In December 2023, 17-year-old Connor Hilton shot two friends inside his home in Friendswood, Texas, killing one of them, authorities said.

Hilton fired at Ethan Riley and Benjamin Bliek, striking both in the head. When police arrived, he was visibly distraught and repeatedly expressed remorse, according to interrogation and bodycam footage featured in a recent CBS News 48 Hours report.

“What I did was wrong. I need to do the punishment. I know that,” Hilton told officers through tears. “But I also need help. I need really, really — I need some help.”

Hilton admitted to experiencing suicidal and homicidal thoughts, which he and his family now claim were triggered by a prescription acne medication. Initially, he told police the shooting happened during an argument and was done in self-defense. Later statements, however, contradicted that account, including comments in which he asked to be placed in a mental hospital.

His defense team argues that isotretinoin — commonly known by the former brand name Accutane — played a central role in the violence. The powerful acne medication, still prescribed in generic form in the U.S., carries a “black box” warning for serious psychiatric side effects, including depression, aggression, hallucinations and psychosis.

According to police transcripts, Hilton said he persuaded his mother to buy him a gun because he feared he might either kill himself or someone else. Records indicate he missed a dose of the medication the day before the shooting and took a double dose on the day of the attack.

Psychiatry professor Dr. Doug Bremner of Emory University told CBS News that isotretinoin has been linked to psychiatric reactions in some patients.

“I think he became psychotic on Accutane,” Bremner said, adding that Hilton’s violent thoughts reportedly subsided when he stopped taking the drug and returned when it was resumed — a pattern he described as evidence of a possible causal link.

The case is expected to hinge on whether the medication’s alleged side effects can be successfully used as part of Hilton’s legal defense.