Its not a case that Jeremy is guilty its a case of incompetence!

[Jane]

More than 100MG for any length of time is not considered safe.  The health risks MIGHT in some extreme cases have been deemed worthwhile to endure IF 200MG were significantly more effective than a lower dose.  But since it is not significantly more effective there is no real benefit simply harm caused by it. 

It would be like a doctor prescribing a dose of high blood pressure medicine that causes other long term effects instead of a lesser dose even that causes less problems even though both doses have virtually the same effectiveness at controlling high blood pressure.  That constitutes malpractice and a drug company manufacturing such could be sued as well. Low demand and threat of lawsuit equals discontinuing the product.   

I believe you've "fudged" one of my points and "hedged" another. You can talk al you like about the 200mg dose being considered unsafe, but MY contention is that Dr F clearly didn't think so. He wouldn't deliberately have prescribed an unsafe dose. I will allow that because she was in hospital and being monitored, she MAY have been given a higher dose for the time she was there, which would have been reduced before she left. However, I have to rule this out because Dr F doesn't say anything about persuading her to stay until her meds were checked, just that she insisted on leaving earlier than he would have liked.

If we look AGAIN!! at what Dr Wilkinson took it upon herself to do, it's possible that prior to her appointment at Sheila's surgery two days prior to seeing Sheila, she had been at a seminar on the efficacy of anti psychotic drugs and the revised thinking about dosage. Had that been the case, the correct and, indeed, COURTEOUS procedure, on seeing the dosage suggested for Sheila, would have been to contact Dr F and talk to him about it, and if he hadn't been available, to administer the dose he'd prescribed until such time as she COULD contact him. At the VERY least she should have discussed it with Dr Angelugou(s).

[Alias]

 Sheila was on more than 400 mg-s per month - and even more, since she got her injections every two weeks. The halving time of Haloperidol is 21 days. So  possibly Sheila was cut down from 400 to a 100 mg-s.
What scipio doesn´t seem to understand is that it can have devastating consequenses to cut down the dose drastically. It is recommended that patients are in a hospital setting, monitored during such a procedure; that the dosage is cut down 10mg at a time, monitor for a week - then cut down 10mg again, if the patient doesn´t show any signs of agitation - and so forth.
This was far from the reality in Sheila´s case, her dose was brutally reduced and she was left to herself.

[scipio_usmc]

I believe you've "fudged" one of my points and "hedged" another. You can talk al you like about the 200mg dose being considered unsafe, but MY contention is that Dr F clearly didn't think so. He wouldn't deliberately have prescribed an unsafe dose. I will allow that because she was in hospital and being monitored, she MAY have been given a higher dose for the time she was there, which would have been reduced before she left. However, I have to rule this out because Dr F doesn't say anything about persuading her to stay until her meds were checked, just that she insisted on leaving earlier than he would have liked.

If we look AGAIN!! at what Dr Wilkinson took it upon herself to do, it's possible that prior to her appointment at Sheila's surgery two days prior to seeing Sheila, she had been at a seminar on the efficacy of anti psychotic drugs and the revised thinking about dosage. Had that been the case, the correct and, indeed, COURTEOUS procedure, on seeing the dosage suggested for Sheila, would have been to contact Dr F and talk to him about it, and if he hadn't been available, to administer the dose he'd prescribed until such time as she COULD contact him. At the VERY least she should have discussed it with Dr Angelugou(s).

In the hospital she was being given an oral dose of both Haldol and a countering agent. When she got out it was converted to an injection.  We didn't see her records and he never stated what the oral dose was or how he calculated the transition. He was supposed to be reducing her dosage to find the minimum dosage needed to control her condition.  It doesn't seem he did that for her to receive such a high dosage still after a month of treatment or his calcualtion of the injeciton dosage was way off what it should have been. It doesn't matter that Ferguson was unaware at the time of things we know now about Haldol all that matters is what we know about it.  We are not looking into whether he harmed her with the dosage and such be liable, we care about whther the dosage would have been effective and the impact on her physical abilities.

