Someone tuning into the closing arguments in the Clancy case without having seen anything that went before, especially if they came to it thinking trials should hinge on facts rather than waffle or emotions, would likely have been left figuring the prosecution has to win. They dealt in details. Details about her illness, what she told her doctors, her drug levels, the timing of events in the final hours.
The defense did not focus on details and didn’t counter the prosecution details. It took an emotional broad picture approach.
The judge stressed keeping to the facts/details. He didn’t quite dismiss all the experts and their opinions about illnesses etc, other than to say they know no more about the details than you – the jurors do. Courts can be skeptical of expert witnesses and so it is not impossible that in between the lines he might have been hinting the experts know less about what counts than you the jurors do.
In response to the judge’s request for their comments on the instructions he had drawn up about what he should tell jurors their job was, the prosecution and defense input seemed to center on clarity in the case of the medicines on a question as to whether drug induced toxicity, if present, was debilitating. In the case of any mental disorder, if present, whether it removed Lindsay Clancy’s capacity to distinguish right from wrong or to conform her behavior accordingly,
Meanwhile, the Clancys had filed a parallel legal action on January 22 2026 claiming most of those who saw her, Dr Tufts et al along with the healthcare organizations they worked for, were negligent in failing to make the correct diagnosis which, the action claims, is a bipolar diagnosis. If that had been made, she would have been treated in a manner that would have saved the lives of her children and saved her from permanent disability.
The argument in this Negligence Lawsuit lists very similar points to the prosecution’s closing list of points but frames these points entirely differently.
Two points stand out. One centers on Command Hallucinations and the other on a Bipolar diagnosis
Command Hallucinations
The only people with command hallucinations I’ve seen, talked to or dealt with in any detail have been on psychotropic meds.
Command hallucinations are auditory. Auditory hallucinations are traditionally linked to schizophrenia and delusional psychoses in contrast to visual hallucinations which are more likely linked to drug toxicity. But I’ve never spoken to a person with schizophrenia or psychosis that I can recall who has been medication free and reporting command hallucinations.
It’s close to impossible for any clinician today to have ever seen such a person. Some patients who have been labelled as having schizophrenia, many of whom will not have it, may be drug free. But command hallucinations in my experience invariably start on meds and can persist long after the meds stop, so an interviewer may be misled into thinking these have no link to treatment.
Command hallucinations are also not known to be responsive to antipsychotics. This is not saying some might appear to respond – they can seem to clear up with or without treatment. It’s saying there is little or no guarantee they will respond. They can be one off phenomena or clear up with time on or off meds or can persist indefinitely while on meds.
Is it possible we have only recently developed Command Hallucinations. Are they described before the introduction of chlorpromazine in 1952 or anti-seizure meds like the barbiturates in 1912 or the bromides from around 1860?
The startling answer AI will offer you is the term Command Hallucinations came into use in the 1970s linked to Julian Jaynes ideas about Bicameral Minds – Left Brain, Right Brain ideas. Jaynes traced a lineage for Command Hallucinations back to the Ancient Greeks, claiming when they talked about communications from the Gods, they were having Command Hallucinations. Hearing voices like that is not madness – is certainly not psychosis.
Jaynes idea gave rise to the view that many normal people today can hear Voices and are like Greeks and no more mentally ill than the Ancients.
In 1987, Marius Romme, a Dutch psychiatrist, and Patsy Hage, a Voice Hearer, appeared on TV talking about her voices. She heard voices but apart from that appeared normal. This led to the creation of a Hearing Voices Network, where voice hearers meet in a non-mental health setting. This has been a very good outcome.
Many of us can hear voices without having a psychiatric disorder. We can hear them when falling asleep or when waking up and these voices can be very vivid and real. We can hear them under hypnosis. They can be helpful indicators of how we are thinking – voices that make us aware we may be actively considering more than one option at the same time. Lots of voices are benign and keep us company. Hearing voices groups are far better for many than antipsychotic or other drugs.
