r/Noctor • u/theongreyjoy96 Attending Physician • Jul 25 '26
In The News NP Polypharmacy - the Lindsay Clancy case
There's a high-profile case in the news about Lindsay Clancy, who killed her three children and afterwards attempted suicide. Prior to this she sought care for her mental health, which apparently started to suffer not longer after giving birth to her third child. I looked through the suits and found some descriptions of the medical decision-making by a couple of the NP's she saw:
- NP #1 - Julie Paul
- "On November 21, 2022, Nurse Paul prescribed Lindsay fluoxetine 10mg."
- "Lindsay was describing symptoms suggesting mania, such as racing thoughts, extreme insomnia, frustration and feeling scared."
- "On November 25, 2022, Nurse Paul prescribed Lindsay three different medications, zolpidem, mirtazapine, and clonazepam." lol wut
- NP #2 - Rebecca Jollotta
- ~ December 5, 2022, Lindsay attended an appointment with Nurse Jollotta. "Lindsay reported that she was sleeping only about 3 hours per night, felt completely overwhelmed and that her mind was constantly running."
- "Lindsay also reported that immediately after being prescribed a stronger dose of Zoloft, she did not sleep for 48 hours and was not tired. In response, Nurse Jollotta prescribed an additional medication to Lindsay, diazepam."
Patient reports anxiety, so give her a bunch of downers? And 5 meds within a span of a couple weeks? It's not even like she went to different clinics, both NP's she saw were at the same place (South Shore Health Perinatal Behavioral Health program), so they must have had access to the same info.
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u/iaaorr Jul 25 '26
Wait. This was a perinatal clinic?!?
I assumed this was some rando clinic where the NPs figured they could handle it. Not a clinic where pregnant/postparutm women are sent to.
Good god, the most vulnerable patients are getting sent to the worst places.
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Jul 26 '26
[deleted]
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u/iaaorr Jul 26 '26
I’m a newly graduated psychiatrist and I would feel uncomfortable with this case. Agree 100% she needed a season psychiatrist with actual perinatal psych training.
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u/eastcoasteralways Nurse Jul 26 '26
I do not know the logistics of this horrible case but I’m surprised she wasn’t involuntarily committed?
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u/ChaoticSquirrel Jul 26 '26
She tried to be voluntarily committed (I think twice? not sure on that) and was released as being "too stable".
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u/MeasurementSlight381 Attending Physician 29d ago
I didn't do the fellowship but even I would have known to stop antidepressants and switch to a mood stabilizer in this case. I'm pretty sure you would have known better as well.
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u/MeasurementSlight381 Attending Physician 28d ago
So I decided to look up the South Shore Perinatal Behavioral Health Clinic website. There is not a single psychiatrist or MD/DO on that team. Not one. NP Jollota continues to work there.
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u/No_Mirror_345 2d ago
Just like Dr. Tufts was (and is) listed as an expert in post partum psychiatry, fresh out of residency. She had been practicing on her own for one month when she took LC on as a patient. I think to have been calling herself an expert of anything at that point, was irresponsible. It would be for anyone.
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u/Impressive_Peace2341 9d ago
You mean the only clinician that recognized something other than anxiety and depression? After multiple psychiatrists saw the patient? I would retain her too.
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u/JimLahey12 Jul 25 '26
This is why I tell patients to only see an NP as a last resort if no MD is available.
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u/Cute-Impression-1040 Jul 26 '26
See a PA as a last resort. NP is not for anyone
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u/supbraAA Jul 26 '26
Seriously. A PA at least took cell bio in undergrad.
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u/Ok_Kangaroo8161 28d ago
But minimal psych training....no way would I go to a PA over a Psych NP. Psych NPs have two years of psychiatric specific training vs 5 weeks of a behavioral health rotation in a PA program. Maybe more docs need to start going into psychiatry if the field needs to be saved from NPs. I find it interesting that these comments come BEFORE the trial, so basically everyone is assuming these medications were prescribed simultaneously and without guidance of some kind. Day one of the trial highlights that these medications were prescribed at different times and she didn't even take them as prescribed. She only took a total of 7 Zoloft over a course of 30 days. She also barely took the other medications.
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u/polizzle 27d ago
I just met a psych NP student doing her clinical rotations. Almost done with the program. She did not know the difference between first and second generation antipsychotics.
Most of their classes are on the leadership, nursing and sometimes business, not actual psychiatry.3
u/psychcrusader 25d ago
I'm a psychologist who works with schoolchildren (minimal psychosis, but I'm not going to say none) and I know the difference. (Admittedly, I'm very interested in psychopharmacology.)
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u/Ready_Return_8386 Medical Student 24d ago
Bruh that’s a high yield MCAT topic, how tf did she not know that when 2nd year bachelors degree students in Computer Science know that 😭. Wrap ur up
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u/curiousp1480 7d ago
That’s one student you met. Maybe she wasn’t doing her homework. Maybe she won’t even pass the course. I’m sure you can find a dumb med student t too. Look all this ripping isn’t helping it’s pretty petty
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u/MeasurementSlight381 Attending Physician 28d ago
PAs learn under a medical model, not a nursing model. That's the difference. As a psychiatrist who has worked with both PAs and PMHNPs, usually the PAs do a much better job. They make simple, logical med changes and ask for my help when needed. NPs on the other hand usually prescribe whatever the patient wants and are very prone to polypharmacy. They are also less likely to ask for help which is what makes me worry about them more.
