…To Sleep, Perchance…

But Who Knows What Dreams May Come?

We’ve been parsing the original affidavit lately, hunting for things perhaps overlooked, trying to fit together the pieces of Robert Wone’s murder.

Among the more difficult pieces to explain is the reaction of Ward, Price and Zaborsky on the first arrival of the EMTs at 11:54pm.   The first technician, an EMT of more than ten years, reportedly asked “what’s going on?” three times: first to Zaborsky on the front steps, second to Ward in the second floor hallway, and third to Price, sitting on the edge of the pull-out bed where Robert Wone’s body was found.

Curiously, Price was the first to respond.  “I heard a scream,” he said, and nothing more.  Zaborsky, wearing a bathrobe and talking on a cell phone, did not respond to the EMT.  Ward, also in a bathrobe, was coming

“…from a small hallway area adjoining a bathroom.  As Ward approached, W-1 confronted Ward and directly asked him, “what’s going on?”  Ward looked at W-1, but did not reply.  Instead Ward walked past W-1 and directly into his bedroom on the second floor.”

A strange scene.  Now there’s no telling how any individual will respond to a crisis situation, but the affidavit paints an odd picture of three individuals strangely out of sync with the setting of a murder in their house.  Most puzzling is Ward’s reaction: this editor can imagine responding many different ways to learning a friend had been killed in my house, but going back to bed is not one of them.

Some posters have speculated – emphasis here on speculation – that perhaps one or more of the three defendants had earlier taken an illegal drug of some sort.  But the affidavit may offer another explanation: at least three legal drugs are mentioned: a “sleeping pill”, Lexapro and Wellbutrin.

In his statement (page 9), Ward recounts showing Robert upstairs, the bedroom, and the shower, “…and that’s when I went to bed.  I went in my room, I was reading for like five minutes or so, and then I took my sleeping pill and went to bed.”

There are dozens of prescribed sleeping pills, but of course by far the most common is Ambien – or its generic zolpidem.  Helpful for many, Ambien takes effect fairly rapidly, within on average 15 minutes or so, with full effects lasting up to three hours.  Assuming the reported time line is accurate and Robert arrived at 10:30, some light talk in the kitchen, and then showing Mr. Wone to his room, Ward could have turned in to his room by 10:45-10:50.  Five minutes later, a sleeping pill, and by 11:30, full effect.

While helpful for many, a small minority of people are adversely affected by Ambien, inducing a hypnotic trance state.  These unfortunates can walk, talk, eat, drive, or do all manner of things – all while in a somnambulistic trance.   Unlike traditional sleep-walking, they can perform seemingly complex tasks (baking, conversing, etc.) while appearing awake – but they are not.  Worse, they have no (or extremely limited) memory of engaging in these behaviors.  This potential induction of a chemically created trance-state might offer some explanation of Ward’s odd behavior.

Price also tells detectives that Ward is taking “Lexapro and Wellbutrin” for depression; adding “…everybody I know takes depression [medication].”   Each medication is prescribed for major depressive disorder; Lexapro is an SSRI (similar in some ways to Prozac) while Wellbutrin is a dopamine re-uptake inhibitor (or DAPI) used for depression but also seasonal-affective disorder and smoking cessation.

Like Ambien, both medications are generally helpful, but some small few may experience euphoria and hallucinations on Wellbutrin and somnolence on Lexapro.  In the right balance, in the right person, the combination of the two can offset each other – Wellbutrin lifting the fog that can come with an SSRI; Lexapro stabilizing the mood that can be thrown off by a DAPI.  In the wrong balance, in the wrong person…well, the web is filled with people asking the same questions.

And there’s another risk.  After much study (and controversy) the FDA concluded that people on anti-depressant medication are at slightly higher risk for an increase in suicidal thoughts or conduct.  Slight, but serious: enough for the FDA to include a “black box” warning for both Lexapro and Wellbutrin, along with dozens of other medications.  While children and adolescents are at particular risk, this warning applies to all.  While “…everyone…” may be taking them (full disclosure, I am not) and while the editors apply no judgement whatsoever to those who do, no-one should forget these are serious and potent medications that can produce a variety of unexpected and unhelpful side effects.

