In December 2023, a tragic incident in Friendswood, Texas, involved 17-year-old Connor Hilton shooting his friends, Ethan Riley and Benjamin Bleek, in the head, leading to their deaths.
When authorities arrived, Hilton appeared extremely upset. During police interviews, he was seen crying, expressing remorse by saying, “What I did was wrong and I have to be punished. I know that. But I also need help. I really, really need help.”
Hilton revealed that he had been battling suicidal and homicidal thoughts. Both he and his family suggest that a widely used prescription acne medication may have played a role in this violent act.
Shortly after the shooting, Hilton told police he shot his friends after an argument, claiming self-defense. Yet, his narrative seemed inconsistent in other exchanges, including an unsettling moment captured on body camera where he remarked, “You should be put in a mental hospital.”
“I had thoughts of suicide or murder for a long time,” he reiterated to the officers. He expressed a mix of guilt and need for support, stating he knew he needed punishment but also help.
His attorney pointed to Accutane as the potential instigator of his actions. This retinoid medication, though effective for severe acne, has serious side effects, including a “black box” warning related to mental health issues like depression and aggressive behavior.
Isotretinoin, the active compound in Accutane, remains accessible in generic forms despite the brand no longer being available in the United States.
Clinical studies indicate that such medications can alter brain chemicals linked to mood, leading to troubling side effects. For instance, one case study from 2014 described how a 27-year-old experienced acute psychosis after just two weeks on isotretinoin, believing others were plotting against him. His symptoms disappeared upon stopping the medication.
Hilton’s police report mentioned he had been open about his distress, even persuading his mother to buy a gun, claiming it was for self-harm or to harm another person.
The day prior to the incident, he reportedly missed his medication dose, which may have influenced his behavior when he doubled up the next day.
Doug Bremner, a psychiatrist at Emory University, noted that numerous individuals on isotretinoin report psychological side effects. He suggested Hilton experienced psychosis due to the medication, pointing to his unpredictable thoughts regarding violence as evidence.
Despite attempts to use the adverse effects of the medication in Hilton’s defense—much like a case from Colorado years earlier—the judge excluded this line of argument and barred Bremner from testifying on Hilton’s behalf.
Ultimately, Hilton pleaded guilty to murder and aggravated assault, receiving a 50-year prison sentence in September 2025.
Recently, Matthew and Tara Riley, parents of the deceased Ethan Riley, were awarded a $60 million judgment in a civil case, determining that Hilton’s mother had been significantly negligent for not preventing her son from accessing the firearm.
If you are in New York City and facing a mental health crisis or suicidal thoughts, you can call 1-888-NYC-WELL for confidential support. Outside the city, the National Suicide Prevention Hotline is available at 988.