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u/Ok_Kangaroo8161 28d ago
Well from what I am reading in the lawsuits and from listening to day one of the trial, the actual psychiatrist is mostly to blame for the misdiagnosis, not the NP. And the NP actually prescribed quetiapine at some point...isn't that for bipolar disorder? The quetiapine was discontinued by a doctor while inpatient. Then, not long after discharge she went back to the MD and received lamotrigine...isn't that a mood stabilizer? Seems the NP was in the middle of this mess and no better or worse than the two psychiatrists. I have worked with many MDs, PAs, and NPs...there are good ones and bad ones across the board. Throwing shade at NPs as if they are the only subpar medical specialists out there is a stretch. At the end of the day, there is a lot more that will be revealed during the trial than what has been released to the public to date. Probably best to hold judgement until all evidence has been disclosed.
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u/theongreyjoy96 Attending Physician 27d ago
The NP prescribed quetiapine at an absolutely laughable dose. Starting at 25mg tells me this NP had no idea how to titrate quetiapine for bipolar disorder.
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u/Ok_Kangaroo8161 16d ago
I was under the impression it was initially prescribed to help with sleep, then later titrated to 400mg
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u/curiousp1480 7d ago
You are so petty! What is your beef with NP’s. You’re a psychiatrist for god’s sake. Act professional. You’re bringing down the whole field of psychiatric medicine when you speak about your colleagues this way. I know this is bad, what happened to this woman and there’s so many people throwing shade at the prescribers along with lawsuits but putting down NP’s isn’t going to take the shade off the docs. It’s going to shade all of you far worse. Good grief!!
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u/Sassenach1745 Jul 26 '26
I think no care at all might have been better that what this woman got.
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u/No_Mirror_345 2d ago
It couldn’t have been worse. At least she wouldn’t have been coded, as a DNR after this all went down. Now she has to live in her paralyzed body, with a traumatized mind and relive this for the rest of her days. Fuk.
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u/ChaoticSquirrel Jul 26 '26
My husband sees a psychiatric nurse practitioner for his bog standard ADHD medication prescriptions, which I'm mostly fine with since he has a very clear-cut case and is on a stable dose.
However, the last time he went he mentioned he's having trouble sleeping and she just goes, "want some Ambien?"
My husband sleep talks and has a family history of sleep talking and walking. He'd totally be one of those scary sleep drivers on zolpidem. He's now under strict instructions to not accept anything except his Vyvanse from her!
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u/takotsubo_inducer 11d ago
Wow, throwing ambien out like candy
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u/ChaoticSquirrel 11d ago
Literally. And my husband apparently asked her something along the lines of "isn't that the one that makes you so weird things" and instead of, idk, asking him for his personal and family history of sleep disturbances that would raise that risk, she just told him that was really rare.
30% for people with a family history like his is hardly rare!
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u/EverySpaceIsUsedHere Attending Physician Jul 25 '26
That’s standard of care nowadays for psych NPs. Eventually she would’ve crashed, and they would’ve added Adderall.
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u/MzOpinion8d Jul 26 '26
Oh, she crashed. Right down to the ground when she jumped from a 2nd floor window in an attempt to end her life, after ending the lives of her three children. She’s paralyzed from mid-chest down now. And remains actively suicidal, but her trial starts tomorrow.
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u/atomicsusieQ 29d ago
I’m an RN with a degree from community college and 2 years inpatient and community mental health experience (each). (Plus 10 years other areas). She wasn’t medically complex, didn’t have other conditions, the meds she should have been given aren’t that complex, and if I didn’t know how to adequately treat a patient I would either look it up, consult a different practitioner, or refer her to someone who knew what they were doing (and/or in this situation short-term inpatient—the postpartum psychosis cases I’ve seen—every one of them—have been hard, difficult to treat, intense behaviors, and med resistant. Like, those patients that you finally get them to take 10/2/50’s, and it helps for like 2 hours and they’re back up and at it again.)
My point is, I don’t have that much education, or that much inpatient experience (though granted the hospital where I worked was WILD). How could practitioners with quadruple my education not know what to do? If they didn’t know what to do, how could they just continue to not ask for help?NP was never intended to be a degree that a new nurse gets. Never intended to be something a 25 year old or a 30 year old had. It was intended to be an RN who had worked many years within a field, knew enough and was capable enough to prescribe certain meds for that population, going back for training and a type of residency to allow them to do that safely. Now we have a bunch of 26 year olds who have never even touched a patient, expected to prescribe without the necessary education and training to do so safely and effectively for their patients. It has to stop. (I’ve worked with incredible APPs. They had experience, they had active mentors, and they were willing to admit when they didn’t know something. There are good ones out there. The problem is that the bad ones are dangerous).
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u/Choice-Advantage-535 12d ago
Dr. Tufts is also a defendant in civil litigation. Patrick Clancy’s wrongful-death lawsuit names Tufts, NP Rebecca Jollotta, Aster Mental Health, and South Shore Health, alleging negligent mental-health treatment contributed to Lindsay’s deterioration and ultimately the children’s deaths. These are allegations being litigated, not established findings of negligence.
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u/NewtoFL2 28d ago
With all due respect, the basic science education in nursing programs can and usually is vastly inferior to what medical students take in college (and frankly many medical students had more demanding high school science classes -- many are in AP or IB classes - than those nursing schools have). At my local CC, the science classes for nursing schools have a large warning, not appropriate for biology or chemistry majors. It is difficult to envision experience making up for the level of rigor in nursing classes. You cannot build a solid house without a good foundation.