We know now that 200MG was way too high and that even 100MG can be too high a dosage.  Whether a patient needs the 100MG instead of 50MG will depend on the patient. There is only a couple of percentage points separating the effectiveness of 50MG and 100MG.  Even with the 50MG a countering agent is prescribed.  We have no way to know why Sheila wasn't taking it regularly.  We simply know she wasn't so the tranquilizing effects of the drug as well as the side effects were not being countered at all at the time of the murders.  Whether she had been taking it at any point after leaving the hospital is unknown and will neve rbe known becaus eonly she knows.

After her reduction to 100MG things did not change she was still observed as being sleepy, vacant and having speech difficulties.  The bottom line is that the efficacy of the dose is not in question, there is little difference in the medical effectiveness of 100G and 200MG, so there is no reason she would have had a psychotic episode at all let alone an episode in the middle of the night where for the first time she became violent towards others.  In fact she would have had difficulty carrying out the murders given the overall reduction in her physical abilities as a result of taking the medication without any counter.




     


without no countering agent can cause severe problems. 

[Jane]

In the hospital she was being given an oral dose of both Haldol and a countering agent. When she got out it was converted to an injection.  We didn't see her records and he never stated what the oral dose was or how he calculated the transition. He was supposed to be reducing her dosage to find the minimum dosage needed to control her condition.  It doesn't seem he did that for her to receive such a high dosage still after a month of treatment or his calcualtion of the injeciton dosage was way off what it should have been. It doesn't matter that Ferguson was unaware at the time of things we know now about Haldol all that matters is what we know about it.  We are not looking into whether he harmed her with the dosage and such be liable, we care about whther the dosage would have been effective and the impact on her physical abilities.

We know now that 200MG was way too high and that even 100MG can be too high a dosage.  Whether a patient needs the 100MG instead of 50MG will depend on the patient. There is only a couple of percentage points separating the effectiveness of 50MG and 100MG.  Even with the 50MG a countering agent is prescribed.  We have no way to know why Sheila wasn't taking it regularly.  We simply know she wasn't so the tranquilizing effects of the drug as well as the side effects were not being countered at all at the time of the murders.  Whether she had been taking it at any point after leaving the hospital is unknown and will neve rbe known becaus eonly she knows.

After her reduction to 100MG things did not change she was still observed as being sleepy, vacant and having speech difficulties.  The bottom line is that the efficacy of the dose is not in question, there is little difference in the medical effectiveness of 100G and 200MG, so there is no reason she would have had a psychotic episode at all let alone an episode in the middle of the night where for the first time she became violent towards others.  In fact she would have had difficulty carrying out the murders given the overall reduction in her physical abilities as a result of taking the medication without any counter.




     


without no countering agent can cause severe problems.

Scipio, for the first time I feel as if you've heard me!!!!!!! It's possible you may know where I'm coming from now.

We are still at variance about HOW sleepy Sheila was. There is a statement somewhere by someone who I believe Sheila met by accident and just happened to be a psychiatric nurse. The first time they met Sheila appeared unkempt and not entirely with it. The next time they met -within a few days- Sheila appeared brighter. She'd taken care with her clothes, had washed her hair and applied make up.

 We hear from Colin how distant and quiet she was on the journey to Essex. This MAY have been caused by the medication but could equally well have been caused by something Colin said OR she didn't want to go where she was being taken. We know that a local shopkeeper said she was lethargic.

 We also know that during her stay she WALKED!!! -nobody has admitted to giving her a lift- approximately 7 miles to the monastery from which she later RAN, screaming approximately 7 miles back. We know she managed, by screaming at him, to frighten the meter man into retreating to the safety of his car and we are told that she was seen skipping with the children. All this activity requires enormous ENERGY which you imply wouldn't have been possible because of the level of her medication. I can only believe that her energy levels, MAYBE because of the medication, fluctuated.

[scipio_usmc]

Scipio, for the first time I feel as if you've heard me!!!!!!! It's possible you may know where I'm coming from now.

We are still at variance about HOW sleepy Sheila was. There is a statement somewhere by someone who I believe Sheila met by accident and just happened to be a psychiatric nurse. The first time they met Sheila appeared unkempt and not entirely with it. The next time they met -within a few days- Sheila appeared brighter. She'd taken care with her clothes, had washed her hair and applied make up.

 We hear from Colin how distant and quiet she was on the journey to Essex. This MAY have been caused by the medication but could equally well have been caused by something Colin said OR she didn't want to go where she was being taken. We know that a local shopkeeper said she was lethargic.

