Psych Nurse Practitioner Testifies About Lindsay Clancy's Prozac Prescription

A board-certified psychiatric nurse practitioner testified today about prescribing Lindsay Clancy Prozac in 2022, weeks before she killed her three young children on Jan. 24, 2023. Julie Paul works in South Shore Hospital's perinatal behavioral health program in Weymouth, Massachusetts. She established the program in 2018 to address mental health issues in pregnant and postpartum women. Paul described her initial contact with Clancy on November 20, 2022, and subsequent interactions, and her decisions to prescribe Prozac, mirtazapine and klonopin. She got in touch with Clancy at the request of Clancy's mother in law, Sue Clancy, a nurse who worked with Paul. Paul noted Clancy's anxiety and sleep issues and her decision to discontinue Prozac after three days. She transferred Clancy's care to Rebecca Jolotta on November 30, 2022. 01:37 "There's a lack of resources on the South Shore for perinatal, for pregnant and postpartum with mood disorders, so I really felt compelled because I had a couple clients that really struggled with mental health issues as a nurse midwife, and really wanted additional education and being able to prescribe for them, so and take care of them in a proper way. So, I went back, got my psych NP, and then worked with South Shore Hospital to establish the program." 08:54 "Did you know a nurse, or do you know a nurse named Susan Clancy?" "I do." "How do you know her?" "I worked with her off and on throughout my years as a nurse midwife." 10:54 "I asked when the birth of Callan was, and she said it was May 26, 2022." "And so, after determining that she was in fact postpartum with a baby at home, did you ask any questions, or did you learn any information about how the experience was earlier in the postpartum, right after birth?" "I did. She said she did really well for the first 12 weeks. She was excited, really happy, and then when Patrick went back to work, she said she started to struggle with some anxiety." 11:41 "And do you recall her indicating that she was having difficulty leaving the baby, that she was feeling overwhelmed and having racing thoughts?" "Yes." "And so, in your training and experience, is that thing? Are those things that you would hear from new moms?" "It was very typical of what I hear." 13:50 "I encouraged her to take the medication that she already had on hand. That if the Benadryl and the Ativan were working, she should take that to help her sleep that night. And we talked the next morning about different options." 14:57 "Were you addressing or assessing during the whole course of this conversation whether there was any immediate safety risk or need for her?" "Yes, I was." "And did you find that there was any?" "There was no immediate need." 18:11 "And if a person is scheduled for an in-person visit and there are no observed issues on your end, can they opt to change it to a virtual appointment at any at any point?" "Yes." "And that's just the normal course of of business at the clinic?" "Correct." 25:02 "she was significantly high in the GAD 7, which is for generalized anxiety. She scored 21 out of 21, which is they're just screening, so it's not diagnostic." 26:44 "I encouraged her to take the Ativan. ... Prozac can sometimes be very activating, it can make the anxiety worse before it gets better when you first start it. So I wanted to pair it with the Ativan just in the beginning, just to help her be more comfortable with the anxiety and to make sure that it didn't interfere with her sleep." 32:05 "prior to you communicating November 30th that you were transferring her care, did you have further contact with Lindsay Clancy?" "Yeah, we had a few phone calls and MyChart messages going back and forth." 35:50 "Okay, so on November 25th, did you prescribe her some additional medications?" "I did. So she wasn't tolerating the Prozac. So we had a conversation about stopping the Prozac. I gave her. She was really having a hard time sleeping, so I gave her a one-time dose of Ambien, and then I also prescribed mirtazapine, which is another antidepressant, but it works really good for sedation and anxiety. So started that at 7.5 milligrams. Told her to stop the Prozac, and I also paired it with klonopin, but I told her explicitly not to take the Ativan, just to take the klonopin to help." 42:37 "So on the 28th, there was no back and forth about her taking the medicine and the effects, or how she was feeling?" "She actually had a panic attack earlier in the day before those communications about work, and I recommended she take 0.5 of Ativan and go for a run. And I also recommended that she consider doing the partial hospitalization program at women and infants."