A psychiatrist has told the trial of a man charged with murdering an elderly man in a psychiatric unit that the accused was unable to refrain from killing the deceased because of medication withdrawal.
Ian Harman (50), of Carrigallen, Mountain Lodge, Cootehill, Co Cavan, has pleaded not guilty at the Central Criminal Court to murdering Michael Treanor (81) at the Psychiatric Unit of Cavan General Hospital, Lisdarn, Co Cavan on June 27, 2011.
The court was told that Mr Harman, who was originally from England, had been admitted to the unit following a suicide attempt.
Caroline Biggs SC defending told the jury at the beginning of the trial that she was instructed “to make certain submissions on behalf of her client”, which included that the accused accepted he caused the death of Mr Treanor.
Giving evidence for the defence, consultant psychiatrist Dr Bob Johnson told the court that he met with Mr Harman on October 16, 2013 and was provided with a background to the case.
He told Ms Biggs that the accused was deemed an inpatient at the psychiatric unit on June 20, 2011 and an anti-psychotic medication he was taking called olanzapine was stopped the next day.
Nursing notes stated that on June 23 he had racing thoughts and was given hot milk and encouraged to go to bed.
He broke a flowerpot and tried to kill himself. He was pacing up and down and was restless, the court was told.
On June 24 he was pacing up and down the unit, said he was going to kill himself and said he got up with the intention of being positive everyday but ended up being negative.
The next day he was pacing the corridor and was preoccupied with his sleep pattern over the last few days and was given a sleeping tablet. On June 26 he was also unable to sleep.
Dr Johnson told the court that it takes 48 to 72 hours for the level of the drug to fall after it has been stopped.
He said Mr Harman asked for it not to be discontinued and it had a “marked affect on his mental state and his behaviour.”
“My thoughts went AWOL and took me to places I’ve never been before” Mr Harman told the psychiatrist.
Dr Johnson told the court that one of the side affects of olanzapine is akathisia, which causes the patient to be restless.
“It is hard to convey to a non-medical audience how distressing akathisia can be,” he said.
Last week the court was told how Mr Harman informed gardai after his arrest that he had been “fantasising about ways of getting into prison” and considered killing “a couple of his neighbours” prior to his admission to hospital.
Dr Johnson, who the court heard had previously treated 60 murderers, said the motive for the killing provided by Mr Harman was “bizarre”.
“I’m looking for this homicidal push and there was none,” he told the court.
The psychiatrist said Mr Harman’s responsibility for the killing was not only diminished it was destroyed.
Dr Johnson said Mr Harman was unable to refrain from the act, which Ms Biggs said is a higher test of insanity.
Under cross-examination by Mr Paddy McCarthy SC prosecuting Dr Johnson said he did not accept the view of psychiatrists who will give evidence for the State that Mr Harman had a personality disorder.
The psychiatrist also said he did not agree with their view that akathisia is not a mental disorder.
Dr Johnson told Mr McCarthy he was aware that Mr Harman beat his wife with a baseball bat and had to be hospitalised but he said that was due to his alcohol consumption.
He also said that he was aware Mr Harman seriously assaulted another prisoner by repeatedly striking with a brush.
“Mr Harman is not on alcohol while in prison,” said Mr McCarthy.
Clinical pharmacologist Dr Andrew Herxheimer giving evidence for the defence told the court that he visited Mr Harman in hospital on October 23, 2013 and was given a medical history for the accused.
He told Ms Biggs that Mr Harman was prescribed olanzapine in November 2010, which was used mainly for schizophrenia to slow down thinking and quieten wild ideas.
“I could not understand why it was given to Mr Harman because he was not a psychotic,” Dr Herxheimer told the court.
In February 2011 Mr Harman was changed to another anti-depressant while continuing with olanzapine.
Dr Herxheimer told the court Mr Harman took an overdose of olanzapine and paracetamol in May 2011and the accused attempted suicide again on May 30.
On June 15 he was continuing to olanzapine before it was ceased on his admission to hospital.
He told the court that on June 25 he complained he could not sleep and was given a sleeping pill.
Dr Herxheimer told the court that on June 27 “Mr Harman suffocated Mr Treanor”.
The witness said Mr Harman was suffering from akathesia, which he said is a mental disorder, which diminished his responsibility.
The trial continues before Mr Justice Garrett Sheehan and a jury of six men and six women.