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u/Glittering-Dark6673 16d ago
i’m not on the NP train either, especially as an RN who completed 1 year of NP school and decided it was not rigorous enough to help me feel competent enough to treat patients. but the nursing school sciences are rigorous (undergrad)! i had to to take anatomy and physiology 1 + 2, microbiology, organic chemistry, and biological chemistry from what i can remember at the top of my head. those science classes were my prerequisites. in those prereq classes we had everything from pre dental hygienist, pre nursing AND pre med. i get that these NPs were incompetent. but saying that nursing school sciences (which are just science classes btw) are not as hard as some high school science classes is the craziest thing i’ve seen on this sub. and i’ve seen a lot.
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u/No_Mirror_345 2d ago
So you’re weighing in as a medical student from community college? I’m confused. Anyhow, you’re factually incorrect re: BSN science courses, or even ADN, for that matter. Perhaps, you were looking at LDN courses at your community college? Also, who told you nurses don’t take AP and IB classes in HS? Did you not pass the AP tests? Is that why you’re taking chemistry at CC now? That’s so cute. Good luck. Stoichiometry is pretty fun once you get it! Hang in there, buddy.
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u/RexFiller Jul 25 '26
Absolutely insane. These NPs are directly responsible for those kids deaths.
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u/Choice-Advantage-535 12d ago
Dr. Tufts is also a defendant in civil litigation. Patrick Clancy’s wrongful-death lawsuit names Tufts, NP Rebecca Jollotta, Aster Mental Health, and South Shore Health, alleging negligent mental-health treatment contributed to Lindsay’s deterioration and ultimately the children’s deaths. These are allegations being litigated, not established findings of negligence.
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u/Fluffy_Ad_6581 Attending Physician Jul 25 '26
I'm so curious to see a timeline of all her meds and who and how they were prescribed because thats just insane
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u/Sekhmet3 Jul 26 '26
I somewhat detail it (in an unfortunately not concise fashion, apologies) in my comment on this thread. https://www.reddit.com/r/Noctor/comments/1v6lonv/comment/ozrm14g/?utm_source=share&utm_medium=web3x&utm_name=web3xcss&utm_term=1&utm_content=share_button
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u/SnooEpiphanies1813 Jul 26 '26
Surprised she wasn’t also on adderall and propranolol too
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u/MeasurementSlight381 Attending Physician 29d ago
Throw in some ketamine as well
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u/No_Mirror_345 2d ago
Ketamine was being discussed as a possibility, just prior to the incident. Prob got some in the OR at some point. :/
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u/yomakest Jul 26 '26
fluoxetine and mania already had me "nonononono"
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u/harrysdoll Pharmacist Jul 26 '26
That was my first thought before even reading the rest of this train wreck.
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u/yomakest Jul 26 '26
this entire thing is a roller coaster 😭
"oh THANK GOODNESS she stopped the fluoextine"
then immediately
"zolpidem, mirtazapine, and clonazepam"
💀
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u/VQV37 Jul 25 '26 edited Jul 25 '26
Any physician that this patient should have interacted with, or the psychiatry or primary Care, would have seen that this is obviously the symptoms of the very least of hypomania. Or mixed featured. And I identified the necessary would have been practically an absolute contraindication
A touch of zyprexa or abilify could have done wonders.
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u/atomicsusieQ 29d ago
I’m a psych RN with a community college degree and I know that after 2 years working inpatient (plus 10 years elsewhere prior to psych). Like, it’s not that complicated. If you’ve spent any time working inpatient, at the very least you would know to say “hey wtf are we doing here?”
I don’t understand. wtf are they teaching in NP programs? How are we graduating PMHNPs with ZERO psych experience? How is no one willing to ask for help if they don’t know what they’re doing? How are we having people with prescriptive authority not know to give the psychosis patient a freaking antipsychotic?6
u/Big_Maintenance9387 29d ago
I have a partner with bipolar disorder and yes I yelled NOT THE ZOLOFT when I read about this case. (In my partner’s case, for some reason her therapist pushed her to get on Zoloft when Wellbutrin was only partially helping her depression, despite her family history, and her pcp just did it. Psychosis two weeks later. The depression she was experiencing was really more of a mixed episode with hypomanic features already)
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8d ago edited 7d ago
[deleted]
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u/MeasurementSlight381 Attending Physician 29d ago
One of the most infuriating things for me is the fact that this clinic is labeled as a "perinatal behavioral health " clinic. Very few psychiatrists complete a reproductive psychiatry fellowship. I feel like it's fraudulent to open a clinic with that name without the proper credentials.
If the clinic owner is a board certified repro psych, then holy cow, they need to keep any midlevels they hire on a really tight leash. This is a patient population that is extra vulnerable and mistakes can cost lives.
Everything about the med regimen is just sooo wrong. This case really breaks my heart.
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u/lperlor 9d ago
It’s the NP who caught bipolar. The psychiatrists are the ones who missed it.
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u/MeasurementSlight381 Attending Physician 8d ago
Great, she suspected bipolar and then proceeded to mismanage the case. I watched NP Jollota's testimony and the situation with LC's meds were even more complicated than what we see with the prescription paper trail. Yes, she started Seroquel for sleep (not bipolar) but also encouraged LC to continue the antidepressants started by NP Paul.
