As police continue to hunt for a credible motive to explain why 64-year-old millionaire, real-estate investor Stephen Paddock sprayed a crowd of country music fans with bullets – a suicide mission that police say was the result of meticulous planning – the Las Vegas Review Journal reports that Paddock was recently prescribed anti-anxiety medication that studies have shown can lead to violent, impulsive behavior.
The suggests that the characterization of events offered by Paddock’s brother that the gunman, who killed 59 people and wounded more than 500 more Sunday in night in the worst mass shooting in modern US history, “simply snapped” may be accurate.
According to records from the Nevada Prescription Monitoring Program obtained by the paper on Tuesday, Paddock was prescribed 50 10-milligram diazepam tablets on June 21 by Henderson, Nevada physician Dr. Steven Winkler. Diazepam – better known by its brand name, Valium – is a sedative and muscle relaxer in the class of drugs known as benzodiazepines, which studies have shown can cause aggressive behavior in some patients. Chronic use has also been linked to psychotic episodes.
Paddock purchased the drug without insurance at a Walgreens store in Reno on the same day it was prescribed. He was supposed to take one pill a day. “If somebody has an underlying aggression problem and you sedate them with that drug, they can become aggressive,” said Dr. Mel Pohl, chief medical officer of the Las Vegas Recovery Center. “It can disinhibit an underlying emotional state. … It is much like what happens when you give alcohol to some people … they become aggressive instead of going to sleep.”
The effects of the drug are amplified by alcohol, Pohl said.
That said, Valium is a widely and commonly prescribed medication in the US – as are its chemical cousins Xanax and Klonopin. But its familiarity has evidently obscured this potentially sinister side-effect. A 2015 study of 960 Finnish adults and teens convicted of homicide showed that their odds of killing increased by 45% when they were on benzodiazepines.
To be sure, the drug is more likely to trigger impulsive aggressive behavior than something like Sunday’s premeditated attack, according to Dr. Michael First, a clinical psychiatry professor at Columbia University.
“What this man in Las Vegas did was very planned,” he noted, referring to reports that Paddock sneaked an arsenal of weapons into the Mandalay Bay and placed cameras inside and outside his room before launching his attack.
Winkler had previously prescribed Paddock 50 10-milligram tablets in 2016, advising him to take two pills a day. Questions about the role that psychiatric medication plays in mass shootings have been percolating for decades, though no definitive link has ever been found, the LVRJ pointed out. There’s also the danger that, by publicizing unscientific linkages in the media, that patients who require the drug to manage moderate to severe anxiety might be unfairly stigmatized for using it.
Determining why the medication was prescribed may ultimately prove more helpful to investigators as they try to piece together Paddock’s motive, First said.
“That may have more to do with why he did what he did.”
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