He was charged in the Aug. 15 killings of John Stevens, 59, and Michelle Mishcon, 53, at their home in Tequesta, Fla. He was also charged with the attempted murder of Jeff Fisher, who was stabbed after he heard the couple’s screams and ran to help.

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Officials are waiting for toxicology tests to reveal whether Harrouff was under the influence of hallucinogenic drugs like bath salts or flakka, which have caused violent outbursts in the past.

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Investigators said Harrouff may have ingested caustic chemicals inside the couple’s garage. His father, a dentist, said that at one point, Harrouff’s liver was failing, he had fluid in his lungs and his esophagus was bleeding, the AP reported.

Sheriff William Snyder said the teen will need ongoing therapy after the attack.

The bizarre case began on a Monday night, when a sheriff’s deputy responded to a 911 call in an upscale neighborhood and found a shirtless person on top of a man he had apparently just stabbed, “biting and removing pieces of the victim’s face with his teeth,” Snyder said.

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The deputy fired her stun gun at the shirtless man, but it had no effect.

Other deputies arrived and punched and kicked the suspect. Nothing.

Even a police dog’s bite didn’t deter the attacker from biting the dead man’s face, authorities said.

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“He was exhibiting abnormal levels of strength,” Snyder said in a press conference after the attack.

In the end, it would take four deputies and the police dog to subdue the attacker.

As deputies took Harrouff into custody, he was making “guttural sounds and animal noises,” Snyder told The Post.

With Harrouff in custody and on his way to the hospital, investigators surveyed the grisly scene at the home near Jupiter, Fla.

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Stevens was pronounced dead in the driveway. Mishcon, his wife, was found dead in the garage. Fisher returned home bloodied, but managed to call 911.

Snyder told The Post that Stevens and Mishcon typically spent evenings sitting in their garage with the door open, looking out at the neighborhood and talking. That’s what they were probably doing when Harrouff came across them, the sheriff said.

“It was a random, unprovoked brutal attack on people enjoying a quiet South Florida evening,” Snyder told The Post. “There was an extraordinary amount of violence in that garage.”

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The victims were stabbed with Harrouff’s pocket knife and may have been attacked with “tools of opportunity” in the garage, the sheriff said.

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They had never met their attacker, Snyder said, and probably had no idea why he wanted to kill them.

“He exhibited every indication of a flakka overdose — abnormal strength, peeling off some of his clothes, making guttural sounds, fighting with law enforcement, not stopping when a tremendous amount of energy was expended by my deputies,” Snyder said.

Flakka has also been referred to as “$5 insanity,” “powdered psychosis” and “total mind melt.” It has surfaced in Ohio, Chicago and Houston, according to a Post article on the epidemic; but is most prevalent in Florida.

Until recently, the drug was easily obtained online from Chinese retailers. In Broward County, a major hospital system said it seen up to 20 flakka-related emergencies in one day last year. At least 16 deaths have been attributed to the cheap drug since September.

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Flakka causes users’ body temperatures to soar to 104 or 105 degrees, causing them to rip off their clothes. It also sends a surge of adrenaline through their bodies, giving them seemingly superhuman strength and a high pain tolerance.

But slight changes in purity or dose can result in bizarre or deadly reactions. In April 2015, a man high on flakka tried to have sex with a tree, according to the Miami Herald. An officer used a Taser to try to subdue the man, but the suspect pulled the electric probes from his body and tried to stab the officer with his own badge.

Last summer, an 83-year-old grandmother was badly beaten by a 26-year-old man who had ingested flakka before knocking on her door and attacking her, according to the Palm Beach Post. She died three months later.

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As The Post’s Peter Holley wrote:

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Flakka, according to the county’s human services department, “is a potent, highly addictive stimulant drug. In a small amount the drug provides euphoria, stimulation, and hallucinations. However, just a little bit more can trigger heart problems, agitation, aggressiveness, psychosis, paranoia and excited delirium.” The drug — a more potent form of what was previously known as bath salts — gets its name from “la flaca,” Spanish slang for a beautiful woman, according to CNN . It is known elsewhere in the country as “gravel” and, according to Reuters , has surfaced in Ohio, Chicago and Houston. “People, they start going crazy, just like PCP and LSD did in the old days,” Kevin Stanfill a special agent with the Drug Enforcement Administration’s Miami field office, told Jacksonville station WJXT . “They get superhuman strength, they get paranoid. We get instances here in Florida where a man bit his baby; we get instances here in southern Florida where a man put this baby under water.”

But after the drug strained emergency services and hospitals for nearly two years, authorities had seen a significant decline in flakka use in recent months.

According to a Post report in April: “What happened in Florida, experts say, was the result of unprecedented coordination among local groups to fight flakka’s demand and — most importantly — the unusual willingness of the Chinese government to halt flakka’s production.”

The August attack, however, may be a sign that the drug isn’t totally gone from the region, Snyder said. His investigators are trying to piece together how Harrouff may have gotten the drug and what he was doing in the minutes before he encountered the middle-aged couple relaxing in their garage.

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Nothing in Harrouff’s past pointed at any violent tendencies, Snyder told The Post. Before he was accused of a double homicide, he had no criminal record.

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Harrouff was in town visiting his family and hanging with fraternity brothers a few weeks before school was scheduled to resume.

His family met up at a nearby restaurant for dinner, but Harrouff grew agitated when the food took too long to come to the table. He walked out of the restaurant and his worried family called the Jupiter police, asking officers to help locate him.

This post, originally published Aug. 16, has been updated multiple times.

