The military's top appeals court has ordered a new trial for a soldier who claims he was in a psychotic state caused by the anti-smoking drug Chantix when he viciously stabbed a fellow soldier to death.

The U.S. Court of Appeals for the Armed Forces agreed unanimously Wednesday on a retrial for Pfc. George MacDonald, finding that the judge in the original trial failed to advise jurors that "involuntary intoxication" is a valid defense.

Army Pfc. George MacDonald entered the barracks room of Pvt. Rick Bulmer at Fort Benning, Ga., on May 18, 2008, and attacked him with a knife while he slept. With no apparent motive, but with a clear intent to kill, according to court documents, MacDonald stabbed Bulmer in the neck once, and after the private tried to fight him off, stabbed him again more than 50 times.

Bulmer, 23, had been at basic training just three days.

MacDonald was charged with premeditated murder and assault with a dangerous weapon and other charges. But during the trial, the defense revealed that a month before the murder, MacDonald had been prescribed Chantix, also known as varenicline, to help him quit smoking.

Months before the murder, the FDA sent a memo to doctors warning about a possible link between the drug and suicidal and aggressive behavior.

And a month after the death, the FDA slapped a "black box" warning on Chantix, saying patients should be observed for neuropsychiatric symptoms, including behavioral changes such as "hostility, agitation, psychosis and suicide-related events."

In his trial, MacDonald admitted to intending to kill Bulmer. It was also found that he'd asked his girlfriend the day before the murder whether she would still love him if he were to kill somebody.

After he was found guilty and was sentenced to life without parole, his attorneys appealed on two points: the judge's failure to advise jurors and whether he erred in quashing a subpoena that would have forced manufacturer Pfizer to produce documents on the drug's clinical trials and adverse event reports.

In their 37-page decision, the military appellate judges said the lack of instruction may have clouded the case's original outcome.

"We cannot be confident beyond a reasonable doubt that the members would have concluded the appellant appreciated the wrongfulness of his actions if they had been properly instructed on involuntary intoxication with respect to Chantix," wrote Chief Justice James Baker. "As a result, we are not confident the error did not contribute to the verdict in this case."

While Chantix has been proved to help smokers kick the habit — 44 percent of patients who took the medication along with brief weekly counseling stopped smoking within 12 weeks, according to company studies — and has been prescribed to more than 20 million patients, it has caused unwanted side effects in some and prompted the FDA to require it carry the strongest type of warning.

A search of FDA records by Military Times found that since September 2012, 117 unique adverse event reports related to Chantix have been received by the FDA for suicide attempts, suicide or homicide, including 31 completed suicides and five homicides.

To date, Pfizer has paid at least $299 million to settle Chantix-related lawsuits.

The U.S. Court of Appeals for the Armed Forces issued the MacDonald decision on the last working day of the 2013-2104 term.

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