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Raleigh mass shooting in Hedingham neighborhood
On Oct. 13, 2022, seven people were shot in Raleigh, NC, in the Hedingham neighborhood near the Neuse River Greenway Trail. Five were killed, including a Raleigh police officer. High school student Austin Thompson was charged with their murders. Read The News & Observer’s ongoing coverage of the mass shooting, Thompson’s guilty plea and his sentencing hearing.
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As the sentencing hearing continues in the Hedingham neighborhood mass-shooting case in Raleigh, the defense has pointed to a commonly prescribed acne medication, minocycline, as a possible factor in confessed shooter Austin Thompson’s behavior.
In court filings and testimony, attorneys have suggested that therapeutic doses of the antibiotic may have affected the teenager’s mental state in the days leading up to the 2022 deadly shooting.
While medical authorities list typical physical side effects such as nausea and dizziness, case reports and clinical guides do state rare psychiatric symptoms, including mood changes and anxiety, have been associated with minocycline use in isolated instances, according to Piction Health, a teledermatology company that provides virtual care for skin conditions.
But is the drug known to cause violence?
It’s complicated, said Ivan Litvinov, an associate professor in the Department of Medicine at McGill University in Montreal.
In 2019, he co-authored a case study analyzing the depersonalization side effect of minocycline. In the study, only one case was reported of a 37-year-old woman who was diagnosed with periorificial dermatitis, or inflamed acne, and was prescribed the drug.
Two days after starting the medicine, she experienced feeling disconnected from reality and stopped using the drug, immediately feeling more like herself.
“Minocycline does cross the blood-brain barrier. It’s very interesting,” Litvinov said. “We use minocycline because it has a very strong anti-inflammatory effect, and it can be great for acne. It’s also used in multiple neurologic disorders, such as multiple sclerosis.”
Litvinov said he has only seen one case where a patient described the symptoms of disassociation, but that person did not become violent. Mainly, the risk of long-term effects of minocycline are suicide.
“How far away is suicide from homicide? I don’t know,” Litvinov said. “When we researched it at the time, the associated symptoms are often troubling and can lead to serious consequences such as suicide.”
Litvinov’s case study reported that minocycline is being studied as a treatment for psychiatric conditions like mood disorders, schizophrenia, and addiction. The most common side effects of the medicine are light-headedness, nausea, dizziness. Other side effects, when mixed with other drugs like isotretinoin, another acne medication, include hyperpigmentation, drug-related lupus, and pulmonary side effects.
Disassociation is not listed as a side effect of minocycline in most medical references, the case report stated.
“The most common precipitants of depersonalization disorder are severe stress, depression, panic, marijuana, and hallucinogen use,” the case report read. “Mood, anxiety, and personality disorders are frequently comorbid, but depersonalization can occur in the absence of another psychiatric disorder.”
The chances of a patient becoming violent or having thoughts of violence are possible, but “very rare,” Litvinov said. On average, patients are told minocycline takes about 12 weeks to clear any acne. If patients report any severe side effects, dermatologists will stop the medicine, Litvinov said.
“Minocycline does impact the neurological functioning of the individual, hopefully, in a positive way,” he said. “It’s a medication given to millions of teenagers every day.”
The News & Observer’s Lexi Solomon contributed to this report.
NC Reality Check is an N&O series holding those in power accountable and shining a light on public issues that affect the Triangle or North Carolina. Have a suggestion for a future story? Email realitycheck@newsobserver.com.
This story was originally published February 13, 2026 at 5:30 AM.
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Evan Moore is a service journalism reporter for the Charlotte Observer. He grew up in Denver, North Carolina, where he previously worked as a reporter for the Denver Citizen, and is a UNC Charlotte graduate.