Violent Behavior, Impulsive Decision-Making, and Anterograde Amnesia While Intoxicated
With Flunitrazepam and Alcohol or Other Drugs: A Case Study in Forensic Psychiatric Patients
A. M. Daderman, M. K. Bjorn Fredriksson, L.-H. Nilsson and L. Lidberg,
Journal of the American Academy of Psychiatry and the Law
30(2): 238-251, 2002.
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.