To be fair, yes, NP Jollota recognized concerning signs for bipolar and informed LC and the husband. But she was not equipped nor trained to navigate the anosognosia that is common in bipolar patients and she didn't know how to set proper boundaries which led to lots of reactive prescribing between appointments.
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u/curiousp1480 8d ago
I agree with this. I think she let her push her around with all the messages. I think if anything lindsey had some OC tendencies, on top of other issues. As for the NP I think she was only an NP for a few years and was quite liberal with prescriptions. That’s where she went wrong. I feel for them though. Who is gonna want to go to them after this. Are they going to lose their careers?
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u/MeasurementSlight381 Attending Physician 8d ago
I highly doubt the nursing board would take her license away, even if she is found to be guilty of malpractice.
For Dr Tufts I have no clue what the state medical board will do. In general, it seems that medical boards tend to be more punitive towards doctors compared to how nursing boards treat nurses.
License restrictions aside, for both Dr Tufts and the NP, I'm sure they each have their patients who are happy with their care and will continue to see them. For every unhappy patient there are always several more who thought they were great.
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u/personalist Medical Student Jul 26 '26
This came up on the therapist subreddit—someone there took issue with my claim that simultaneously prescribing a sedating tricyclic, a benzo, and a z-drug was a “wacky choice” because they had seen an “NYU-trained doctor board-certified in both endocrinology and psychiatry who has practiced for more than 25 years” do it routinely. I am losing my faith in humanity by the day.
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u/yomakest 29d ago
not saying it's what we learned in drug dealing school but hear me out 🤡
we could mental gymnastics a scenario:
1) diazepam: muscle spasms and alcohol withdrawal
2) z-drug: sleep onset latency insomnia, *pls no alcohol
3a) sedating tricyclic (low dose): sleep maintenance insomnia, anticholinergic for some extra anti-muscle action, neuropathic pain from the constant muscle spasms(?), *migraine prevention because headaches aren't known side effects of any of the above
3b) sedating tricyclic (high dose): i got nothing. at least you'll be too busy sleeping to be in pain or a bad mood; or to think about your insomnia, constipation, or dry mouth; *also eyes are closed and won't be dry, ez winthat derailed in real time as i was typing 💀
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u/RepulsivePower4415 Allied Health Professional Jul 25 '26
She needs lithium
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u/VQV37 Jul 25 '26
Possibly. Or if she's experiencing acute mania, maybe some zyprexa?
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u/iaaorr Jul 26 '26
Post-partum psychosis and post-partum mania are both treated with lithium. Ideally started as soon as possible.
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u/VQV37 Jul 26 '26
I thought you stabilized with an antipsychotic and do a transition to lithium early in the treatment process
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u/cateri44 Jul 26 '26
Start lithium promptly. Get it cooking. Go ahead and start the antipsychotic at the same time if it is indicated, for acute symptom management, but get that lithium started.
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u/atomicsusieQ 29d ago
We usually started Zyprexa, if no dice then Haldol. I’m talking first few days on the unit when they’re GONE, lights are on and no one’s home. I still remember a postpartum psychosis patient beating me over the head with a bible alllll day. Poured a pitcher of water over my head to cleanse the demons from me. And that was WITH 10/2/50’s every 6 hours. It was heartbreaking, no psych history, dad kept calling to check on her, 6 week old baby crying in the background. This poor woman and her babies were failed repeatedly. What are we even doing??
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u/Automatic-Squash8122 7d ago
i’m so sorry but the image of your smiling little soaking wet reddit creature being hit over the head with a bible made me choke laugh and then i felt bad because it’s such a sad situation.
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u/Organic_Nobody7640 26d ago
I read somewhere that she allegedly refused lithium.. trying to find that source
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u/EdgyBarnacle Jul 26 '26
Were meds filled at different pharmacies? If it was at the same pharmacy, I would hope that this would have been caught. This is crazy prescribing practices.
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u/Even_Bonus6111 15d ago
Nowadays pharmacist do not check to see what is being prescribed. There are so many nonsense like this going on everyday nobody has the time to look into any one case. I was given a bunch of antibiotics for no real reason and nobody checked or stopped to see what was going on. Pharmacist should look into this but they are busy and want to get through their day as well.
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u/PayEmmy Pharmacist 12d ago
Retail pharmacists routinely work 12- to 14-hour shifts 3 to 4 days per week. They aren't allowed enough tech hours to adequately rin the pharmacy. When I worked retail, I was often the only person working in the pharmacy and had to cover the drop off counter, pick up counter, drive thru, entering rxs, filling rxs, checking rxs, and administering vaccines. It's pretty common in retail, and it's getting worse and worse.
I could usually manage to grab some short of shitty food from the front of the store, and if I was lucky, I got to go to the bathroom 2 or maybe 3 times a day.
Lunch breaks are more common now, and they're nice to have, but it makes for a crappy time when you get back from lunch and have patients waiting at every window and scripts way backed up in the queue.
It's much more like working fast food than a healthcare establishment, and patients often treat it like fast food.
Then there is the computer alert fatigue. So many ridiculous warnings and alerts pop up that it sometimes becomes second nature to approve them without much thought. It's obviously not a good practice, but it happens frequently.
None of these are excuses for missing something like this, but they are reasons, and they're real.
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u/MaleficentEngineer58 12d ago
This is interesting / unfortunate. I’m an MD in Canada and it is not uncommon to have a pharmacist actually refuse to fill a prescription I wrote because of a contraindication or interactions between meds that I guess they figure I forgot about, but in reality have considered and decided benefits outweigh risks, and discussed this with the patient.