Lex, Welly and A-Minus: potentially a powerful combination of psycho-active drugs, all in 1509.

-posted by Doug

46 comments for “…To Sleep, Perchance…

  1. CDinDC
    04/20/2009 at 10:19 AM

    Seems, from his calm demeanor after EMTs arrived, Victor got all hysteria vented.

    Again, perhaps it wasn’t Victor that screamed at all.

    Just because Victor said he screamed doesn’t mean he did. (Just as Bea pointed out, just because he said he arrived and went to bed prior to Wone’s arrival, doesn’t mean he did.)

  2. CDinDC
    04/20/2009 at 10:24 AM

    Someone told me a story of their experience with taking a (prescribed) combination of well-known anti-depressants (not Wellb or Lexapro). He went to his neighbor’s house and proceeded to clean his closet. He was completely unaware of what he was doing and didn’t remember it at all (the neighbor told him about the next day).

  3. Poirot
    04/20/2009 at 11:23 AM

    Excellent post. I’d like to add the following excerpt from the Lexapro prescribing information, which I feel is relevant in this case:

    “The following symptoms, anxiety, agitation, panic attacks, insomnia, irritability, hostility, aggressiveness, impulsivity, akathisia (psychomotor restlessness), hypomania, and mania, have been reported in adult and pediatric patients being treated with antidepressants for major depressive disorder as well as for other indications, both psychiatric and nonpsychiatric. Although a causal link between the emergence of such symptoms and either the worsening of depression and/or the emergence of suicidal impulses has not been established, there is concern that such symptoms may represent precursors to emerging suicidality.”

    While the major concern with antidepressants is patient suicide, negative behavior directed towards others is not uncommon. With Lexapro and other SSRI’s irritability, hostility, aggressiveness, and impulsivity are included in the list of negative side effects.

    The media has reported that the killers in several of the mass shootings at schools were taking SSRI’s at the time of the shootings.

    Hostile. Aggressive. Impulsive. All possible emotional states to commit a murder…

  4. Bea
    04/20/2009 at 12:01 PM

    Any pharmacologists on this site? Interesting question.

    I suspect that all three of them being essentially mute when the EMTs arrived is due to Joe TELLING them not to say anything, concern over his/their own drug use (on top of the 3 scrips), or a combination of the two.

    • Ex Swann Dude
      04/20/2009 at 12:06 PM

      Agreed!

      • Lexapro User
        04/20/2009 at 12:14 PM

        As someone who has taken Lexapro for anxiety and depression for some time, I can say that it has only been beneficial to my mental health. I think the more obvious explanation is that put forth by Bea above.

  5. CDinDC
    04/20/2009 at 12:23 PM

    Just wondering…..were the police dispatched at the same time the EMTs were? What did the police get out of them during the time Robert Wone was being removed from their house? Or were they even present at that point???

    • Ex Swann Dude
      04/20/2009 at 1:18 PM

      The police arrived 5-10 minutes after the EMTs.

      • Swann Eye Leading the Blind
        04/20/2009 at 2:54 PM

        That’s correct. Also the EMTs were on a firetruck.

  6. Fascinating
    04/20/2009 at 12:34 PM

    I agree with Bea. While re-reading the reactions all three had to the CMTs, my first thought was: They knew they didn’t have to say anything, and they knew the CMTs would write a report. And maybe they were waiting for their lawyer to call them back at that point. So they decided not to say ANYTHING.

    If you had a dead man in your house, wouldn’t you call your lawyer?

    • Ex Swann Dude
      04/20/2009 at 1:24 PM

      They were not represented with counsel during the initial interviews that night (25 hours total but only 6-7 hours of video).

      I would say nothing until my lawyer arrived if there was a dead body in my house. But our little Joe “the intruder murdered the dude in the office/guestroom” Price has been described arrogant and aloof at times …

      • CDinDC
        04/20/2009 at 1:38 PM

        And considering he’s an attorney, he knew what to do.

      • CDinDC
        04/20/2009 at 1:40 PM

        I probably wouldn’t say anything if I were…..guilty and there was no evidence of an intruder.

