Picture: REUTERS
Firefighters pay their respects at a memorial site for twenty school children and six adults killed in a shooting at Sandy Hook Elementary School in Newtown in December 2012. Picture: REUTERS

ON FRIDAY December 14 in Newtown, Connecticut in the US, a 20-year-old gunman shot his mother to death, then walked to a nearby elementary (primary) school, and massacred 20 children, aged between six and seven, and six adults, before killing himself.

Theories about what led Adam Lanza to commit such an horrific act have been spreading over ever wider, and wilder, fertile ground.

Lanza killed his mother with her own gun — one of five she owned, including a semi-automatic assault rifle — that allowed him to fire dozens of high-velocity rounds in seconds, building up a quickly shocking tally of young victims.

Not surprisingly, the first knee-jerk reaction was to target the powerful pro-gun lobby in the US, and raise mounting pressure to call for tougher gun controls.

The US enjoys (if that’s the right word under these tragic circumstances), a reputation as the country with the highest gun ownership rate in the world. That’s 89 guns for every 100 Americans, compared to a reported 12.7 in South Africa, according to a blog on The Guardian’s website in July (I would have thought it’s a lot higher than that), six in England and Wales, and just about zero (0.6) in Japan.

The Land of the Rising Sun has been able virtually to eliminate shooting deaths in part simply by forbidding almost all forms of firearm ownership, say analysts.

Yet the US does not have the world’s worst firearm murder rate. That 'prize' goes to Honduras, El Salvador and Jamaica, a blogger says in The Guardian. The US comes in at number 28, with a rate of 2.97 per 100,000 people, he says. Puerto Rico "tops the world’s table for firearms murders as a percentage of all homicides — 94.8%", he says, followed by Sierra Leone in Africa, and Saint Kitts and Nevis in the Caribbean.

I’m no fan of guns, and wouldn’t have one in my own home. And while I can see the sense in banning all forms of firearm ownership, the fact is guns on their own don’t kill. It’s the people behind them who are deadly.

So if guns are not the prime suspect in the Sandy Hook elementary school shooting, then what is?

The shooting has renewed the perennial debate about the effects of violent video games. Lanza is reported to have been "obsessed" with playing violent video games.

However, there are many people around the globe, probably hundreds of thousands, who play the same violent video games Lanza played. Very few of them go on to murderous rampages thereafter.

A report in The Washington Post on December 18 says police believe Lanza’s relationship with his mother, Nancy, holds the key. Lanza was supposed to have been angry at his mother because she planned to have him committed to a mental institution.

However, despite media reports that Lanza had Asperger’s syndrome (a high-functioning form of autism) there has been no official confirmation of that from the family, or indeed of any specific mental illness.

Rather, reports have been more general, describing him at best as a "troubled genius", at worst as a loner, withdrawn, socially awkward. Certainly no suggestion of a darker side that would make him a child killer.

When it comes to speculation on his state of mind, overlapping symptoms make things more murky. Lanza displayed symptoms psychiatrists say are the hallmarks of schizophrenia — "emotional and social withdrawal, flat affect, lack of spontaneity, inability to feel pleasure, attention impairment, and other restrictions in thought, speech, and behaviour". These same symptoms crop up in a diagnosis of autism.

So, while his relationship with his mother may very well turn out to be a key, it is likely to be just one of many keys that eventually unlock the mystery of his murderous rampage.

Another theory rapidly gaining ground on the internet, reportedly stemming from an uncle, is that Lanza was taking a controversial anti-psychotic drug, Fanapt (iloperidone), used to treat schizophrenia in adults, and contraindicated for use in children.

Age-wise, Lanza, at 20 years old, couldn’t have been called a child. Emotionally he could have.

US regulatory body, the Food and Drug Administration (FDA) first rejected Fanapt in 2007 after safety and efficacy concerns, then approved the drug in 2009.

An article by writer Geoffrey Ingersoll on the Business Insider website says Fanapt is just one of many drugs the FDA has "pumped out with an ability to exact the opposite desired effect on people".

Research on negative side effects suggests the drug can induce rather than inhibit psychosis and aggressive behaviour, and cause feelings of hostility, paranoia, confusion, mania, and a lack of impulse-control.

I wouldn’t be surprised if scientologists were behind the spread of that story on and off the internet. Their anti-psychiatry bias — bordering at times on obsessive-compulsive disorder — is well-known, well documented, and integral to their belief system.

However, this is one instance — the only one I can think of — where I have something in common with scientology: psychiatry’s abysmal record when it comes to the use of powerful, psychotropic, personality altering drugs to treat mental illness.

It raises the question of whether any existing mental condition, or treatment for that condition, is implicated here.

It is hard, though, not to be swayed by statistics on how many school shooters have turned out to be on psychiatric drugs.

British psychiatrist Dr David Healy, is founder of RxISK.org, an independent website devoted to research and reporting on prescription drugs. He has gone on record as saying about 90% of school shootings over more than 10 years have been linked to a widely prescribed type of new-generation antidepressant known as selective serotonin reuptake inhibitors (SSRIs), the most well-known of which is Prozac.

Fanapt is not an SSRI. It belongs to a class of drugs known as second-generation (atypical) antipsychotics (SGAs), developed according to the "dopamine receptor antagonist hypothesis". Dopamine is a brain chemical, a neurotransmitter, involved in neurotransmission — communication between neurons in grey matter. Dopamine is a chemical involved in the brain’s pleasure centre, and has been described as critical to mental and physical health.

In certain areas of the brain, excessive dopamine neurotransmission can lead to psychotic symptoms, such as delusions, hallucinations and bizarre behaviour, say psychiatrists.

Behaviour doesn’t get more bizarre than Lanza’s.

Healy, on the WND Education website, says while the public has "to wait to find out what (Lanza) was on, and whether his behaviour does fit the template of a treatment-induced problem", he suspects that prescribed psychiatric medications will indeed prove to be behind Lanza’s violent behaviour.

The website also quotes Harvard-trained psychiatrist and former consultant at the US National Institute of Mental Health Dr Peter Breggin saying Lanza’s problems were likely to be a result of "getting tangled up" with psychiatric medicine.

Breggin says there is "overwhelming scientific evidence correlating psychiatrically prescribed drugs with violence".

Whatever "truth" finally emerges from police investigations and commentary digging into the social and psychological roots of this awful crime, there is unlikely to be a single cause or trigger.

Lanza’s matricide and slaughter of children and their teachers is likely to be from a complex interweaving of factors, including guns, family relationships, mental illness, psychiatric drugs, but also a warp in the American psyche that makes the phenomenon of school shootings so prevalent. That complexity may never ultimately be unraveled.