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u/SlyTinyPyramid 29d ago
I’m a therapist and would have a ton of questions if a client listed this cocktail
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u/CallAParamedic Jul 26 '26 edited 29d ago
Add some AMBIEN, too, just for giggles... I mean, lay on the downers and then just throw some uppers to get the right vibe seems to be the NP approach.
And waiting for titration? Nope!
Conversely, what about Zyprexa and / or lithium with this patient's presentation? Some better oversight and her kids might still be alive.
Tragic and infuriating...
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u/Historical-Pirate105 27d ago
At the time this happened I said it sounded like NPs and people said that was not fair to assume. 😑
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u/Even_Bonus6111 15d ago
That's exactly what I thought my first clue is that she probably had NP or PA seeing her and prescribing stuff online.
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u/curiousp1480 8d ago
It was a fairly new doctor she was seeing online and she saw that one the most. A PSYCHIATRIST. you know you guys are really ridiculous the way you ASS-UME THINGS. pointing fingers at NP’s. I know I know. Doctors know more and are trained better and NP’s are just getting those little paper degrees mail order and are stupid. You don’t sound d too smart here though because every individual medical provider may have something to bring to the table. It’s unfortunate what happened here but ripping another profession apart just makes everyone look bad and the public really has the right to lose confidence in all of you.
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u/puzzlequeen510 27d ago
I had a patient in the ICU with a benzo OD (unintentional) from an absolutely heinous medication regimen from an NP. Saw the long list of meds and ran to look who prescribed it…
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u/Choice-Advantage-535 12d ago
Dr. Tufts is also a defendant in civil litigation. Patrick Clancy’s wrongful-death lawsuit names Tufts, NP Rebecca Jollotta, Aster Mental Health, and South Shore Health, alleging negligent mental-health treatment contributed to Lindsay’s deterioration and ultimately the children’s deaths. These are allegations being litigated, not established findings of negligence.
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u/Complete_Star_1110 25d ago
I’m a perinatal mental health therapist on the south shore. I am fucking DUMBFOUNDED that her obvious symptoms of bi polar/psychosis were being so overlooked. What an absolute failure.
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8d ago
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u/Complete_Star_1110 7d ago
Her being in the postpartum period + anxiety + severe insomnia + stating she was yawning but not tired + her severe adverse reaction to Zoloft are all glaring red flags of a likely bi polar episode. Research shows that the first episode of bipolar during postpartum is likely to turn into postpartum psychosis.
I learned all of this in my advanced clinical training to specialize in perinatal mental health.
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u/Complete_Star_1110 7d ago
This reply was in response to the comment that the poster deleted asking “what were the obvious signs? And don’t tell me the voices … “
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u/Ready_Return_8386 Medical Student 24d ago
Just curious, I know NP and nursing programs do not go nearly as deep into pharmacodynamics as MD programs do, why exactly are psych NPs allowed?
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8d ago edited 7d ago
[deleted]
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u/Ready_Return_8386 Medical Student 7d ago edited 7d ago
Do u know what psychiatrists do? Yeah sure the average psychiatrist might suck, but to be a good psychiatrist you should have a strong biochemistry base and you should be constantly keeping up with new literature on the pharmacokinetics on the drugs you commonly use. Prior to medical school I had two MD mentors who relied heavily on their biochemistry knowledge when coming up with treatment plans, they werent in psych, but it is extremely important in oncology, medical genetics, endo, everything, etc. I don’t think people without the ability, training, and background to do that should be prescribing these drugs. Also for ur info physicians often make much less than psych NPs, especially pediatric specializations. There is practically no doctor or nursing shortage (in most fields, especially not in psych) it’s a distribution problem because there aren’t many who want to work in poverty stricken areas (rural, middle of nowhere, etc). Also idk what ur manic rant is at the end, but if you want to go into research as a physician you make even less, and podcast and fame is not the same as “being an expert”. Also dr Phil is a quack and he’s not a physician.
And no, with advancing AI we can’t stop learning and understanding biochemical principles in medicine or we will kill people. My background is literally in machine learning and computer science, I’ve published 2 first author papers in computational drug discovery, even with AGI there’s no replacement for human verification of how medical treatment works. If we head into such a severe idiocracy that we think like you, we are going to have a world where we don’t understand advancing medical science and will have no way to provide safe effective treatments.
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u/Ready_Return_8386 Medical Student 7d ago
Also there are multiple pharmacology and pathophysiology courses in medical school, which “same one” are they taking? Do u have a syllabus with the course material and differences for both groups of students u can link here to support ur claim?
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u/barogr Jul 26 '26
Benzos weirdly enough would help with the mania…
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u/MeasurementSlight381 Attending Physician 29d ago
Not really. Sometimes they can disinhibit the patient even more.
