Autopsy report suggests teen wasn’t taking meds properly — (The Fresno Bee)

SSRI Ed note: Student, 17, given Lexapro and Geodon for depression attacks policeman with baseball bat, is shot and killed.

The Fresno Bee

By Pablo Lopez

05/16/08 23:52:31

Coroner officials released an autopsy report Friday suggesting that a slain Roosevelt High School sophomore who attacked a campus police officer was not taking proper dosages of drugs prescribed to control his mental illness.

Dr. David Hadden, Fresno County coroner, said it’s clear that Jesus “Jesse” Carrizales, 17, had a high dose of the antidepressant Lexapro in his blood that could have caused him to be paranoid.

But the teen’s blood also revealed he was not taking antipsychotic drugs.

Carrizales’ family has said he was taking Lexapro and Geodon, an antipsychotic medication, for depression.

Hadden said it’s far too early to draw conclusions about Carrizales’ use of prescription drugs. People react differently to drugs and have different tolerances to them.

“This picture is not complete,” Hadden said.

On a night when family and friends held a vigil at Roosevelt High, the findings of his autopsy reveal new information about the special education student who was classified as emotionally disturbed.

At the Friday night vigil, family members said they still were waiting to see what the final police report on the incident says. They also said they had submitted a list of questions to Fresno Unified and had yet to receive answers.

“It hurts very much every day, and it doesn’t get any easier,” said Elisa Ortega, Carrizales’ sister.

Said his uncle, Gilbert Abarca: “Something has to change.”

Gloria Hernandez, a mental health patient advocate who came to the vigil in support of the family, said the Police Department needs to provide training to officers in how to deal with the mentally ill.

“They need to learn how to de-escalate the situation,” she said.

Ben Benavidez, of the Mexican-American Political Association, said the group is seeking an inquiry from the FBI and the state Attorney General’s Office.

Police say Carrizales was killed April 16 after he attacked Fresno police officer Junus Perry with a sawed-off bat. Police say Carrizales was standing over Perry, ready to strike again, when the officer fired in self-defense.

The autopsy report confirmed an earlier account that Perry’s bullet entered Carrizales’ right shoulder in a slightly downward angle and hit an artery, causing him to bleed to death in a few minutes.

Hadden said it is clear that Perry fired his weapon in self-defense, but he said his staff still needs to talk to witnesses and police detectives to explain the bullet’s path.

“Everything happened very rapidly,” Hadden said, noting that the coroner’s staff doesn’t have a clear picture of whether Perry was on the ground or about to get up when he shot Carrizales.

The autopsy report essentially states what Police Chief Jerry Dyer has said of the incident:

Perry was struck on the head with a sawed-off bat as soon as he left his campus office. When Perry fell to the ground, Carrizales raised the bat again, causing the officer to pull out his duty weapon. When the bullet magazine fell out of the gun, Perry grabbed another gun — a 40-caliber Glock semiautomatic — from his ankle holster. He then shot Carrizales once.

The bullet hit the clavicle — or collarbone — and then damaged an artery and the spinal cord before lodging in the spine, the autopsy report states.

The autopsy showed Carrizales’ blood had a “lethal level” of Lexapro. His blood and urine were tested for Quetiapine and Risperidone — two antipsychotic drugs used to treat schizophrenia and bipolar disorder. Neither drug was found in Carrizales’ system, the report states.

In general, “lethal level” means that in some people, that amount would kill them, Hadden said. A toxic level of Lexapro also could cause paranoia in some people, but not everyone. The drug’s effect would depend on whether Carrizales had built up a tolerance to the antidepressant, Hadden said.

The autopsy report shows that Carrizales’ blood was not tested for Geodon. Hadden said his staff was told Carrizales was taking Quetiapine and Risperidone. But Carrizales’ family said Friday night at the vigil that no one asked them what drugs Carrizales was taking.

Hadden said if it is confirmed that Carrizales was taking Geodon, another test will be requested.

The case is difficult, Hadden said, because neither he nor his staff are experts in prescription drugs. “We know a lot about heroin, cocaine and other illegal drugs, but we know very little about therapeutic drugs,” he said.

The staff plans to consult a psychiatrist to help them understand Carrizales’ medication.

Police spokesman Jeff Cardinale said the findings in the autopsy report were “not unanticipated.”

Police knew Carrizales was supposed to be on medication, but detectives have focused their attention on Carrizales’ actions, as well as the actions of Perry, Cardinale said.

“Everything in the report we knew already,” Cardinale said.

The report said Carrizales was shot at 11:53 a.m. April 16. Carrizales was pronounced dead at the scene at 12:07 p.m. The autopsy was performed from 9 a.m. to 10 a.m. the following day.

These times can help determine when Carrizales last took his medication.

Fresno pharmacist Nancy Asai, who is not associated with the case, said Lexapro can stay in a person’s blood much longer that the antipsychotic drugs Quetiapine and Risperidone.

Dr. Barry Chaitin, chair of the department of psychiatry at the University of California at Irvine, said in general, Lexapro is “pretty safe” even at high doses. The lack of antipsychotic medicine in Carrizales’ system, however, is troubling — those drugs are typically prescribed to help people cope with aggression, psychosis, hostility and hallucinations, he said.

Carrizales’ behavior is difficult to explain, said Chaitin. On one hand, Carrizales’ family has said that the medication helped him become more sociable. But police say Carrizales sneaked up on Perry from behind and attacked the officer without provocation.

“His conduct appears way out of the ordinary because the attack sounds premeditated,” Chaitin said. “He must have had a misperception that the officer was a threat to him.”

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The reporter can be reachedat plopez@fresnobee.comor (559) 441-6434.