While it has had good outcomes, Jaynes’ and Romme’s links to the Ancient Greeks was fanciful. We don’t know that communications from the Gods are linked to what happens now. Did the guys just conveniently avail of a new phenomenon – Antidepressant, Anticonvulsant and Antipsychotic induced Command Hallucinations? All of these drugs can give rise to Command Hallucinations
Bipolar Boston
There is little doubt that Lindsay Clancy had what she called intrusive thoughts. She began mentioning them after taking Zoloft. Exactly what these ‘thoughts’ were or what their content was don’t seem to have been clarified in the murder trial. The negligence lawsuit seems to convert the intrusive thoughts into command hallucinations lock stock and barrel, whose content increasingly contained ideas that she should kill herself and, en route to doing so, should kill her children. All of this is/was supposedly evidence that she had/has a bipolar disorder.
There is a negligible amount of evidence, rather than opinion, that she does have a bipolar disorder. No admissions for mania, no convincing hypomanic episodes.
The event that supposedly should have caused the scales to drop from the eyes of those treating Lindsay was the activation of her thoughts on Zoloft.
This SSRI drugs reveal Bipolar Disorder notion was likely invented in Boston. It was picked up by Pharma around 2004 when the SSRIs ran into suicidality problems. SSRIs weren’t causing suicide (or homicide). These events were happening because the person had been misdiagnosed as depressed when they were really bipolar and should have been put on a mood-stabilizer.
This is total baloney but not surprising in a part of the world that was then well on the way to diagnosing bipolar disorder in utero – as the Bipolar Child unashamedly claims is feasible. See The Latest Mania.
Activation on an SSRI is a toxic effects of SSRIs that can be seen in healthy volunteers. That is all it is. It is not a diagnostic test for bipolar disorder.
The idea that it might be possible to make a bipolar diagnosis in utero was only one feature of Bipolar Mania that gripped Massachusetts and spread across the US. Another was the complete neglect of the data from company trials that show a statistically significant excess of suicidal events on anticonvulsants compared to placebo. The excess held whether the trials were done in epilepsy, migraine, pain, bipolar disorder or other conditions. See FDA, Anti-Seizure Meds and Suicidality.
The mania for bipolar disorders came at a wonderfully convenient time for pharma who were then bringing olanzapine, risperidone, and quetiapine onto the market. The door was opened to getting a license for bipolar disorder, which was then in the process of transitioning from Cis Manic-Depression, one tenth as common as schizophrenia, into Trans-Bipolar, a 5 times more common disorder than schizophrenia.
Manic-Depression had an established high rate of suicide. The bipolar 2, 3, 4, 5, 6, and in utero bipolar didn’t. Nor did schizophrenia. Schizophrenia had a very low rate of suicide and a patient with schizophrenia committing homicide was almost unheard of before the introduction of chlorpromazine – See Mortality in Schizophrenia.
The clinical trials of olanzapine and risperidone in schizophrenia had the highest rates of completed suicides and suicidal events in company trial history – higher than the suicidal event rates for SSRIs or anticonvulsants. So high that Eli Lilly have never divulged the true figures submitted to FDA, and FDA haven’t stepped up to the plate to force them to do so.
Why has no-one in Boston stepped up to this plate? What illness do the people who become suicidal on an anticonvulsant have – presumably not bipolar if they become suicidal? What should they really have been diagnosed with? What illness do the people who become suicidal on an antipsychotic mood stabilizer have – presumably not bipolar disorder? What should they really have been diagnosed with?
The idea that everything would have been just fine for Lindsay Clancy if she had been diagnosed as bipolar and put on a mood-stabilizer is deluded. Were most of the Boston (and American) psychiatric establishment responding to Command Hallucinations?
