What Black Box Warnings Leave Out

     In his August 23rd podcast this week, Dr. Josef Witt-Doerring speaks about the similarities between Lindsay Clancy and Tranyelle Harshman. These two women were both suffering from post-partum difficulties, both were prescribed psychiatric medications for their symptoms, and both ended up murdering their children and trying to commit suicide. Harshman was successful; Clancy was not.

     Each case involves careless prescriptions by psychiatrists and psychiatric nurse practitioners, but a striking detail in Dr. Josef’s coverage of these two is his revelation of what the terms “anxiety” and “dissociation” include when listed as psychiatric drug’s “side effects.”

     Dr. Josef knows. He was part of the original Jannsen Pharmaceutical team that ran the trials when they were developing Spravato, the nasal esketamine that Harshman was faultily prescribed.

     Two of the adverse reactions listed to what was then a trial drug were anxiety and dissociation. These two terms are listed in many of the Black Box warnings on SSRIs and benzos today, including what Lindsay Clancy was prescribed. However, as Dr. Josef reveals, these two terms have wrapped into them as psychiatric drug “side effecs” a subset of symptoms that are far more severe than mere anxiety or dissociation.

     The drug manufacturer’s use of anxiety includes not only fear and panic attacks, but also psychomotor hyperactivity. Today that is better known as akathisia, a movement disorder that causes an intense, uncontrollable internal restlessness and a compulsion to continuously move. Colloquially it is described as wanting to jump out of your skin, and it is a symptom connected to the uncontrolled homicidal impulses of many of today’s medicated school and workplace shooters.

     Dissociation includes not only depersonalization – which itself can remove a native sense of responsibility one has for one’s action – but also auditory, visual, and mixed hallucinations. These would include the “voices” heard in one’s head, like the commands Lindsay Clancy and Tranyelle Harshman felt they had received to kill their children.

     Although these risks are apparently included under the terms anxiety and dissociation, they are not the ones revealed in the frequently abridged informed consent protocol given patients these days by psychiatrists and psychiatric nurses. Revealing them in a full informed consent discussion would probably decrease the number of patients on these covertly lethal psychotropic drugs.

     It might also open up more and more medical practitioners to lawsuits by acknowledging the true risks involved with taking these drugs. Better to just leave these pesky details out, eh?

     In February 2025, , a Wyoming mother of four with no history of violence, shot her four daughters and then took her own life. Her family describes an event completely out of character for a loving mother. Husband stand s by her. Tranyelle sought help for postpartum depression in late 2024 and was prescribed ketamine lozenges to take at home.