Murder Prozac 28/07/2000 Massachusetts Man Stabs Wife: Med Exacerbates his Paranoia Summary:

Fourth paragraph from the end reads:  "On Nov. 25, 1998, a doctor at an East Boston health clinic prescribed Prozac for Erazo, recommended he avoid eating lunch at work, and scheduled a follow-up appointment for him. Erazo never showed up."

Second paragraph reads:  "It climaxed a year later on the morning of Dec. 6, 1998, when - convinced that his wife was part of a conspiracy to poison him - he wordlessly picked up a knife and plunged it into her chest, killing her in full view of his 6-year-old stepdaughter, according to testimony."

The Physicians Desk Reference states that antidepressants can cause paranoia.
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INSANITY FINDING SOUGHT IN KILLING\ PSYCHOSIS CITED IN MAN'S ALLEGED STABBING OF WIFE
Boston Globe
July 28, 2000
Author: Ralph Ranalli, Globe Correspondent
Estimated printed pages: 3
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Luis Erazo's slide into madness began quietly, with the nagging fear that his boss at a Chelsea supermarket was making fun of him and laughing behind his back, according to court testimony.

It climaxed a year later on the morning of Dec. 6, 1998, when - convinced that his wife was part of a conspiracy to poison him - he wordlessly picked up a knife and plunged it into her chest, killing her in full view of his 6-year-old stepdaughter, according to testimony.

What happened to Erazo, two psychiatrists said, was such a textbook example of paranoid delusional psychosis that a Suffolk County prosecutor and defense lawyers took an extraordinary step yesterday: They both urged a judge to declare Erazo not guilty of murdering Maribel Caraballo, by reason of mental defect.

Suffolk Superior Court Judge Diane Kottmyer said she will decide by next Friday whether to accept the recommendation. If she does, Erazo would then be referred for a 60-day evaluation at Bridgewater State Hospital to determine whether he should be treated in a locked psychiatric facility.

Elizabeth A. Keeley said that in her 17 years as a prosecutor, it was only the second case she could remember where both sides agreed that a killer was not legally responsible for his crime.

"It is not the usual occurrence that two doctors would both conclude - that a defendant suffered from a major disease which made him not criminally responsible," Keeley said.

But the victim's niece, Diana Caraballo, 23, said relatives are having a hard time comprehending that Erazo may do no prison time for the death of his soft-spoken, gentle wife.

"We're not saying he's completely sane," she said. "But he knew what he was doing" when he killed her.

Technically, what happened in Kottmeyer's courtroom yesterday was a jury-waived criminal trial. But prosecutor Keeley presented no evidence other than police reports, hospital records, witness statements, and the testimony of the state's psychiatrist, Dr. Malcolm Rogers of Brigham and Women's Hospital.

Defense attorney James M. Doyle presented only one witness, Harvard Medical School professor Prudence Baxter. Both psychiatrists said essentially the same thing - that Erazo, 33, truly believed his wife wanted to kill him.

Unlike defendants who only claim to have heard voices after they are arrested, Erazo had a documented history of frightening auditory hallucinations and tried to get medical help.

Erazo immigrated to the United States in the mid-1990s and found work in the meat department of the Market Basket supermarket in Chelsea, where he met Caraballo, a divorced single mother, according to testimony. They were soon living together and later married.

Around Christmas of 1997, Erazo began to fear that his boss at Market Basket was trying to get rid of him because he was "doing too good a job," Rogers said. Erazo knew that his feelings didn't make sense, and their irrationality frightened him, the psychiatrist said.

His condition soon worsened, however.

Voices began telling him that he should take charge, be "the boss" at the supermarket, even president of the United States, the doctors said. He started believing that his Market Basket superiors were "doing witchcraft on him," Baxter said, and, finally, plotting to poison him.

In reality, however, his managers considered him an exemplary employee and tried to talk him out of taking a new job at the Boston Coffee Cake Co. bakery in Woburn.

For a time, at Boston Coffee Cake Co., the voices went away and he was less fearful. One day, however, he felt dizzy after eating lunch, an incident that he "interpreted as proof he was being poisoned," Baxter said.

His paranoid delusion expanded, both doctors testified, to include his new supervisors whom he now believed were in league with his old ones, according to testimony. Caraballo, meanwhile, had elected to keep her job stocking the supermarket's health and beauty aisles, a decision that may have cost her her life.

At home, Erazo insisted that someone was trying to poison him, but his wife's efforts to change his mind - combined with her employment at Market Basket - only fed his paranoia.

Their inability to conceive a child also may have contributed to his delusion, Rogers said. When the couple learned that his sperm count was low, Erazo was certain that poisoning by his wife was responsible.

On Nov. 25, 1998, a doctor at an East Boston health clinic prescribed Prozac for Erazo, recommended he avoid eating lunch at work, and scheduled a follow-up appointment for him. Erazo never showed up.

Two or three days before the stabbing, Rogers said, Erazo was consumed by thoughts of dying and of killing his wife. The sight of her preparing breakfast on a Saturday morning that December may have been the last straw.

He allegedly stabbed her as she cooked. Caraballo staggered from their Chelsea apartment, collapsed, and bled to death on the sidewalk.

"It was his intense fear that unleashed the attack on her," Rogers said.
Edition:  THIRD
Section:  Metro/Region
Page:  B1
Index Terms: MURDER TRIAL MENTAL HEALTH NAME-ERAZO; MET