Criminal Behaviour Following Drug Treatment for Psychiatric Disorders: Medicolegal and Ethical Issues

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SummaryThe intake of drugs used to treat psychiatric disorders has been used as a defence for individuals who have committed crimes. This defence has developed from the involuntary intoxication defence. Just as an individual drinking a ‘spiked’ beverage could not be held responsible for their actions while intoxicated, neither can the accused who is under the influence of prescription drugs. Because the effects of the drugs are largely unknown by the general public, their use affords such a defence.Use of drugs such as triazolam and fluoxetine has been raised as a successful defence to criminal acts, but scientific evidence appears unable to link either drug to actually causing crime. However, the use of the drug is able to negate the intent (or mens rea). With no criminal intent the accused may be able to raise a successful defence and reduce the charge and/or punishment. The Ilo Grundberg case is illustrative. Mrs Grundberg, under the influence of the benzodiazepine triazolam, murdered her mother. The defence of triazolam use succeeded, and Mrs Grundberg went on to sue the manufacturer of the drug for damages. The case was settled out of court for an undisclosed amount.A successful defence is complex and depends on many parameters, including the agent used, concomitant use of other medications, pre-existing medical conditions and the dosage of the drug(s) involved.For the accused and their legal counsel, drug-induced crime means a successful conclusion to a criminal charge. For drug manufacturers and prescribers, the relationship can lead to litigation.

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