The trial of Lindsay Clancy, accused of murdering her three young children in 2023, is highlighting the controversial use of the antipsychotic medication Seroquel, particularly its prescription for insomnia.
Testimony revealed that Clancy was prescribed Seroquel, an FDA-approved antipsychotic, by her nurse practitioner. Initially, it was prescribed off-label for insomnia, with the dosage later increased for mood stabilization. The drug, known for its strong sedating effects, is a subject of debate regarding its safety when used for sleep, especially in an outpatient setting.
Clancy's defense team is reportedly seeking to attribute her alleged actions to a combination of prescribed medications, including Seroquel. Her journals have documented worsening anxiety, panic attacks, numbness, and intrusive thoughts after starting the medication. Whether Seroquel played a role in her mental state and subsequent actions is a central point of examination in the trial.
Medical professionals have expressed varying views on Seroquel's use. Some, like a psychiatric mental health nurse practitioner, described it as a "go-to" for agitated or delirious patients in intensive care units where continuous monitoring is possible. However, they cautioned that its use for ordinary insomnia in an outpatient setting presents different risks, including the potential for sleepwalking, a side effect that is difficult to manage at home.
Dr. Lauren Grawert, a psychiatrist and addiction specialist, noted that sedation does not equate to restorative sleep and that using Seroquel solely for insomnia involves a different risk-benefit calculation compared to its approved psychiatric uses. Other psychiatrists, like Dr. Gil Lichtshein, stated they rarely prescribe Seroquel due to its potency and potential for serious adverse effects, reserving it for patients with a clear psychiatric indication.
Patient accounts shared with The Post describe significant adverse experiences with Seroquel. One woman with bipolar disorder reported experiencing a "trance-like state" and severe sleepwalking, sometimes leaving her apartment while asleep. She also described intense withdrawal symptoms, including severe insomnia and days that felt like a blur, when attempting to stop the medication. Another individual, prescribed Seroquel for nightmares and anxiety, initially found some sleep improvement but continued to experience exhaustion and nightmares. She questioned the informed consent process when medications are prescribed for sleep, especially when they are potent drugs with known side effects.
Well-documented risks associated with Seroquel include weight gain, elevated blood sugar, and other metabolic changes. The FDA label also lists nervous system adverse reactions such as psychosis, hallucinations, and delusions. In 2010, Seroquel's manufacturer, AstraZeneca, paid a $520 million fine to resolve allegations of illegally marketing the drug for unapproved uses, including insomnia. While doctors can legally prescribe approved medications off-label, this past marketing issue adds a layer of scrutiny.
Online forums and support groups reveal a polarization of experiences with Seroquel. Some users describe the drug as life-ruining, while others credit it with stabilizing their mood and enabling them to sleep when other treatments failed. One individual who found mood stabilization with Seroquel also acknowledged the concerns surrounding its powerful effects when used off-label.
Another patient, diagnosed with bipolar disorder and treated with Seroquel for years, was later reevaluated and found not to have the condition. This individual empathized with Clancy's experience of "trialing and erroring multiple medications" and suggested that high patient loads in psychiatric care might lead to prescribing practices focused on immediate crisis management.
In January 2023, after reporting escalating anxiety and suicidal thoughts, Lindsay Clancy was admitted to McLean psychiatric hospital, where Seroquel was discontinued. Days later, her children were found dead.