title: Violent behavior, impulsive decision-making, and anterograde amnesia while intoxicated with flunitrazepam and alcohol or other drugs: a case study in forensic psychiatric patients.
abstract: It is known that many male juvenile delinquents commit violent crimes while intoxicated with flunitrazepam (FZ), often in combination with alcohol or other drugs. We have also noted the combined abuse of FZ with, for example, alcohol in male forensic psychiatric patients. Our objective was to study violent behavior, impulsive decision-making, and amnesia in male forensic psychiatric patients who were intoxicated predominantly with FZ, to increase knowledge of the abuse of FZ in vulnerable subjects. We studied five forensic psychiatric patients, all of whom were assessed in 1998. All of the subjects reported earlier reactions to FZ, including hostility and anterograde amnesia. At the time of their crimes they were all intoxicated with FZ, often in combination with alcohol or other drugs, such as amphetamine or cannabis. In contrast to their behavior based on their ordinary psychological characteristics, their crimes were extremely violent, and the subjects lacked both the ability to think clearly and to have empathy with their victims. Our observations support the view that FZ abuse can lead to serious violent behavior in subjects characterized by vulnerable personality traits, and that this effect is confounded by the concurrent use of alcohol or other drugs. It is evident that FZ causes anterograde amnesia. Previous research and the results presented herein allow us to draw the following conclusion: on the basis of the neuropsychopharmacologic properties of FZ, legal decisions, such as declaring FZ an illegal drug, are needed in countries where it is now legal.
authors.affiliation: Department of Clinical Neuroscience, Occupational Therapy and Elderly Care Research, Karolinska Institute, Huddinge, Sweden. anna.daderman@neurotec.ki.se
authors.forename: Anna Maria
authors.initials: AM
authors.lastname: Dåderman
authors.forename: Björn
authors.initials: B
authors.lastname: Fredriksson
authors.forename: Marianne
authors.initials: M
authors.lastname: Kristiansson
authors.forename: Lars-Håkan
authors.initials: LH
authors.lastname: Nilsson
authors.forename: Lars
authors.initials: L
authors.lastname: Lidberg
mesh_terms: D000293:Adolescent; D000328:Adult; D020324:Amnesia, Anterograde / Q000139:chemically induced*; D014151:Anti-Anxiety Agents / Q000009:adverse effects*; D000987:Antisocial Personality Disorder / Q000523:psychology*; D003417:Criminal Psychology; D003657:Decision Making; D017831:Diagnosis, Dual (Psychiatry); D005445:Flunitrazepam / Q000009:adverse effects*; D005555:Forensic Psychiatry; D006708:Homicide / Q000523:psychology*; D006801:Humans; D007175:Impulsive Behavior / Q000139:chemically induced*; D008297:Male; D019966:Substance-Related Disorders / Q000150:complications*; D013548:Sweden; D014754:Violence / Q000523:psychology*
chemical_list: D014151:Anti-Anxiety Agents; D005445:Flunitrazepam