pure speculation and far-fetched," says Ronald Schouten, M.D., J.D., director of law and psychiatry service at Massachusetts General Hospital and an associate professor of psychiatry at Harvard Medical School. He adds that there is ample evidence Paddock pre-planned his violent attack long before he was ever given the prescription in June 2017. (Recent reports say Paddock owned 47 guns, 33 of which he'd purchased between October 2016 and the shooting, according to CNN.)
Diazepam also has a relatively slow onset, meaning it's less likely to trigger side effects—like the violence referenced in the study of teenage homicides—compared to other benzodiazepines, says Schouten. (Previous research has also shown that teens react differently to mood medications than adults do.) "I’ve never seen rage as a side effect of diazepam in 30 years of practice," Schouten says. "In fact, the most common side effect is sleepiness."
While aggressiveness, psychosis, and delusions, are acknowledged by the FDA as potential side effects of diazepam, Schouten says any personality change from the medication would be more comparable to that of a person going from sober to drunk—not a total Dr. Jekyll/Mr. Hyde switch.
Furthermore, Schouten notes that any aggression triggered by diazepam is "not likely to (1) be the result of the medication alone, but rather involve the interaction between the medication and an underlying disorder or (2) involve the sort of predatory violence engaged in by this individual."
As for speculating on underlying disorders, Schouten notes, "We simply do not know enough about him, his life, his personality, his other medications, or other medical problems to come to any conclusions about what motivated him or otherwise caused his behavior. I know everyone wants answers, but sometimes there aren’t clear answers, and speculation that gins up peoples’ anxiety is a disservice to everyone and further stigmatizes people with mental illness."
Forty million adults in the U.S. suffer from an anxiety disorder, making anxiety the most common mental illness, according to the Anxiety and Depression Association of America. The vast majority of those people harbor no violent impulses, including those on anti-anxiety medications, yet there persists a stereotype that people with a mental illness are dangerous or violent. Blaming Paddock's rampage on his mental illness or his meds perpetuates that inaccurate stereotype, says Mayra Mendez, Ph.D., a psychotherapist and program coordinator for mental health services at Providence Saint John's in Santa Monica, California.
"Sometimes anxiety can cause irritability, but nothing like what [Paddock] did," she says. "He may have had an anxiety disorder, but it [most likely] wasn't the reason he murdered people. There was something else going on there." Blaming his mental illness or his medication is irresponsible and harmful to sufferers of anxiety, as this may make people reluctant to seek help, she adds.
"If you are suffering from anxiety, treatment can really help you make your life better," Mendez says. "Don't let this one-in-a-million sensational story scare you."