        • Ex Swann Dude
          04/20/2009 at 2:16 PM

          And yet, without an attorney present, he conceeded that “the intruder murdered the dude in the office/guestroom” was an implausible theory …

  7. Fascinating
    04/20/2009 at 2:13 PM

    I’d love to see that video.

    • CDinDC
      04/20/2009 at 2:43 PM

      We need Nancy Grace for that.

  8. Lisper Doll
    04/20/2009 at 3:16 PM

    All very interesting, but keep a few things in mind.
    If someone in the house was suffering from delusions, then being on an anti-depressant, as everyone else was, as Price said, would not help. As Price’s comments indicate, being on an anti-depressant is like the new normal. But needing an anti-psychotic still has a stigma, and thus many still go untreated. By the way, it is said that schizophrenia has as one its characteristics low-affect. That might speak to the behavior when the police arrived, or it might have been subterfuge. There is also another delusion-centered problem which is distinct from schizophrenia, called simply “delusional disorder”. These can be much more functional than schizophrenics, but can still secretly maintain bizarre beliefs and delusions for years and years. They tend to keep it to themselves for a lengthy period until their bizarre behavior eventually might force them to get treatment. But clearly there is a big difference between this and people who go on to commit a crime. Surely our society needs to do all it can to help people, especially by supporting organizations which help
    with such mental disorders and promote a compassionate attitude. As the health officials in New York refer to it, quite correctly, it is a matter of mental hygiene.

    • CDinDC
      04/20/2009 at 3:35 PM

      Lisper Doll says: “….it is said that schizophrenia has as one its characteristics low-affect. That might speak to the behavior when the police arrived, or it might have been subterfuge.”

      They all acted the same. They were ALL subdued and closed-mouth with the EMTs.

      Unless schizophrenia is contagious, it sounds like an organized attempt at staying in control.

      • Ex Swann Dude
        04/20/2009 at 4:06 PM

        BINGO!! I understand what Lisper is getting at but …

      • Lisper Doll
        04/20/2009 at 4:30 PM

        You are making sense with that, but still the ability to stay in weird control under such circumstances may still speak to something more. I am not a criminality expert, but I think a normal person would find it hard to be so low-affect if you just found a friend brutally murdered. It speaks to guilt, illness, or all of the
        above.

        • CDinDC
          04/20/2009 at 4:34 PM

          Lisper Doll says: “normal person.”

          There’s a very high-profile case in the news right now…..Casey Anthony.

          She’s not mentally ill. She’s psychopathic. You don’t need to be crazy to be “low-affect.”

          • Lisper Doll
            04/20/2009 at 4:58 PM

            Probably right on that, especially given the variety of human reactions. That part is just my speculation from people in life. I can’t imagine a normal person having such a reaction. But this is why experts study crime in particular. I am sure crime has its own very niche behaviors, so to speak.

      • Lisper Doll
        04/20/2009 at 4:45 PM

        Also, as to the second point you made, though I’m not sure this what you were getting at….all the theories that schizophrenia is the result of a virus or a germ (from cats for instance) have been debunked. What is “contagious” is the social pattern of denial of mental illness, or even worse bolstering bizarre beliefs or delusions. This happens in families sometimes I think. E.g. “That person is secretly against us and trying to do us in….” or erotomania: “That person is really into you, even though they don’t show it….”. Perhaps Price or Ward maintained an erotomanic fantasy that Wone was in love with them. When the person with delusions is confronted with reality, that is with the un-reality of the delusion, anger is a frequent concomitant.

        • CDinDC
          04/20/2009 at 4:56 PM

          I was being TOTALLY feticious when I said “contagious.”

          Re erotomanic…..interesting point.

          Given Joe Price’s complete control of the household, I think Narcissistic Personality Disorder is on target for him. Dylan Ward……extreme insecurity, hence his roll as a dom (gave him power)…….Victor Z…..just plain stupid.

          • Lisper Doll
            04/20/2009 at 5:09 PM

            A shrink once told me to never get information on psychiatry from the internet. Well, I just did, because I think
            though your point about Narcissistic Personality Disorder is interesting and maybe right for Price, but it is not the same as erotomania. Erotomanic delusions are not just beliefs of grandiosity which might lead one to think “well, of course he’s in love with me…” But rather a real delusion that the person is in love and sending special signals which only the person can discern. I am saying that Price may have had a long-standing delusion about Wone.

