Can Antidepressants Cause Temporary Loss of Judgment in Patients?

Q: Can Antidepressants Cause Temporary Loss of Judgment in Patients?

Hello, Huang Wanwan： Based on the medications you listed and your mother's statements about her behavior, there are certain cases where individuals may resort to theft under conditions of high stress, low mood, seeking excitement, or emotional release, and the items stolen may no

Is it possible to experience temporary loss of judgment or reasoning ability after taking antidepressant medication?

Hello Dr.
Hsiao,
My mother has been diagnosed with depression and has been experiencing symptoms such as rapid heartbeat, anxiety, and insomnia.
She has been receiving treatment and medication since 2012.
The list of medications she is currently taking includes:
- Eglonyl (morning)
- Ritalin (before bed)
- Metoprolol orally disintegrating tablets (before bed)
- Vitamin E capsules (before bed)
- Sustained-release Sertraline tablets (before bed)
Recently, she has been caught shoplifting three times in a short period, which has left our family very concerned.
When I asked her why she stole, she said she didn't know.
She understands that stealing is wrong, but she genuinely cannot explain her actions.

I would like to know if the medications she is taking (either the morning medications or the nighttime medications that may not have fully metabolized) could potentially impair her judgment and lead to a temporary loss of her ability to discern right from wrong during these incidents.
I am unsure if this could be a valid defense in court, so I would appreciate your professional opinion on this matter.
Thank you.

Huang Wan Wan, 20~29 year old female. Ask Date: 2016/06/22

Dr. Xiao Minghong reply Psychiatry

Hello, Huang Wanwan: Based on the medications you listed and your mother's statements about her behavior, there are certain cases where individuals may resort to theft under conditions of high stress, low mood, seeking excitement, or emotional release, and the items stolen may not necessarily have value.
The medications currently being taken typically do not impair the ability to discern right from wrong, and some may even help reduce the impulse to steal.
If you wish to assert a claim of mental incapacity or diminished mental capacity in court, it may be necessary to understand more about your mother's state at that time.
If the court finds it necessary, they may arrange for a forensic evaluation to clarify the situation.
Wishing you all the best! Sincerely, Dr.
Hsiao Ming-Hung

Reply Date: 2016/06/22

More Info

Antidepressants can indeed have various effects on a patient's cognitive functions, including judgment and decision-making abilities. In your mother's case, the combination of medications she is taking for her depression and anxiety could potentially contribute to episodes of impaired judgment, although it is essential to consider multiple factors that may be at play.

Firstly, the medications your mother is taking, such as Sertraline (the generic name for the antidepressant you referred to as "癒利舒盼錠"), can cause side effects that may affect cognitive functions. Common side effects of antidepressants include drowsiness, dizziness, and confusion, particularly when starting a new medication or adjusting dosages. Additionally, some individuals may experience a phenomenon known as "disinhibition," where they act in ways that are out of character, which could include impulsive behaviors like shoplifting.
Moreover, the interaction between multiple medications can also lead to increased side effects. For instance, the combination of Rifampicin (利福全), which is an antibiotic, and other psychotropic medications can alter the metabolism of these drugs, potentially leading to higher levels in the bloodstream and increasing the likelihood of side effects.
It's also worth noting that mental health conditions themselves, such as depression and anxiety, can impair judgment and decision-making. When individuals are in a state of heightened anxiety or depression, their ability to think clearly and make rational decisions can be compromised. This could explain why your mother might engage in behaviors that she knows are wrong but feels compelled to do anyway.

Regarding the legal implications of her actions, it is crucial to consult with a legal professional who can provide guidance on how mental health issues and medication effects might be considered in a court setting. In some cases, a mental health evaluation may be necessary to determine whether her actions were influenced by her mental state at the time.

In summary, while it is possible that the medications your mother is taking could contribute to temporary lapses in judgment, it is essential to consider the broader context of her mental health and the potential interactions between her medications. It would be advisable to discuss these concerns with her prescribing physician, who can evaluate her treatment plan and make any necessary adjustments. Additionally, involving a mental health professional in her care could provide further insights into her behavior and help address any underlying issues that may be contributing to her actions.

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