Summary:

Paragraphs 11 through 13 read: "Joseph said McDermott told him that he had increased his dosage of Prozac by Dec. 1, first from 70 milligrams per day to 140 milligrams, and then to 210 milligrams. Joseph said McDermott increased the dosage without his doctor's permission or advice.

Although Prozac is an antidepressant, potential side effects include restlessness, agitation, psychosis, rage, anger and violence, Joseph said.

"I would offer the opinion that it's very possible that Prozac is the final piece of the puzzle that explains the level of rage and anger that allowed the killings to occur," said Joseph, an attending psychiatrist at McLean Hospital and an associate clinical professor of psychiatry at Harvard Medical School.


http://www.boston.com/news/daily/18/office_shootings.htm

Prosecutors try to shake psychiatrist's testimony about office gunman
By Denise Lavoie, Associated Press, 04/18/02
Michael McDermott
(Globe Staff / John Blanding)
 TODAY'S GLOBE

CAMBRIDGE -- Prosecutors on Thursday tried to shake the testimony of a psychiatrist who said a man who killed seven co-workers was mentally ill and unable to understand right from wrong when he went on a shooting rampage.

Dr. Anthony Joseph, testifying for the defense, did not waver from his earlier testimony, repeating his claim that Michael McDermott suffered from paranoid schizophrenia and other mental disorders when he gunned down his colleagues at Edgewater Technology on Dec. 26, 2000.

"I do not believe Mr. McDermott was malingering," Joseph said.

Middlesex District Attorney Martha Coakley focused on Joseph's multipart diagnosis, in which he says McDermott was not only schizophrenic, but suffered from depression and paranoia, as well as several other disorders. Those include: seasonal affective disorder, better known as winter depression; cotard syndrome, a disorder that makes people believe they're dead; and delusional misidentification syndrome, which makes people mistake the identities of people, places and things.

During two days on the witness stand last week, McDermott, a 43-year-old software engineer, said he believes he killed Nazis -- not his co-workers.

He said St. Michael the Archangel appeared to him 12 days before the killings and told him he could prevent the Holocaust and earn a soul if he traveled back in time to 1940 and killed Adolf Hitler and six German generals.

Under questioning from Coakley, Joseph acknowledged that he did not corroborate everything McDermott told him about his medical and psychological history. He also admitted he reached the conclusion that McDermott was not faking his mental disorders before he learned that McDermott had purchased a clinical textbook on malingering and searched the Internet for materials on "how to fake mental illness."

But Joseph said he still believes McDermott is not faking.

Prosecutors contend that McDermott killed his co-workers after becoming enraged about the company's decision to comply with an IRS order to withhold some of his wages to pay back taxes he owed.

On Wednesday, Joseph testified that McDermott had tripled his dosage of Prozac before the shootings, a move that may have heightened his rage and sparked the shooting spree.

Joseph said McDermott told him that he had increased his dosage of Prozac by Dec. 1, first from 70 milligrams per day to 140 milligrams, and then to 210 milligrams. Joseph said McDermott increased the dosage without his doctor's permission or advice.

Although Prozac is an antidepressant, potential side effects include restlessness, agitation, psychosis, rage, anger and violence, Joseph said.

"I would offer the opinion that it's very possible that Prozac is the final piece of the puzzle that explains the level of rage and anger that allowed the killings to occur," said Joseph, an attending psychiatrist at McLean Hospital and an associate clinical professor of psychiatry at Harvard Medical School.

He acknowledged, however, that he could not say to "a reasonable degree of medical certainty" what effect the increased dosage had on McDermott.

Prosecutors planned to call medical experts of their own as rebuttal witnesses to support their theory that McDermott concocted an elaborate tale to make himself look insane to the jury.