Gregory Williams was convicted by a jury of attempted murder and first degree assault, arising from an incident in which he struck the female victim in the head with a baseball bat. The Appellate Court reversed the conviction, and the Connecticut Supreme Court reversed the Appellate Court, remanding the matter back to that Court.
Among the issues now before the Court was whether the trial court abused its discretion when it allowed the Defendant's physician to testify as a prosecution rebuttal witness, rather than in the prosecution's case-in-chief. The rebuttal was prompted by testimony presented for the defendant by another physician regarding the drug Ativan, which the defendant took the day before the assault. This physician testified that he would not have prescribed Ativan to someone in the defendant's condition because it could worsen depressive symptoms and impair a person's reasoning. The defendant then testified that he took Ativan the night before the assault, and that on the day of the assault he felt sluggish and depressed.
The defendant's physician, who had prescribed the Ativan which Williams took, testified on rebuttal that the two milligram dosage of Ativan that he prescribed for him was a “standard dosage” for someone of his size. Furthermore, he testified that the Bridgeport Hospital records concerning Williams' treatment noted no ill effects of the medication and listed as normal his ability to concentrate and speak on the morning of the assault.
Held: Affirmed. Specifically, as to the issue of the testimony of the defendant's physician, the Court found no error in his testifying on rebuttal. The Court noted that at the trial, the issue of whether drugs affected the defendant's mental state was introduced during the defendant's case. The state was not obligated to address the issue in its case-in-chief, said the Court, and it was therefore proper for the trial court to give the State an opportunity to rebut the defendant's evidence on this issue, through the testimony of the defendant's physician.
 | Michael Welner, M.D. Chairman The Forensic Panel |
Dr. Welner comments: All too often, sedative hypnotic drugs from the class known as the benzodiazepines are attributed in legal proceedings to causing depression. While these medicines depress the central nervous system, this is more a depression of anxiety and arousal than of mood. The expert in this case who testified he would not prescribe Ativan because it can worsen depressive symptoms is distorting fact. Ativan is actually commonly prescribed in conjunction with activating antidepressants in order to facilitate sleep, or to counteract side effects of agitation. Clonazepam has been described as causing depression in a small percentage of patients, but otherwise, the incidence of depression caused by the benzodiazepines is extremely rare.
How can a defense attorney utilize a history of Ativan use? Provided there is evidence for the medicine being in the system still (Ativan's effects are generally appreciated for several hours), the effects of Ativan can diminish capacity for understanding one's actions. If a person has sufficient levels of the drug in the system, it can produce a hypnotic effect that a creative counsel can link to the intent of the crime.
Prosecutors may counter that only rarely do the benzodiazepines cause what is known as a disinhibiting effect, when a person loses control of his behavior or becomes violent. Of the benzodiazepines, Alprazolam (Xanax) has been shown to be the most commonly associated with disinhibition, and more frequently in those with a history of idiosyncratic reactions to medications and a diagnosis of borderline personality disorder [Dietch JT and Jennings RK, Journal of Clinical Psychiatry 49: pp. 184-881] .
