Luigi Mangione withdraws psychiatric defense in UnitedHealthcare CEO murder trial

Jun 18, 2026

In a reversal, lawyers for Luigi Mangione withdrew a planned psychiatric defense in his state murder trial for the December 2024 killing of UnitedHealthcare CEO Brian Thompson. The "extreme emotional disturbance" defense, if successful, could have reduced a murder charge to manslaughter. Mangione, who has pleaded not guilty, faces a state trial on September 8 and a separate federal stalking trial on October 13.

Mangione psychiatric defense withdrawal

▪The withdrawal occurred on the deadline for the defense to provide prosecutors with information supporting the claim.
▪Luigi Mangione's lawyers withdrew their plan to assert a psychiatric defense in his state murder trial on June 18, 2026.
▪The decision was a reversal, coming one day after his lawyers told a judge they planned to pursue the defense.
▪In a letter, lawyer Karen Friedman Agnifilo said the defense "respectfully withdraws" its notice under New York's psychiatric defense statute "at this time."

Extreme emotional disturbance defense strategy

▪A successful "extreme emotional disturbance" defense would require a jury to convict for manslaughter instead of murder.
▪A manslaughter conviction carries a sentence of up to 25 years in prison, while a murder conviction carries a potential life sentence.
▪The proposed defense involved claims that Luigi Mangione suffered from "extreme emotional disturbance" during the December 4, 2024, killing of Brian Thompson.
▪The "extreme emotional disturbance" defense is distinct from an insanity plea and is not permitted in Mangione's federal case.

State murder trial proceedings

▪After the defense was withdrawn, Judge Carro rescinded an order to unseal a transcript from a secret June 3 hearing, though some media had already received it.
▪Mangione's state murder trial before Judge Gregory Carro is scheduled to begin on September 8, 2026.
▪Luigi Mangione has pleaded not guilty to state charges including murder, weapons, and forgery.
▪Judge Gregory Carro previously ruled that a 3D-printed pistol and a notebook can be used as evidence against Mangione.

Federal charges dismissal

▪The dismissal of the federal murder charge eliminated the possibility of the death penalty for Mangione.
▪Mangione still faces federal stalking charges, with that trial scheduled to begin on October 13, 2026.
▪A federal judge dismissed murder and weapons charges against Luigi Mangione in January 2026, citing legal technicalities.

UnitedHealthcare CEO killing background

▪Mangione was arrested five days after the shooting at a McDonald's in Altoona, Pennsylvania.
▪Luigi Mangione is accused of fatally shooting UnitedHealthcare CEO Brian Thompson, 50, on December 4, 2024, in Manhattan.
▪A notebook found by prosecutors reportedly describes wanting to "wack" a health insurance executive and rebelling against "the deadly, greed fueled health insurance cartel."
▪Thompson was shot from behind by a masked gunman while walking to a hotel for a UnitedHealth Group investor conference.
▪Police reported that the words "delay," "deny," and "depose" were written on the ammunition used in the shooting.