R v Smallshire…influenced by Citalopram!

R v Smallshire [2008] All ER (D) 186 (Dec)

This is an English Appeal Case appealing the Length of sentence imposed upon the defendant (Ronald Smallshire).

The background to the Case…

The victim, 23, and his three step-sisters were walking their two dogs. One of the dogs attacked the defendant, his wife and one of the defendant’s dogs. The defendant, Mr Smallshire, 56, who had consumed alcohol, went into his house, got a steak knife and emerged wearing a coat with the hood pulled over his head. He hit the victim to the head and back, causing him to fall to the ground. Mr Smallshire then straddled the victim and stabbed him 19 times, also to the head and back. The victim suffered a pneumothorax (collapsed lung) and stab wounds. He stayed in hospital overnight. He made a good recovery but he and his stepsisters suffered psychological effects.

The Defendant Mr Smallshire had no previous convictions and was described by the Court as ‘a man of impeccably good character’. The Court further stated that it was quite apparent that his conduct was out of character. So what could make a person behave in such an uncharacteristic fashion? Ah yes, Citalopram again!

The appeal centered around the side-effects of the medication he was prescribed. 11 days before the incident, Mr Smallshire was prescribed Citalopram. Mr Smallshire said, upon starting the medication, he felt agitated, unreal and confused.

Excerpt;

Mr Smallshire relies, in support of his challenge to conviction, upon evidence of Dr Andrew Herxheimer, a consultant clinical pharmacologist, experienced in the investigation and evaluation of the adverse effects of drug therapy and who in recent years has studied a large number of reports of effects relating to SSRI (Select Seroxat Inhibitors) antidepressant drugs, of which Citalopram is one.

Dr Herxheimer wrote a report for the Court where he concluded:

“. . . citalopram very likely contributed decisively to Mr Smallshire’s actions on 16 December 2005. He had started taking this antidepressant medication 11 days earlier; its concentration in his brain would have been steadily increasing from about seven days. It is highly probable that alcohol augmented the effect of the drug: on its own alcohol would not account for his behaviour.”

In allowing the appeal, the Court reduced Mr Smallshire’s sentence from six-and-a-half years to four-and-a-half years.  Full Judgment R v Smallshire


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