What was the verdict in Commonwealth v. Lindsay Clancy?

No verdict as of Aug 31, 2026. Trial ran July 29 – Aug 28, 2026 in Plymouth Superior Court. Jury began deliberations Aug 28 and is still deliberating. Possible outcomes: guilty, manslaughter, or not guilty by reason of lack of criminal responsibility (McHoul).

What is the McHoul standard?

Under Commonwealth v. McHoul, 352 Mass. 544 (1967), a person is not criminally responsible if, as a result of mental disease or defect, they lacked substantial capacity to appreciate wrongfulness or conform conduct to law. Burden on Commonwealth beyond reasonable doubt.

Where can I watch the trial?

Each of the 14 transcript pages links its YouTube court recording via Court TV / Law&Crime / PBS NewsHour. No Rev.com paywall. See /transcripts and /media.

Switch to Mania After Acute Antidepressant Treatment for Bipolar Depression: A Systematic Review and Network Meta-Analysis of Randomised Controlled Trials

Citation

Oliva, V., De Prisco, M., La Spina, E., Paolucci, S., Fico, G., Anmella, G., et al. (2025). Switch to mania after acute antidepressant treatment for bipolar depression: a systematic review and network meta-analysis of randomised controlled trials. eClinicalMedicine, 87, 103413. https://doi.org/10.1016/j.eclinm.2025.103413

Published

2025

Journal

eClinicalMedicine (The Lancet)

Study Design

Systematic review and network meta-analysis (NMA) of randomised controlled trials (RCTs)

Data Sources

PubMed, Embase, PsycINFO, and Web of Science from database inception up to Feb 19, 2025, with no language restrictions.

Study Selection

2434 records screened

13 RCTs included (1362 patients)

818 female (60.1%)

511 male (37.5%)

33 not disclosed (2.4%)

Primary Outcome

Rate of switch to mania after antidepressant treatment

Key Findings

1. No individual antidepressant showed a significantly increased switch risk compared to placebo

2. Venlafaxine showed the highest risk estimate among antidepressants, though not statistically significant: RR 4.53 (95% CI 0.47-43.25)

3. Venlafaxine was the only compound with consistent signals of increased switch in individual studies

4. Evidence base was larger for add-on therapy, while fewer data were available for monotherapy

5. Sensitivity analyses confirmed the results

6. Heterogeneity was low

7. Overall confidence in the evidence was rated as low

Interpretation

Although some evidence of increased risk of switching to mania was observed, no individual antidepressant showed a significantly increased switch risk compared to placebo. However, venlafaxine consistently showed the highest relative risk across individual studies, sensitivity and post-hoc analyses. These findings offer a more granular understanding of switch risk among antidepressants and highlight venlafaxine as a compound warranting special attention.

Implications

Supports cautious short-term use of antidepressants in bipolar depression, particularly as add-on therapy

Treatment decisions should prioritize patient-specific factors (bipolar subtype, treatment history, comorbidities, prior switch episodes)

Long-term risk remains uncertain due to short trial durations (max 10 weeks)

Longer-term studies and real-world data needed

Limitations

Short trial durations (max 10 weeks)

Low confidence ratings

Unable to perform stratified analyses by bipolar subtype

Heterogeneity in definition of switch to mania across studies

Post-hoc analyses should be interpreted with caution

Preregistration

Protocol preregistered on the Open Science Framework

Relevance to Clancy Case

This study is relevant to understanding the pharmacological context of postpartum psychiatric treatment. The finding that venlafaxine consistently showed the highest (though not statistically significant) risk of switch to mania is clinically significant for understanding medication-related risks in bipolar spectrum conditions. The study underscores the complexity of antidepressant management in vulnerable populations.