A psychiatric nurse practitioner who treated Lindsay Clancy in late 2022 testified Tuesday that the Massachusetts mother repeatedly asked to change her medications despite concerns about sticking to a treatment plan. Rebecca Jollotta, a psychiatric nurse practitioner with South Shore Hospital’s perinatal behavioural health program, created a plan to treat Clancy’s anxiety, depression and insomnia in late November into early December 2022. During that time, Clancy repeatedly sought changes to her medications, saying they were causing intrusive thoughts, insomnia and numbness, Jollotta testified. Clancy also wrote that she was concerned about becoming dependent on the benzodiazepine Ativan. “It’s just a very scary stressful time for me, and starting new meds with side effects is very scary to me,” Clancy wrote in one note. Jollotta responded she understood her concerns but advised that the medication takes several weeks to be effective. She told Clancy she believed her problems were more likely postpartum depression, rather than side effects from the drugs. “All of this sounds like postpartum depression,” Jollotta wrote. Jollotta’s testimony comes three weeks into Clancy’s trial on three counts of murder in the killings of her children Cora, 5; Dawson, 3; and Callan, 8 months. Jollotta is one of several psychiatric medical professionals who have testified this week about their efforts to treat Clancy’s mental health problems. The trial has featured testimony about the lead-up to the killings and Clancy’s struggles with postpartum anxiety, depression and insomnia – and stoked a nationwide conversation about the issues. Prosecutors have argued Clancy “acted intentionally, rationally and swiftly” when she fatally strangled her three children and attempted suicide at their Duxbury home on Jan. 24, 2023. Her defence attorneys have argued what’s known as the “insanity defence,” saying she is not criminally responsible because she was in the midst of a psychotic episode stemming from postpartum mental illness. Her family, friends and mental health professionals have said Clancy did not show any signs of psychosis before or after the killings and did not believe she was a danger to herself or her children. Those who knew her unanimously said she was a caring mother whose mental health was deteriorating. Clancy told one friend in January 2023 that a medication caused her to have “some dark thoughts,” the friend testified. Trial testimony began two weeks ago with opening statements and an emotional witness account from her husband, Patrick Clancy. Last week’s testimony focused on her mental health status before and after the killings, her physical injuries from her suicide attempt, and her friends’ and family’s concerns. Tuesday marks Clancy’s 36th birthday. The trial is expected to last six to eight weeks. Clancy faces life in prison if convicted of murder. She is being held at the public Tewksbury Hospital in Massachusetts, which specializes in treating those with mental illness. Concerns about lack of sleep Jollotta said one of her key goals with her treatment plan was to get Clancy a full night’s sleep. During an in-person appointment on Dec. 6, Clancy said her issues with insomnia first began after she took Zoloft, which kept her awake for 48 straight hours. Jollotta described that as an “unusual” reaction to the medication and said it suggested Clancy might have an underlying bipolar disorder. Jollotta was concerned Clancy was in a mixed manic or hypomanic state, meaning a combination of manic symptoms like lack of sleep, along with depression. By the following week, Clancy was back to regular sleep, but she still felt hopeless and numb, Jollotta testified. On Dec. 15, Clancy reported persistent intrusive thoughts of suicide and went to the emergency room at Massachusetts General Hospital, Jollotta testified. Clancy also went to the Women & Infants Hospital in Rhode Island for treatment, but she was discharged. Jollotta’s last contact with Clancy was on Dec. 21, 2022. Doctors and nurses speak on Clancy’s mental health On Monday, Clancy’s defence attorney Kevin Reddington sharply questioned Dr. Jennifer Tufts, Clancy’s primary psychiatrist, about her treatment plan and her expertise. Tufts saw Clancy 14 times between September 2022 to January 2023, repeatedly adjusting her prescriptions as Clancy grappled with anxiety, depression and insomnia. Clancy took about a dozen different medications between late 2022 and January 2023 as she tried to find the right treatment, according to testimony. “I think it’s my problem. I keep reaching out to different people and not sticking with the plan,” Clancy said, according to Tufts. Reddington challenged Tufts on her qualifications and experience, her use of telemedicine, her many prescriptions and her notes. He repeatedly cut off her answers with follow-up questions, leading to objections from the prosecution and admonishments from the judge. “If I ask you a question, respectfully, can you just not go on and ramble? Answer yes or no, that’s all,” Reddington said. “It’s sometimes impossible to do that,” Tufts responded. Tufts finished her residency in August 2022 and saw Clancy for the first time a month later. She testified she had treated at least 50 people with postpartum issues during her residency. Tufts’ and Clancy’s 14 visits were all conducted via telemedicine, and this trial is the first time they have been in the same room together, Tufts testified. Reddington challenged her use of telemedicine and noted she couldn’t even give Clancy a hug over the computer. “I couldn’t give her a hug, but that’s not actually something psychiatrists typically do with patients,” Tufts said. Tufts said she almost exclusively relied on Clancy’s own statements in evaluating her mental health. She did not speak to Clancy’s parents and only spoke to her husband at one session in December 2022. On Monday afternoon, Julie Paul, a psychiatric nurse practitioner, testified that Clancy in November 2022 had anxiety, felt overwhelmed and had racing thoughts, conditions that are “very typical” for postpartum patients. Paul prescribed Clancy Prozac and advised her that the medication takes some time to see benefits, but within days Clancy reported she wanted to switch to a different medication. This story has been updated with additional information. By Eric Levenson, CNN