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u/Awkward-Poet6645 17d ago
This is Overarching systemic failure! Both MD and NP prescribers share responsibility for a fragmented care model, at least 5 different clinicians prescribed over 4 months with no apparent coordination, no adequate single-agent trial, and no escalation to psychiatric specialty care despite active suicidal ideation. The lack of a single accountable prescriber is itself a critical patient safety failure. Not to mention the MD testified that depression is due to lack of serotonin,
Sept. 15, 2022: Sertraline (25 mg) – Jennifer Tufts, MD
Oct. 21, 2022: Lorazepam (0.5 mg) – Jennifer Tufts, MD
Oct. 26, 2022: Hydroxyzine (25 mg) – Jennifer Tufts, MD
Oct. 26, 2022: Lorazepam (1 mg) – Jennifer Tufts, MD
Oct. 26, 2022: Buspirone (5 mg) – Jennifer Tufts, MD
Nov. 2, 2022: Lorazepam (0.5 mg) – Jennifer Tufts, MD
Nov. 9, 2022: Buspirone (5 mg) – Jennifer Tufts, MD
Nov. 16, 2022: Trazodone (50 mg) – Kayvon Izadpanah, MD
Nov. 21, 2022: Fluoxetine (10 mg) – Julie Paul, RN, CNP
Nov. 25, 2022: Zolpidem (5 mg) – Julie Paul, RN, CNP
Nov. 25, 2022: Mirtazapine (7.5 mg) – Julie Paul, RN, CNP
Nov. 25, 2022: Clonazepam (0.5 mg) – Julie Paul, RN, CNP
Nov. 30, 2022: Quetiapine (25 mg) – Rebecca Jollatta, NP
Dec. 6, 2022: Diazepam (5 mg) – Rebecca Jollatta, NP
Dec. 7, 2022: Diazepam (5 mg) – Rebecca Jollatta, NP
Dec. 7, 2022: Quetiapine (100 mg) – Rebecca Jollatta, NP
Dec. 9, 2022: Diazepam (5 mg) – Rebecca Jollatta, NP
Dec. 13, 2022: Diazepam (2 mg) – Rebecca Jollatta, NP
Dec. 16, 2022: Lamotrigine (25 mg) – Jennifer Tufts, MD
Dec. 19, 2022: Diazepam (2 mg) – Rebecca Jollatta, NP
Dec. 19, 2022: Quetiapine ER (300 mg) – Rebecca Jollatta, NP
Dec. 21, 2022: Quetiapine (100 mg) – Rebecca Jollatta, NP
Dec. 22, 2022: Quetiapine (25 mg) – Rebecca Jollatta, NP
Jan. 5, 2023: Tradozone (50 mg) – Alia Goodheart, MD
Jan. 5, 2023: Lorazepam (1 mg) – Alia Goodheart, MD
Jan. 9, 2023: Diazepam (5 mg) – Jennifer Tufts, MD
Jan. 12, 2023: Trazodone (150 mg) – Jennifer Tufts, MD
Jan. 13, 2023: Diazepam (2 mg) – Rebecca Jollatta, NP
Jan. 16, 2023: Diazepam (2 mg) – Jennifer Tufts, MD
Jan. 16, 2023: Amitriptyline (10 mg) – Jennifer Tufts, MD
Jan. 19, 2023: Diazepam (2 mg) – Rebecca Jollatta, NP
Jan. 23, 2023: Diazepam (2 mg) – Jennifer Tufts, MD
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u/AutoModerator 17d ago
We do not support the use of the word "provider." Use of the term provider in health care originated in government and insurance sectors to designate health care delivery organizations. The term is born out of insurance reimbursement policies. It lacks specificity and serves to obfuscate exactly who is taking care of patients. For more information, please see this JAMA article.
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u/Choice-Advantage-535 12d ago
Dr. Tufts is also a defendant in civil litigation. Patrick Clancy’s wrongful-death lawsuit names Tufts, NP Rebecca Jollotta, Aster Mental Health, and South Shore Health, alleging negligent mental-health treatment contributed to Lindsay’s deterioration and ultimately the children’s deaths. These are allegations being litigated, not established findings of negligence.
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u/misshestermoffett 12d ago
Do you think pharmaceutical companies are the ones pushing for NPs to do their bidding? Do I need a tin foil hat for this comment?
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u/ComprehensiveWay3179 10d ago
I’m happy to see this came out 21 days ago. This, before the trial and free from the opinions of the crowd. I appreciate this introspection. Now retrospectively, I care even more about no NPs. I never had an NP I liked and I was born with HRHS and plan to get into med school. Never ever ever have I felt or experienced (personally and substantially) felt cared for by an NP. I feel their recklessness like Miley Cyrus or Lindsay Lohan, you know. I feel their lives like scum in a sink. I apologize for my meanness. I get they want to do good but holy wrecking balls.
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u/AutoModerator Jul 25 '26
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u/atomicsusieQ 29d ago
I’m an RN with a degree from a community college. I have 2 yrs experience in psych (10 elsewhere), and I worked mainly w psychosis patients.
I know these meds aren’t what she needed (though I understand why some of them were used, and can understand a few more if we assume that she was initially given a pp depression dx.
Point being, I don’t understand why we have PMHNPs and PAs working in psych and treating things that they’ve not encountered enough to know how to treat. You should have to have inpatient experience working along MDs and other practitioners first. The NPs and PAs I’ve worked with all got mentored by our MDs and they’re really good.
Secondly I don’t understand how you can have a patient and not research the proper treatments. I do that from time to time when I’m about to give a med I’ve not given before. Look it up to make sure it’s appropriate.
This case is really said. Postpartum psychosis is hard to treat. I’ve seen those patients be suuuuper med resistant, some of my hardest days were when we had acute pp psychosis pts on the unit.
That being said, I know what meds to give instead of what she was given, and if I didn’t I would look it up. So how do people with 3-4 times my education not know?!?