            • CDinDC
              04/20/2009 at 7:58 PM

              I understand your point completely, and I find it very interesting.

              I also understand that Erotomania is not the same as Nar.Personality Disorder. My thoughts are IN ADDITION to yours.

          • SheKnowsSomething
            04/20/2009 at 5:12 PM

            Concur on Victor … stupid, bordering on delusional. Kind of like Little Edie from “Grey Gardens”.

            • Delores Claiborne
              04/20/2009 at 5:14 PM

              it could have been me, jackie…..

  9. CDinDC
    04/20/2009 at 4:26 PM

    Doug says: “Lex, Welly and A-Minus: potentially a powerful combination of psycho-active drugs, all in 1509.”

    And then mix in a cocktail or two, and the possibility of some cocaine, meth-amphetamine (both allegedly possessed by Price at one time), Ecstacy (found in Ward’s room) and/or Ketamine…..geezy peezy.

  10. Lance
    04/20/2009 at 5:04 PM

    Note #1: I’m very much still waiting to hear the roommates’ version of what happened when the EMTs arrived. I gather (and I forget where I gathered this) that they disagree with many of the “facts” as stated in the affidavit; the EMT assessment of their behavior might be one of those facts.

    Note #2: psychoactive drugs do indeed have side effects. On the other hand, if a patient reports side effects, the doctor will switch the patient to another medication. (Thus, every time I went to see my psychopharmacologist to get a refill on, er, whichever thing it is I’m taking now, he’d invariably ask, “Any negative side effects–irritability, trouble sleeping…?” Of course, as y’all know by now, it’s hard to tell if a pill is making me irritable, insofar as “irritable” is my natural state of mind….) If Ward had had any obvious negative effects from Wellbutrin, his doctor would probably have switched him to Ritalin, or Prozac, or whatever. That, of course, is presuming that the Wellbutrin prescription wasn’t particularly recent. But all things being equal, I would guess that Ward didn’t have any major side effects.

    Ambien, on the other hand, does very much have the “trancelike” effects described in the post, and since patients have no memory of the event (which can include sleep-eating and even sleep-driving!), Ward may have had that side effect without anyone realizing it.

    • Legal Beagle
      04/20/2009 at 5:13 PM

      About switching from Wellbutrin to Prozac. A lot of guys are on Wellbutrin because it won’t quash sex-drive so much. Prozac and Zoloft really dampen it, so a lot of guys don’t want to be on those.

    • Michael
      04/20/2009 at 6:20 PM

      Many people simply do not discuss the negative side effects with their pharmacist or physician, especially if the side effects feel minor in comparison to ongoing depression or sleeplessness.

      Since the release of Prozac and similar antidepressants, most of these psychoactive medications are now prescribed by family and primary care physicians, who may or may not be less in tune with side effects or even the patient’s behavior. It’s very common for a patient to mention to the physician that s/he is depressed or feeling down and the prescription is often written without a thorough psychiatric evaluation.

      Sudden onset of irritability and violent behavior is not uncommon with SSRI’s. Clinical trial data suggests that less than 1% of patients experience these side effects. The industry considers these side effects as anecdotal, since there are only subjective ways to measure irritability and aggressive/violent behavior in a clinical trial. However in a population of 10 million patients that equals 100,000 potential irritable and/or violent patients.

      The prescribing information for all SSRI’s is almost identical. The drug manufacturers use pooled clinical trial data for each drug as part of a class of drugs, hence the same “black box” warning for Prozac as for Effexor and Lexapro. It is not like the patient goes to their physician and confides that s/he is abusing their spouse or children. Sometimes it is simply an outburst that seemingly comes out of nowhere. The drug manufacturers fought very hard to avoid the “black box” warning on antidepressants, out of fear that sales would decline and primary care doctors would resist prescribing them. The language in the “black box” warning was carefully crafted in negotiations between the FDA and the pharmaceutical companies, with many medical professionals concerned that it was too soft. Note that the warning excludes adults and pertains only to children and teens under 18 years of age. Poof, one turns nineteen, and there is no need to be concerned.

