Sheila re loading. Twice.

[david1819]

In normal subjects after a single oral dose, haloperidol half-life has been reported to range 14.5-36.7 hours (or up to 1.5 days). After chronic administration, half-lives of up to 21 days have been reported

http://www.ncbi.nlm.nih.gov/pubmed/15538130

I have never seen the autopsy report, However the drug can remain in your system for many weeks having not taken the drug. You need to take the drug on a daily basis for it to work and it will stay in the body tissue for several weeks as the half life time states. 

[Caroline]

Shelia was prescribed the antipsychotic Haloperidol, the common side effects of Haloperidol explain Shelia's behaviour

Dystonia
Muscle rigidity
Akathisia
Parkinsonism
Hypotension
Agitation
Confusional state
Visual disturbances
Neuroleptic malignant syndrome
and many more less common side effects

She stopped taking this medication at the time of murders. The drug is used to prevent mania and other episodes common with schizophrenia.

A .22 semi automatic rifle is easy to load and use. The trigger and the bolt lever is all you can move and all you can use. Its a simple weapon.

http://youtu.be/vx2hKR_XI2A?t=4m46s

The gun cannot be used as forensic evidence, Its been proven that the police handled and moved it several times thus contaminating it. I have heard conflicting claims that Shelia' fingerprints where on the gun and where not the gun but like I said the gun cant be used as forensic evidence because its been tampered with.

Here's one for you. If Jeremy went though all the effort to plan and premeditate this including the false police telephone calls using a bike and even dying his hair jet black why didn't he consider wearing gloves to cover his prints?

Not sure where you are getting your info from, but Sheila didn't stop taking Haloperido at all.

[david1819]

Not sure where you are getting your info from, but Sheila didn't stop taking Haloperido at all.

The Mammoth Book of CSI By Roger Wilkes.
-------------------------------

You also need to consider that the effects of oral Haloperido last between 2-6 hours depending on dosage. At the time of the crime it would have weared off, Unless she took it before bed.   

http://www.healthyplace.com/other-info/psychiatric-medications/haloperidol-full-prescribing-information/

[Myster]

Sheila wasn't taking Haldol orally at the time of the murders... she had monthly injections - 100 mg per month, reduced from 200mg in July1985 because it was making her very lithargic. When questioned Dr Ferguson's opinion was that she would not have killed her father or the twins.

[APRIL]

Sheila wasn't taking Haldol orally at the time of the murders... she had monthly injections - 100 mg per month, reduced from 200mg in July1985 because it was making her very lithargic. When questioned Dr Ferguson's opinion was that she would not have killed her father or the twins.

I have grave doubts about the efficacy of Dr F's treatment of Sheila, partly because he seems NOT to have been aware that his instructions weren't followed to reduce the dosage to 150 mg and partly because he may have been compromised by also treating June. Certainly Sheila was medicated but there seem to have been no inroads made into assessing her psychological state of mind.

[Myster]

I have grave doubts about the efficacy of Dr F's treatment of Sheila, partly because he seems NOT to have been aware that his instructions weren't followed to reduce the dosage to 150 mg and partly because he may have been compromised by also treating June. Certainly Sheila was medicated but there seem to have been no inroads made into assessing her psychological state of mind.

Where are you getting this information from, April?  Who didn't follow the instructions to reduce her dosage to 150mg - her local G.P?   I thought it was 100 rather than 150 too. If Sheila was drugged up with 200mg on August 7th then no wonder she appeared out of it on the phone!

[Caroline]

The Mammoth Book of CSI By Roger Wilkes.
-------------------------------

You also need to consider that the effects of oral Haloperido last between 2-6 hours depending on dosage. At the time of the crime it would have weared off, Unless she took it before bed.   

http://www.healthyplace.com/other-info/psychiatric-medications/haloperidol-full-prescribing-information/

I think several people have now told you that Sheila was receiving monthly injections and not taking the drug orally.

[Caroline]

Where are you getting this information from, April?  Who didn't follow the instructions to reduce her dosage to 150mg - her local G.P?   I thought it was 100 rather than 150 too. If Sheila was drugged up with 200mg on August 7th then no wonder she appeared out of it on the phone!

Hi Myster, that is what April means, the dose was meant to be reduced to 150mg (on Dr F's instructions) but it was reduced to 100mg. So, his instructions were not followed.

[APRIL]

Where are you getting this information from, April?  Who didn't follow the instructions to reduce her dosage to 150mg - her local G.P?   I thought it was 100 rather than 150 too. If Sheila was drugged up with 200mg on August 7th then no wonder she appeared out of it on the phone!

