Lindsay Clancy murder trial: toxicologist testifies about medications found in defendant’s blood

The trial of Lindsay Clancy, the Massachusetts mom accused of killing her three children in January 2023, continued on Wednesday with a forensic toxicologist testifying to the variety and concentration of medications found in the defendant’s blood.

Justin Brower, a forensic toxicologist with NMS Laboratories, testified that his lab examined the levels of four psychiatric medications detected in Clancy’s blood after she allegedly strangled her kids and attempted to take her own life.

Those drugs included the antidepressant mirtazapine, the mood stabilizer lamotrigine, the antidepressant trazodone and quetiapine, a drug used to treat schizophrenia, bipolar disorder and major depressive disorder. Brower noted that quetiapine could also be prescribed in low doses to treat insomnia.

Asked if the concentrations of each drug were different from what was prescribed, Brower said the only drug that appeared slightly elevated was quetiapine, but noted that it was not at a “toxic concentration” or “suicidal concentration”.

“Usually people take handfuls of pills when they’re trying to harm themselves and take their own life, and this is not consistent with that,” Brower testified.

He later testified, upon questioning from Clancy’s defense attorney, that the toxicology results “don’t tell the entire story”.

Prosecutors say Clancy acted intentionally when she killed her children Callan, eight months old; Dawson, three years old; and Cora, five years old. Her defense team says she was a loving mother who was overcome by postpartum psychosis, had undiagnosed bipolar disorder and was on problematic medications.

The court has heard from a range of experts for the prosecution, with testimony at times halted when witnesses, including Clancy’s ex-husband, Patrick Clancy, or the defendant have become overwhelmed.

If convicted, Clancy faces life in prison without parole. A not-guilty verdict by reason of a lack of criminal responsibility could lead to commitment to a state mental health facility.

On Monday, jurors heard excerpts from Clancy’s journals that revealed her mental struggles including thoughts of suicide and her feeling overwhelmed with motherhood, including her struggles to get her newborn to sleep, going back to work as a labor and delivery nurse, not being able to breastfeed, and feeling disconnected from her children and husband.

“I’m so desperate to get a mental break from taking care of everyone that my mind is trying to find something physically wrong with me,” she wrote in an entry on 18 November 2022.

The trial has shone a light on significant gaps in the diagnosis and treatment of postpartum psychosis and postpartum depression. Clancy’s attorneys say her condition seemed to worsen on an ever-shifting lineup of psychiatric prescriptions.

In the three months before the killings, various clinicians prescribed a range of antidepressants, sleep aids, an antipsychotic and other medications while she reported increasingly profound insomnia, anxiety, despair and confusion about what was real, according to a civil lawsuit filed against caregivers that claims they should have recognized that both she and her children were at risk.

In her diaries, Clancy wrote, “I want help. I want to be well,” and described feeling “incredibly sad and guilty” about not breastfeeding. She also wrote that she was “obsessed” with managing Callan’s sleep and nap schedule.

“I have crazy brain fog. I feel like I can’t make a plan,” she wrote in another, undated entry. “I live moment to moment waiting for the next nap time. I’m terrified of Cal getting overtired now because I feel can’t help him.

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“Hearing him cry for 1 plus hours and not intervening just about killed me,” Clancy wrote, adding that she had told her husband, Patrick, “I want to die.” She also wrote: “I now have horrible insomnia and anxiety which is causing depression. I have no appetite. I don’t know what’s wrong with me. I want help. I want to be well.”

Clancy first sought help from a postpartum depression program in late December 2022. She went on to check herself into a psychiatric hospital and later told a psychiatrist that she heard a “man’s voice” in her head telling her to “kill the children so you can kill yourself”. Nineteen days later, after being discharged, she carried out the killings.

The defendant is now paralyzed from her attempt to take her own life. When she woke up in hospital and was asked by a forensic psychologist how she felt, she responded: “Horrified.” Dr Jhilam Biswas of Brigham and Women’s hospital testified that Clancy asked “can she have visitors, and where her family is”.

The court has also heard from Patrick Clancy, who recounted the medications his former wife was taking, her health and demeanor, and the destructive thoughts she was having. He has said he forgives Lindsay and believes that the killings were motivated purely by her mental health.

When the jury heard the anguished 911 call Patrick Clancy made on the night of the killings, several members could be seen holding back tears. He described returning home after collecting medications and a takeout meal to find their home “quiet”.

Patrick Clancy went upstairs to find found the door to their bedroom locked. After breaking in, the room was covered in blood and the window was open. His wife was lying on the ground below. She told him she had tried to take her own life. He asked where the children were, and she told him they were in the basement.

When emergency services arrived, he ventured downstairs to find their three children with exercise resistance bands around their necks. Duxbury police officer Brian Josephine testified that he heard Patrick scream, “She killed the fucking kids.”