      SSRI’s have dramatically changed the treatment of depression and other psychiatric disorders, but have also created an environment that discounts the seriousness of the medication and the disorder. Joe Price’s comment that everyone he knows takes antidepressants underscores this attitude.

      Michael, editor

    • David
      04/20/2009 at 6:33 PM

      Lance,

      My guess, and it’s only a guess, is we will not hear about roommates version of what happened when the EMT’s arrived because that would require them to take the stand during trial, which would open them up to cross examination, which is always a risk for a defendant.

      David, editor

      • Friend of She Did It
        04/20/2009 at 7:55 PM

        So true, David, editor. Unless, one of the defendant’s strikes a deal — comes to his senses and realizes that it doesn’t have to end like this. Many on here believe the most likely candidate would be the person with the least comparable culpibility for the events of that evening — and many believe that person to be Victor.

        Editors, I expect comprehensive substantive coverage of Friday’s hearing. But perhaps just as insightful will be the appearance and mannerisms of Victor, Dylan and Joe. Are they still one big happy family? Are Victor and Dylan best buddies, arriving together, sitting with each other, giggling? Or is there some sign of distance, tension, among the gang. Maybe someone will try to cut their losses before the fat lady sings (no, not the downstairs neighbor!).

        If someone was depressed and on medications and somehow involved in an accidental/intentional murder and cover-up (and charged with at least a portion of the crime) I can not image what their mental health state would be like at this time. One would probably need intense treatment to sort through the issues – not sure if Dylan is or is not in therapy. His appearance may offer a clue as to his current state.

        • Corcoran Cutlet
          04/20/2009 at 8:25 PM

          The word “giggling” is the most amazing and surprising thing I have read on this sight. I thought I had become numbed to it. But I must ask, I know it sounds simplistic: Were they actually giggling in court???????? That is just freaking amazing if true. By the way, I thank the editors that they will be covering court events. There was a time I actually thought I would go down to court for the events themselves, but now I can just read about them in detail. You saved me a cab ride and a headache from all the flourescent
          lights in that courthouse! I’m a delicate flower.

          • Lance
            04/20/2009 at 8:34 PM

            Er what? Reread what FoSDI said: “Are Victor and Dylan best buddies, arriving together, sitting with each other, giggling?” That’s not by any means an assertion that they actually were; it’s a question about what will happen this coming Friday.

          • Craig
            04/20/2009 at 9:37 PM

            CC – Come on down. Team coverage.

            -Craig, ed.

          • David
            04/21/2009 at 12:58 PM

            CC,

            And don’t forget that Mike Scarcella from the blog of Legal Times noted that Victor was even “winking” to his supporters while in court. It was very interesting for Scarcella to note that, so it obviously made an impression on him about Victor’s behavior in court.

            David, editor

            • Corcoran Cutlet
              04/21/2009 at 1:45 PM

              Winking ….incredible…..I had missed that detail.

            • SheKnowsSomething
              04/21/2009 at 2:10 PM

              Victor and his supports were also described as laughing and running away from the courthouse after Joe Price’s arrest and initial court appearance.

      • Lance
        04/20/2009 at 8:31 PM

        Well, we might not hear from them, but even so their version of events may be presented as part of the defense.

  11. Fascinating
    04/21/2009 at 9:23 AM

    I don’t know about these things … Can anyone in the public attend the hearing on Friday?

    And will the trio of roommates attend? Or is it just a lawyer thing?

  12. Craig
    04/21/2009 at 9:32 AM

    The thinking right now is that Friday’s 9:45am status hearing is an open session. Room 318 at DC Superior Court. Hard to tell who will be attending. More on this later.
    -Craig

    • CDinDC
      04/21/2009 at 2:26 PM

      Craig,

      Any word on the response to defendant’s Bill of Particulars?

      • Craig
        04/21/2009 at 2:47 PM

        We haven’t heard but are wondering if we get an update / ruling from Judge Weisberg on that motion this Friday.

  13. CDinDC
    04/21/2009 at 3:13 PM

    The board waits with bated breath!

Comments are closed.