 Myster, at some point, after discharging herself from Dr F's care -in his opoinion, too soon- Sheila visited her GP and requested that he dosage of Haloperidol be reduced. Her GP wrote to Dr F. who EVENTUALLY received the letter and he suggested that the dosage was reduced to 150 mgs. Sheila was unable to keep her appointment with her regular GP -Dr Angelou?- so she saw a locum. I'm presuming that she would have explained to this locum her request for a reduced dose of meds, and, again, I'm assuming that the locum knew nothing of her case and didn't check, but she DID administer a dose of only 100 mgs which IMO, should NEVER have b een done without close monitoring. We already know that Dr F. said, of Sheila, that she was difficult to treat because she failed to keep follow up appointments. He also said, because she chose to leave his care earlier than he would have liked, that she should be visited by psych. nurses. THIS never happened. I feel PASSIONATELY that Sheila was BADLY let down.

[scipio_usmc]

Myster, at some point, after discharging herself from Dr F's care -in his opoinion, too soon- Sheila visited her GP and requested that he dosage of Haloperidol be reduced. Her GP wrote to Dr F. who EVENTUALLY received the letter and he suggested that the dosage was reduced to 150 mgs. Sheila was unable to keep her appointment with her regular GP -Dr Angelou?- so she saw a locum. I'm presuming that she would have explained to this locum her request for a reduced dose of meds, and, again, I'm assuming that the locum knew nothing of her case and didn't check, but she DID administer a dose of only 100 mgs which IMO, should NEVER have b een done without close monitoring. We already know that Dr F. said, of Sheila, that she was difficult to treat because she failed to keep follow up appointments. He also said, because she chose to leave his care earlier than he would have liked, that she should be visited by psych. nurses. THIS never happened. I feel PASSIONATELY that Sheila was BADLY let down.

You would have a vlaid argument if 100MG were not an effective dose.  But as I pointed out to you what we know today is that 100MG is considered the largest safe dose to give on a regular basis and there is no significant difference in effectiveness between 100MG and 200MG.  The fact that there is no major difference in effectiveness yet many problems from dosages greater than 100MG is why it is not considered safe.

You keep ignoring this and pretending 100MG was not enough of  adoasge and that as a result she relapsed.  It is a wasted effort though.

[APRIL]

You would have a vlaid argument if 100MG were not an effective dose.  But as I pointed out to you what we know today is that 100MG is considered the largest safe dose to give on a regular basis and there is no significant difference in effectiveness between 100MG and 200MG.  The fact that there is no major difference in effectiveness yet many problems from dosages greater than 100MG is why it is not considered safe.

You keep ignoring this and pretending 100MG was not enough of  adoasge and that as a result she relapsed.  It is a wasted effort though.

Scipio, I'm fully aware of what YOU have said but I've discussed this with a friend who is a psychiatrist and I naturally put far more store by what SHE has to say, than you, on this particular point. Quite reasonably, I wouldn't seek her advice on legal matters. Each to their own.

You do seem to be missing some of the point here, anyway. I don't know what would be the procedure in  America, but here it isn't usual for a GP -let alone a locum who wasn't au fait with the patient- to go against the instructions of a consultant, added to which, said consultant has put it in writing how difficult was Sheila to treat because she failed to keep follow up appointments. She had left hospital too soon, having been there only about a month. Had she stayed longer they may have corrected the dosage. She wasn't fully well. She had written a very strange letter to AE.

I AM prepared to allow, that under supervised conditions, reducing her meds by half. to counteract side effects, might have been reasonable, but to lift someone out of lethargy without close monitoring and ASSUME that they're safe, when they have mentioned suicide, even in passing, is NOT a step that most psychiatrists would take. 

[scipio_usmc]

Scipio, I'm fully aware of what YOU have said but I've discussed this with a friend who is a psychiatrist and I naturally put far more store by what SHE has to say, than you, on this particular point. Quite reasonably, I wouldn't seek her advice on legal matters. Each to their own.

You do seem to be missing some of the point here, anyway. I don't know what would be the procedure in  America, but here it isn't usual for a GP -let alone a locum who wasn't au fait with the patient- to go against the instructions of a consultant, added to which, said consultant has put it in writing how difficult was Sheila to treat because she failed to keep follow up appointments. She had left hospital too soon, having been there only about a month. Had she stayed longer they may have corrected the dosage. She wasn't fully well. She had written a very strange letter to AE.

I AM prepared to allow, that under supervised conditions, reducing her meds by half. to counteract side effects, might have been reasonable, but to lift someone out of lethargy without close monitoring and ASSUME that they're safe, when they have mentioned suicide, even in passing, is NOT a step that most psychiatrists would take.

I presended documentary evidence including the prescribing instructions currently in force. That trumps the opinion of a nurse by far.  Her opinion means nothing when the prescribing information says not to do more than 100MG and there are studies that document the effectiveness of 100MG is virtually identical to 200MG.  In fact the studies found not much difference between 50MG and 100MG. 

