Psychiatrist says acne meds provoked Raleigh mass shooter, dermatologist says otherwise

A local dermatologist disputes claims that Austin Thompson killed 5 people three years ago in Raleigh's Hedingham neighborhood in part because of the teen's acne medication.

Dr. Dean Morrell, a children's dermatologist with UNC Health, said he's never heard of Minocycline, a medicine prescribed to treat acne, having psychiatric side effects from use, let alone leading to murder.

During testimony at Thompson's sentencing on Tuesday, his attorneys argued that acne medication led to the mass shooting. Thompson pleaded guilty weeks earlier to killing five people and injuring two more during the spree on Oct. 13, 2022, in Raleigh's Hedingham neighborhood.

George Patrick Corvin, a general and forensic psychiatrist, was asked to testify and said that minocycline could induce psychiatric side effects, "including and up to depersonalization, a sudden onset of an associative episode where one can engage in conduct but is not really there. They're there and doing things, but almost like they're playing out a dream."

Morrell disputed that, usually, the medication has the opposite effect than what Thompson's defense is claiming.

"Treating inflammatory acne in a teenager or young adult can have profound improved effects on mood, feelings of self-worth and overall mental health," Morrell said.

However, in several medical reviews used by Dr. Corvin, there have been cases where minocycline induced depersonalization symptoms, but there were few, noting the rarity. According to one review from authors with the Journal of Clinical and Aesthetic Dermatology, they searched popular Reddit threads about acne with "concerning titles such as, 'Minocycline ruined my life...'" that had "numerous posts [that] highlighted the association of minocycline with depersonalization/derealization disorder."

In one case report from 2004, a 24-year-old woman with no history of psychiatric disorder said she began feeling "detached from her surroundings, as though she was part of a movie in which she was watching herself perform her daily activities" a few days after starting minocycline. 

After the woman stopped using minocycline after seven days, within 48 hours, her depersonalization symptoms resolved. 

The same happened for a 37-year-old woman in a 2019 case report who felt "extremely disconnected and lost" while on minocycline. This woman took the medication for three weeks before reading online forums who reported the same feelings. In the report, the woman "felt her normal self within 2-3 days of stopping minocycline."

Based on these medical reviews, the defense argued that minocycline, while extremely rare in comparison to its other side effects, does evoke feelings of depersonalization. 

Several health organizations say the most common side effects of minocycline are upset stomach, dizziness and skin rash. In rare cases, it can affect the user's kidneys or liver.

A different acne drug called Accutane, which Thompson was not using at the time of the shooting, has been suggested as being a factor in at least one homicide case and some cases of suicide.

In a simplified statement, Corvin said that with these medications with intense psychiatric side effects, people can be on them for an extended period of time and dissociative emotions can happen suddenly and acutely. 

However, Morrell said Accutane is a very different drug, and added that research on Accutane had few to no psychiatric side effects.

Ultimately, Corvin said he didn't know why Thompson committed the crimes and agreed that no expert has a definitive answer.

"I can't give the answer to why this happened, and that's pretty unusual in these cases," Corvin stated. "It's unusual and frustrating to be unable to ascertain."