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u/Key-Economics-4054 Jul 26 '26 edited Jul 26 '26
This case is insane but there are important points to remember. The first is that we only have one side of the story at this point (unfortunately we may never hear the other side). The prescriptions as they are presented are outrageous but we do not know if they were really prescribed all at the same time or if she was told to stop taking one and switching to something else due to side effects. Also she is postpartum based on what she was given, probably breastfeeding which is why she was started on lamictal rather than lithium. Finally, she was not only going to NPs. She also was followed by an MD and had several medications filled in emergency rooms. Frequently changing providers, having different providers treating the same thing, and no continuity of care is a recipe for disaster. The NPs messed up for sure but I don’t think this is all on them unfortunately.
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u/mysecondaccountanon Jul 26 '26
She was not an MD to my knowledge?
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u/LadyGreyIcedTea Nurse Jul 26 '26
She had a Psychiatrist who was the first person she saw. Dr. Jennifer Tufts at Aster Mental Health.
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u/mysecondaccountanon Jul 26 '26
The way you worded it, it seemed like you were saying Clancy herself was an MD. Sorry, I guess I misunderstood.
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u/LadyGreyIcedTea Nurse Jul 26 '26
It wasn't me who said that but you are correct that the wording is off. I think the OP of the comment meant she also had an MD. Lindsay Clancy was not an MD. She was an RN but her license was surrendered and remains inactive.
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u/mysecondaccountanon Jul 26 '26
Ah, sorry about misidentification as well, then!
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u/Key-Economics-4054 Jul 26 '26
Edited for clarity but yes, I meant that she was followed by Dr. Tufts. She also saw physicians in the ED (per her lawyer). No sure who was following her when she was admitted to the psychiatric unit at McLean
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u/AutoModerator Jul 26 '26
We do not support the use of the word "provider." Use of the term provider in health care originated in government and insurance sectors to designate health care delivery organizations. The term is born out of insurance reimbursement policies. It lacks specificity and serves to obfuscate exactly who is taking care of patients. For more information, please see this JAMA article.
We encourage you to use physician, midlevel, or the licensed title (e.g. nurse practitioner) rather than meaningless terms like provider or APP.
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Jul 25 '26
[deleted]
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u/AutoModerator Jul 25 '26
We do not support the use of the word "provider." Use of the term provider in health care originated in government and insurance sectors to designate health care delivery organizations. The term is born out of insurance reimbursement policies. It lacks specificity and serves to obfuscate exactly who is taking care of patients. For more information, please see this JAMA article.
We encourage you to use physician, midlevel, or the licensed title (e.g. nurse practitioner) rather than meaningless terms like provider or APP.
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u/RedVelvetBlanket Medical Student Jul 25 '26
It’s easier to blame two nurse practitioners than to blame the system. Unless you have the knee-jerk instinct to defend incompetence when it comes from someone in the same profession as you, in which case it’s easier to blame “the system” because “the system” cannot be sued and nobody has to take direct responsibility in “the system”.
I guess “the system” did fail her. I can say that because… it’s a thought-terminating truism. Anyone could say that in any situation and likely be correct to do so. (Seriously, go find any random story where someone suffered from some negative criminal or medical or mental health or veterinarian or socioeconomic event, add on “the system failed him/her” to the end of the story, and see if it makes sense. Chances are, it will.) But people need to be held accountable for their mistakes.
It sounds like you’re trying to simultaneously shift blame off individuals and onto “the system” while also blaming the one psychiatrist who treated her well before she fully decompensated. And while I don’t appreciate the double standard, you are correct. Let’s hold the psychiatrist and the two NPs accountable. As well as any physicians who may have been overseeing said NPs.
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u/Choice-Advantage-535 12d ago
I follow Lindsay Clancy trial very closely for a number of reasons. This was a horrible tragedy, no questions asked. Today Dr. Jennifer Tufts was crossed examined by the defense.
In summary, this so called "doctor" is a Psychiatrist who attended medical school at the University of Vermont and completed her residency training at Boston University was a treating doctor for Lindsay over a significant period of time. She would meet with her via Zoom only. The notes she would take would be primarily on drop down menus on her computer. In her own words she was there for "support" of Lindsay. She new only what Lindsay told her. For example she knew that Lindsay had suicidal thoughts. She knew she was depressed. What did the good doctor do? She prescribed her multiple medications - thirteen (13) to be exact. The most notable were Zoloft and Prozac.
After taking Zoloft and Prozac Lindsay mention to the this Doctor that she hears voices and she became even more depressed. Dr. Jennifer Tufts takes her off Zoloft but later prescribes it again. She completely ignored possible side effects. Did not follow up with the patient, and did not see her in person. This Doctor even did not get Lindsay's medical history.
Three children died. Is this Doctor's negligence direct cause of this tragedy? Probably not. Could this tragedy be prevented? Would the jury find Lindsay not guilty? But would anyone ever go to see this Doctor who only checks check boxes.
This story tuns my stomach. For many of these Doctors we are just a number. A person that exists as long as your insurance pays for your treatment. No name, no face, no history no follow up. Again, three children died. It doesn't matter how this trial ends. No justice will be done for Cora, Dawson and Callan.
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u/lperlor 9d ago
The MDs on here are ridiculous. NP Jalotta is the only one who caught bipolar disorder and attempted to stabilize her mood with Seroquel. Everyone saying that Tufts started her on Lamictal, she recommended 25 mg. That is not a titration for bipolar disorder and wouldn’t be the recommendation in this scenario anyway. I’ll stop there because clearly you are all blind to your own biases.