You can choose to ignore that all you like but it is worthless to go into a debate saying you choose to ignore it because you would rather believe the unsupported opinion of a nurse friend.  Unless your nurse friend can point to stupides to contrdict the findings and say the prescribing instructions used today are in error she is of no use to you at all.

I don't really care about the issue of whether the doctor was wrong to change the dosage on her own because it has nothing to do with the murders.  I care about evidence related to the murders.

In any event since she is a doctor and the one giving the shot I would presume even in the UK she has to make her own assessment of what to give becaus eit is her butt on the line and a doctor is supposed to to just follow blindly what others say.

Ferguson stated that bases on what this doctor said and others said Sheila's dosage was too high and she was being over sedated.  That assessment was that she was oversedated at the time of death which is when she had only 100MG.  I am sure part of that is that she was not taking a countering agent.  Had she been taking it then the effects woudl nto have been as bad. 

[david1819]

DOSAGE AND ADMINISTRATION
HALDOL (Haloperidol) Decanoate should be administered by deep intramuscular injection into the gluteal region. A 2- inch long, 21-gauge needle is recommended. The maximum volume per injection site should not exceed 3
mL. The recommended interval between doses is 4 weeks.

https://www.janssen.com.au/files/Products/Haldol_PI.pdf?ffab46d24955f7a16d07b725fac74a7a

When is the last time Shelia received an Injection?

100mg is the recommended highest dosage today. However the same standards would not have been used in the 1980s

[scipio_usmc]

DOSAGE AND ADMINISTRATION
HALDOL (Haloperidol) Decanoate should be administered by deep intramuscular injection into the gluteal region. A 2- inch long, 21-gauge needle is recommended. The maximum volume per injection site should not exceed 3
mL. The recommended interval between doses is 4 weeks.

https://www.janssen.com.au/files/Products/Haldol_PI.pdf?ffab46d24955f7a16d07b725fac74a7a

When is the last time Shelia received an Injection?

100mg is the recommended highest dosage today. However the same standards would not have been used in the 1980s

That is the whole point we know much more today than back then.  If they knew back then what we know today Ferguson would never have prescribed her 200MG.  She might have been prescribed 50MG for all we know since it is the typicla high doasge and 100MG is reserved for the worst cases but then again she might have been deemed to warrant 100MG we have no idea what his assessment would have been.  All we know is he was wrong in claiming 200MG was safe and wrong about it not causing harmful side effects.  He claimed it was very safe but studies have found he was wrong which is why it is not used much these days there are safer drugs available.

The injections lasted for 6 weeks but she was being injected every 4 weeks.  The reason why you don't wait 6 weeks is you want to make sure it doesn't run out before the next injection and want to have regular intervals so you don't forget and you have some leeway in case there are some scheduling issues. Her last injection prior to death was July 11 (so 3 weeks before her death).  She was supposed to get another injection the week after she died. The dosage of her last injection was 100MG.  It is unknown why she stopped taking the agent prescribed to counter the side effects.  Given her complaints about being too drwsy you would think her doctor would have asked her if she was taking it but apparently she didn't ask.  Thus we have no clue why she stopped was she just too lazy or was there another reason?.  One of the things it is supposed to counter is the drowsiness she complained of...  So that helps explain why she was still so drowsy even after the reduction to 100MG. Had she been taking the countering aganet maybe that would not have been the case. 

 

 

[APRIL]

I presended documentary evidence including the prescribing instructions currently in force. That trumps the opinion of a nurse by far.  Her opinion means nothing when the prescribing information says not to do more than 100MG and there are studies that document the effectiveness of 100MG is virtually identical to 200MG.  In fact the studies found not much difference between 50MG and 100MG. 

You can choose to ignore that all you like but it is worthless to go into a debate saying you choose to ignore it because you would rather believe the unsupported opinion of a nurse friend.  Unless your nurse friend can point to stupides to contrdict the findings and say the prescribing instructions used today are in error she is of no use to you at all.




I don't really care about the issue of whether the doctor was wrong to change the dosage on her own because it has nothing to do with the murders.  I care about evidence related to the murders.

In any event since she is a doctor and the one giving the shot I would presume even in the UK she has to make her own assessment of what to give becaus eit is her butt on the line and a doctor is supposed to to just follow blindly what others say.

Ferguson stated that bases on what this doctor said and others said Sheila's dosage was too high and she was being over sedated.  That assessment was that she was oversedated at the time of death which is when she had only 100MG.  I am sure part of that is that she was not taking a countering agent.  Had she been taking it then the effects woudl nto have been as bad.

WHERE do I say my friend is a nurse? Try READING instead of merely ASSUMING. Prior to her retirement last year, she was a practicing PSYCHIATRIST. WHY would I take the word of a will writer/property conveyancer/articled clerk over a trained doctor? As you are ONLY interested in "the murders" perhaps you should limit your comments to just what pertains to them and leave the rest of us to look at the bigger picture uninterrupted.