MA v Lindsay Clancy - Dr Donald Condie - Forensic Psychiatrist

Testimony of Dr. Donald Condie in the Lindsay Clancy trial regarding Lindsay Clancy's psychiatric treatment, medications, and records: Expert Witness Qualifications (Dr. Donald Condie) • Practice: Massachusetts license since 1983. Child, adolescent, and adult clinical and forensic psychiatrist. Board-certified in adult and child/adolescent psychiatry. • Training: Tulane. LSU medical school. Harvard-affiliated Massachusetts Mental Health Center residency and forensic fellowship. • Postpartum work: Since 1983. Fourteen years as VINFEN chief medical officer, often after delivery when psychosis worsened. • This case: Defense psychopharmacology consultant. Never met Lindsay. Interviewed Patrick for 90 to 100 minutes. Reviewed Tufts, Jollotta, Julie Paul, Brigham and Women's, Women and Infants, McLean, and a New Yorker article. Not police reports or crime-scene photos. Direct Examination: Treatment Timeline • Dr. Tufts (Sept 2022–Jan 2023): Postpartum anxiety after Callan. Telehealth. Records "sparse," mostly checkboxes. • Zoloft: Started 25 mg late September (delayed for breastfeeding). At 50 mg, about 48 hours of total insomnia ("activation"), numbness, crying all day, racing thoughts, brain fog. • Zulresso: About 60-hour IV, about $34,000. She did not receive it. • South Shore perinatal: Julie Paul and Rebecca Jollotta. November 27 Paul wrote she was "disassociated and she was not in touch with reality," a hallmark of psychosis. She felt "heavy," could not get out of bed or feel love. • Jollotta meds: Remeron, Benadryl, Seroquel from 25 mg toward 400 mg. She felt "spacey" and "hungover." • December: South Shore ER. Women and Infants discharged her as medication complications. Aspire twice. No higher level of care without a suicide plan. Mass General ER, then four days locked at McLean around New Year's. • After McLean: Seroquel to zero. Mid-January Tufts prescribed Valium, trazodone, and amitriptyline. Symptoms did not resolve. Direct Examination: Critique of Care • Blood tests: Should check hemoglobin and TSH. Neither Tufts nor Jollotta ordered blood work. • DSM-5-TR: A "dictionary," not a bible. Postpartum psychosis once (page 148). ICD-11 lists it separately. Cross-Examination • CV: Does not specifically list postpartum women. Most work is child and adolescent psychiatry. • Adherence: Zoloft bottle later had only seven pills missing. He had not seen police reports. Lamotrigine prescribed, never taken. Unknown if she reached 400 mg Seroquel. Typically three or four meds at a time. • Voices: Not reported to Tufts, Jollotta, or Latiesha Dukes. Intrusive thoughts and anxiety, helped by Ativan. First report of a voice was January 24, 2023. Redirect and Recross • Minimization: Patients often hide hallucinations. Fear of DCF and of her nursing license. • Episodic psychosis: Can start and stop. An SSRI without a mood stabilizer can worsen suspected bipolar illness. • Recross: He never interviewed Lindsay, so conclusions about her fears were speculative. 00:00:00 - MA v Lindsay Clancy - Dr Donald Condie 00:07:16 - Case Consultant Role and Materials Reviewed 00:09:01 - Fall 2022: Lindsay Clancy's Treatment Begins 00:12:05 - Zoloft Prescription and Severe Adverse Side Effects 00:17:13 - The Zulresso Recommendation and Halting Zoloft 00:19:48 - Transition to South Shore Perinatal Program and Dissociation 00:21:37 - Symptoms of Postpartum Psychosis and New Medication Trials 00:25:31 - How SSRIs and Serotonin Work in the Brain 00:27:19 - Postpartum Hormonal Shifts and Blues vs Psychosis 00:31:19 - Failure to Order Basic Blood and Thyroid Tests 00:33:31 - Bipolar Disorder, Mania, and DSM-5-TR Definitions 00:37:28 - December Escalation: ER Visits and Rhode Island Discharge 00:39:05 - Aspire Hotline Calls and McLean Hospital Admission 00:41:11 - Seroquel Titration and Post-McLean January Medications 00:45:41 - DSM-5-TR Limitations vs ICD-11 00:47:33 - Cross-Examination: CV and Experience 00:49:03 - Cross-Examination: Omission of Police and Crime Scene Reports 00:50:23 - Cross-Examination: Medication Non-Compliance and Seroquel Taper 01:00:39 - Cross-Examination: No Reported Hallucinations Before January 24 01:02:28 - Redirect: Why Postpartum Patients Hide Symptoms 01:03:55 - Redirect: Episodic Psychosis and SSRI Risks 01:05:05 - Recross: Speculation vs Direct Clinical Evaluation Lindsay Clancy Trial Playlist: MA v Lindsay Clancy - Jury Selection Day 1