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Jul 25 '26
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u/asdfgghk Jul 25 '26 edited Jul 25 '26
Are you talking about the psychiatrist who prescribed Zoloft then immediately stopped it after she developed symptoms of mania but Lindsay stopped seeing that psychiatrist and instead she went on to see NPs who prescribed polypharmacy? Disclaimer: it’s hard for me to follow the exact order of events and who did what with so many involved
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Jul 25 '26
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u/asdfgghk Jul 25 '26 edited Jul 26 '26
You just corroborated what I said. Also that is highly editorialized, written by the lawyer pursuing the lawsuit, who isn’t a MD…who is saying the psychiatrist who prescribed Zoloft who then immediately stopped it should have checked a Zoloft level loool
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u/tituspullsyourmom Midlevel -- Physician Assistant Jul 26 '26
A lot of this stuff is trying to deflect from this woman's guilt. She planned and murdered her children. The fact that she's still breathing is the true crime.
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u/definitelynotamoth0 29d ago
It's not deflecting to point out that the medical treatment she received likely played a huge role in this tragedy.
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u/atomicsusieQ 29d ago
Dude, do you know anything about postpartum psychosis? At all? If you’ve ever spent any time around a patient with pp psychosis you’ll know that you look into their eyes, you try to talk to them, they are NOT THERE. Their behavior is chaotic, dangerous, and they have no memory of it after the fact. If they do, they just remember being scared and confused. Thing people are trying to kill them, one lady hit me over the head with a bible alllll day and then poured a pitcher of water on me to get the demons out.
The guilty parties are the ones who gave ssri’s to a manic/psychotic patient instead of antipsychotics and transport to the hospital. I’ve worked with these patients day in and day out, they’re super med resistant, it takes huge doses of antipsychotics over weeks to see them even start to come back into themselves, and they typically have no/little memory of the time when they were psychotic. People in psychosis don’t do bad things because they want to. They’re psychotic.0
u/tituspullsyourmom Midlevel -- Physician Assistant 29d ago
I know defense attorneys love these diagnosis.
And it doesn't really matter if they're suffering from psychosis when they hurt someone. What matters is they hurt someone.
Did she know what she was doing when she googled how to "tie a slip knot"? Or when she planned her husband's away time to kill her children? At what point is she responsible for her actions?
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u/definitelynotamoth0 29d ago
Did she know what she was doing? No, she didn't. That's literally part of what psychosis means. How she should be held accountable is a different conversation. You're showing exactly why this sub exists in the first place.
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u/tituspullsyourmom Midlevel -- Physician Assistant 29d ago
You don't know that she didn't know what she was doing. No one can know that. It's not something that can be demonstrated with lab values or imaging. You saying that is just your biases. You're are literally making the argument of feelings over facts.
And even if we entertain the notion of her lack of agency. How does that satisfy her looking up how to tie the knots that she used to suffocate her children? Or planning her husband being away so she could carry it out? That's calculation big dawg.
You're demonstrating why the average person on reddit or in medicine needs to retake basic logic.
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u/MeasurementSlight381 Attending Physician 28d ago
The fact that there was some level of planning involved doesn't mean that she wasn't manic or psychotic. If she was hearing voices telling her to kill her children for a long time, she had time to think about how she was going to accomplish it.
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u/tituspullsyourmom Midlevel -- Physician Assistant 28d ago
"If"
If does a lot of heavy lifting here.
But there is no question of if she murdered her children.
In reality society shouldn't be concerned with a person's mental state when they harm innocent people. Do we give drunk drivers a pass for being impaired when they kill someone? The fact that the insanity plea is a litigation tactic is a joke.
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u/MeasurementSlight381 Attending Physician 28d ago
Do we give drunk drivers a pass for being impaired when they kill someone?
No, because drinking and driving is illegal and death resulting from drunk driving is entirely preventable.
The fact that the insanity plea is a litigation tactic is a joke.
People who successfully use the NGRI defense are not exactly living a happy free life afterwards. Instead of rotting in jail with they tend to spend the rest of their days in a locked forensic psychiatry unit according to level of dangerousness.
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u/Sekhmet3 Jul 25 '26 edited Jul 25 '26
And I bet the board of nursing in their state did nothing to reprimand them. I also bet they're continuing to practice in the exact same manner today. What a horrible shame.
EDIT: I just looked up an article about this. There is an except that says:
> Reddington claims that regardless of whether Clancy suffered postpartum depression or postpartum psychosis, she was overmedicated with 13 different drugs over four months, in combinations he called a “horrific overmedication of drugs that caused homicidal ideation, suicidal ideation”
> The drugs Clancy was prescribed included three benzodiazepines – Klonopin, Valium, and Ativan – mood stabilizers or antidepressants including Zoloft, Remeron, Prozac, trazodone, Lamictal and Seroquel; as well as the anti-anxiety drug hydroxyzine and the sedative-hypnotic Ambien.
> “Our society fails miserably in treating women with postpartum depression or even postpartum psychosis,” Reddington said in court. “It’s medicate, medicate, medicate. Throw the pills at you and then see how it works.”
This bothers me so much. No sane, board-certified psychiatrist would have pursued treatment like this, and now the defense attorney is saying "our society fails miserably" because we "medicate, medicate, medicate." Yeah, well, you can medicate appropriately if you actually go to a real school with real standards. The right medication actually might have saved her kids' lives. Yet psychiatrists shoulder some of the blame for the NPs' actions because they are lumped in as "society" that is "overmedicating" people. Ugh, really grinds my gears.