Bombing Effexor & Prozac* 11/05/1994 New York N.Y. Subway Bombing: 48 Injured Summary:

Paragraph 4 reads: "Dr. DiGiacomo, a professor at the University of Pennsylvania Medical School, testifying in the fourth week of Mr. Leary's trial in State Supreme Court in Manhattan, described an array of drugs that Mr. Leary had been using: Prozac and another antidepressant, Effexor, and an antianxiety drug, Buspar. The day of the explosion, he also took an antibiotic that, Dr. DiGiacomo said, pushed him over the line into a state of insanity where he was not able to distinguish fantasy from reality or right from wrong."

http://query.nytimes.com/gst/fullpage.html?sec=health&res=9A04E3DB1039F930A15751C0A960958260


Doctor Says Drugs Put Bombing Suspect in Fantasyland

By THOMAS J. LUECK
Published: February 23, 1996

Edward J. Leary was consumed by a dangerous mix of mind-altering drugs and was incapable of realizing the damage that could result from the firebomb he carried onto a Manhattan subway train in 1994, a psychiatrist testifying on his behalf said yesterday.

The testimony by Dr. Joseph DiGiacomo formed the heart of Mr. Leary's defense in his trial for attempted murder and assault: that by December 1994, the three psychotropic drugs he was taking, including the popular antidepressant Prozac, left him living in a fantasy land in which he was unaware of the consequences of his actions.

But a prosecutor countered that Mr. Leary's meticulously calculated actions undercut that argument, suggesting that no one could have carried out such a carefully contrived plot while mentally impaired. The prosecution has argued that Mr. Leary carried the explosives onto two trains as part of an elaborate scheme to extort money from the Transit Authority, but that the second bomb went off prematurely, injuring 48 people, including Mr. Leary.

Dr. DiGiacomo, a professor at the University of Pennsylvania Medical School, testifying in the fourth week of Mr. Leary's trial in State Supreme Court in Manhattan, described an array of drugs that Mr. Leary had been using: Prozac and another antidepressant, Effexor, and an antianxiety drug, Buspar. The day of the explosion, he also took an antibiotic that, Dr. DiGiacomo said, pushed him over the line into a state of insanity where he was not able to distinguish fantasy from reality or right from wrong.

Although defense lawyers in a number of cases have blamed crimes on the use of Prozac, in this case the defense argues that Mr. Leary's "descent into madness" was induced by a combination of different drugs, not Prozac alone.

Dr. DiGiacomo said the Prozac that Mr. Leary was taking prevented his body from breaking down and resisting the toxicity of other drugs. Further, he said the mix -- which included high levels of some of the drugs -- left him in a dreamlike state in which his mind was "fragmented."

In that state, the doctor said, Mr. Leary moved back and forth between fantasy and reality over a a period of days or weeks, conceiving, preparing for and carrying out his bombings in a series of disconnected periods.

But prosecutors dismissed that argument, suggesting in their cross-examination that someone whose mental capacity was so badly disrupted could not have planned and executed such a complex crime as planting bombs in the subway system.

"How long does a fragment last?" asked Peter Casolaro, the lead prosecutor in the case, at one point in his cross-examination.

"Before you build a bomb you have to buy its parts, then you have to plan what it looks like, and all of this takes over 30 seconds," Mr. Casolaro said.

Dr. DiGiacomo testified that he had interviewed Mr. Leary for about five hours after his arrest in the wake of the second bombing, on Dec. 21, 1994, and had studied his medical records. Mr. Leary is also accused of causing an explosion that injured two people aboard a subway train in Harlem, a week before the Dec. 21 blast.

Ira London, one of Mr. Leary's defense lawyers, asked Dr. DiGiacomo: "Do you believe with a reasonable degree of medical certainty that Edward Leary, on the occasions of the two firebombings, lacked the capacity to know and appreciate the consequences of his actions?"

"I believe that," Dr. DiGiacomo replied.

In his testimony, Dr. DiGiacomo said his interest in Mr. Leary's case had been aroused by his broader concerns about the risks of drugs that are prescribed and used in tandem with other drugs. He described such risks as a growing problem, particularly among elderly people who take several drugs at a time.

The danger is most acute among people who use Prozac or other medications that limit the ability of the liver to digest and break down other drugs, he said. "Chemicals get backlogged in the body," he said.

In the case of Mr. Leary, "we have monumentally high levels" of drugs circulating in a destructive way, he said.


"It was as though someone had taken five drinks and they had exploded in his body to 25 drinks," he said.

Throughout the testimony, before Justice Rena K. Uviller, Mr. Leary sat motionless and without expression. A computer expert who had lost his job at Merrill Lynch & Company in January 1994, he has been described in testimony by his wife and other witnesses as being depressed and confused in the months before the bombings.

In one indication of Mr. Leary's confused state, Mr. London told the court yesterday that his client had repeatedly retrieved half-eaten or spoiled food that his wife had thrown into the garbage at their home in Scotch Plains, N.J.

In his questions to Dr. DiGiacomo, Mr. Casolaro, the prosecutor, did not dispute the medical basis of his comments that the combined use of Prozac and other drugs could create a serious mental disorder, and he gave no indication of whether that position would be challenged later in the trial.

But Mr. Casolaro sought to establish that Mr. Leary may not have taken the combination of drugs described by Dr. DiGiacomo as frequently or in dosages as high as the psychiatrist suggested.

In his testimony, Dr. DiGiacomo acknowledged that he had not interviewed Mr. Leary's personal psychiatrist, Dr. John Weihs, who had prescribed the drugs over the 13 months before the December 1994 bombings.

Dr. DiGiacomo said he instead had relied on personal notes kept by Dr. Weihs that indicated what drugs he had prescribed, the dosages, and, in some cases, whether Mr. Leary had obtained a receipt from his pharmacy.

But under cross-examination, Dr. DiGiacomo conceded that several of the prescriptions were not accompanied by a receipt, indicating that Mr. Leary may not have purchased or used the drugs.

Dr. DiGiacomo said he had acted as an expert witness in 24 previous trials involving questions of drug use. In all but four of those trials, he testified for the prosecution, he said.