These antipsychotics and anticonvulsants are now called Mood Stabilizers. But FDA never licensed them as such. There is zero evidence these drugs stabilize moods. The companies applied to FDA for a license based on trials of these drugs in mania – where any remotely sedative drug cannot but produce a drop in scores on mania rating scales and will get a license – See The Latest Mania.
Throw in the fact that antipsychotics can be desperately difficult to stop and someone like Lindsay Clancy whipped off a highish dose of quetiapine risks having major difficulties. Antipsychotics are at least as difficult as SSRIs and perhaps more so to stop. There have been completed suicides in the withdrawal period of company trials of these antipsychotics submitted to FDA – who chose to turn a blind-eye to them
In addition to all that there is abundant evidence dating back 60 years that both antipsychotics and anticonvulsants can cause a range of delirious phenomena including hallucinations.
Negligent?
While it is difficult to see Jennifer Tufts, the nurse practitioners or other clinicians who saw Lindsay Clancy as having done a good job, it is even harder to see them as negligent.
One of the experts in the case, Avram Mack, has come in for a lot of vilification for not towing the bipolar line and offering a view that LC was depressed. On the basis of the limited details I have, I lean toward depression (and not especially major or severe) rather than any other disorder.
Lindsay Clancy did not have classic post-partum psychosis as described by Emil Kraepelin – who did not view post-partum psychosis as part of manic-depressive illness (bipolar disorder). Classic post-partum psychosis has all but vanished – See Post Partum Psychosis. It looked like a steroid psychosis. It happened in women who had no prior or subsequent mental health history. Lindsay Clancy did not look remotely like classic post-partum psychosis before being exposed to the series of medicines she was put on.
Why did Jennifer Tufts and others fail to badly? Because like Tom Kingston’s and Deirdre Morley’s doctors they were Pathway adherent doctors. They were conforming their behavior to the Rules rather than treating the person in front of them. To Rules that are based on ghost-written, often fraudulent trials. What kind of outcomes can we expect if we force doctors to adhere to Treatment Pathways based on junk? Are these treatment pathways not The Perfect Killing Machine?
Moving Forward
The jurors in the Clancy trial have a dearth of detail that might form a basis for an acquittal. This was in part because the medicines Lindsay Clancy was taking were not center-stage. Even if they were front and center, however, there are almost no psychiatrists who could have interviewed her and brought details to light that might help jurors understand what happened.
There are thousands of people who have been harmed on the meds Lindsay Clancy was on who will shout about akathisia but shouting about akathisia is almost irrelevant – except in very severe cases of akathisia. Even if she showed some signs of akathisia, which it isn’t clear that Lindsay Clancy did, jurors have to be able to understand how they can get from whatever it is the drug is causing to an understanding as to how someone loses the capacity to tell right from wrong and conform their behavior accordingly. There is a gap there to be bridged that megaphoning akathisia is not going to bridge.
We desperately need detailed reports from people who have had the intrusive thoughts and command hallucinations and other phenomena that these drugs can cause that might help jurors understand how the ability to tell right from wrong or the ability to conform out behavior may be lost.
There are two posts on RxISK linked to this. The Troubled Dream of Life tries to explain what SSRIs do and how this might lead to a Loss of Capacity to tell Right from Wrong and how to conform our actions to these standards.
Drug Induced Loss of Capacity features a series of cases that might give some of you an idea about the kinds of details jurors, the media and doctors need if they are going to bring the drugs into the frame in any of these cases. Many readers will have had the experience of effects like these or know someone who has. This post is based on what you have told me and others of us linked to RxISK – there is very little in it that comes from books.
We now collectively desperately need more input from you. If you can, respond to the posts in the comments or by email and/or by filing RxISK reports.
Spoiler:
I have no idea what the outcome in the Clancy case will be and no views on what it should be. Unless I got a chance to talk at length to her in my opinion it’s not possible to have a view. The jurors will have a view on what has been presented to them, which does not appear to include anything about the effects of her drugs on her.
Leave a Reply