 We also know that during her stay she WALKED!!! -nobody has admitted to giving her a lift- approximately 7 miles to the monastery from which she later RAN, screaming approximately 7 miles back. We know she managed, by screaming at him, to frighten the meter man into retreating to the safety of his car and we are told that she was seen skipping with the children. All this activity requires enormous ENERGY which you imply wouldn't have been possible because of the level of her medication. I can only believe that her energy levels, MAYBE because of the medication, fluctuated.

I have not seen any reliable evidence at all related to the claim she went to a monastery and ran away screaming.

The evidence of her being vacant, very slow tlaking etc is an observation of many witnesses and we know she was tired so didn't even say goodnight to Pam.  Being able to scream at an intruder to leave doesn't demonstrate much.

The available evidence doesn't present  apicture that she would be likely to relaspe period let alone to harm anyone.

[Alias]

In the hospital she was being given an oral dose of both Haldol and a countering agent. When she got out it was converted to an injection.  We didn't see her records and he never stated what the oral dose was or how he calculated the transition. He was supposed to be reducing her dosage to find the minimum dosage needed to control her condition.  It doesn't seem he did that for her to receive such a high dosage still after a month of treatment or his calcualtion of the injeciton dosage was way off what it should have been. It doesn't matter that Ferguson was unaware at the time of things we know now about Haldol all that matters is what we know about it.  We are not looking into whether he harmed her with the dosage and such be liable, we care about whther the dosage would have been effective and the impact on her physical abilities.

We know now that 200MG was way too high and that even 100MG can be too high a dosage.  Whether a patient needs the 100MG instead of 50MG will depend on the patient. There is only a couple of percentage points separating the effectiveness of 50MG and 100MG.  Even with the 50MG a countering agent is prescribed.  We have no way to know why Sheila wasn't taking it regularly.  We simply know she wasn't so the tranquilizing effects of the drug as well as the side effects were not being countered at all at the time of the murders.  Whether she had been taking it at any point after leaving the hospital is unknown and will neve rbe known becaus eonly she knows.

After her reduction to 100MG things did not change she was still observed as being sleepy, vacant and having speech difficulties.  The bottom line is that the efficacy of the dose is not in question, there is little difference in the medical effectiveness of 100G and 200MG, so there is no reason she would have had a psychotic episode at all let alone an episode in the middle of the night where for the first time she became violent towards others.  In fact she would have had difficulty carrying out the murders given the overall reduction in her physical abilities as a result of taking the medication without any counter.




     


without no countering agent can cause severe problems.

Can you document that - who observed this?
It cannot have been Dr. Ferguson, since he claims that Sheila´s dose was not reduced, because she died before it was done.
"I can say from my records that Dr ANGELOU wrote to me on 15 July 1985 asking for me to cut Sheila´s doze from 200 mg to 100 mg a month, as Sheila felt she was recaiving too large a dose. Because of Sheila´s death nothing was done inrespect of this."

This is not correct. I don´t know how he then can go on to give an assessment of Sheila - he clearly didn´t know what was going on. + Why does Dr Angelou state that Dr Ferguson recommended that the drug be reduced to 150 mg, not 100 mg?
Those statements are very "hazy", I wonder why.

[Alias]

I have not seen any reliable evidence at all related to the claim she went to a monastery and ran away screaming.

The evidence of her being vacant, very slow tlaking etc is an observation of many witnesses and we know she was tired so didn't even say goodnight to Pam.  Being able to scream at an intruder to leave doesn't demonstrate much.

The available evidence doesn't present  apicture that she would be likely to relaspe period let alone to harm anyone.

Oh, but it does. Don´t forget that he "feared for his life" - so did Freddie Emami during another psychotic attack.

[Jane]

I have not seen any reliable evidence at all related to the claim she went to a monastery and ran away screaming.

The evidence of her being vacant, very slow tlaking etc is an observation of many witnesses and we know she was tired so didn't even say goodnight to Pam.  Being able to scream at an intruder to leave doesn't demonstrate much.

The available evidence doesn't present  apicture that she would be likely to relaspe period let alone to harm anyone.

No, I'd agree that if what I've only just read is anything to go by, the evidence of her running screaming is "iffy" to say the least. However, she was clearly capable of walking there and back.

The ability to scream demonstrates a certain energy level probably not attainable if one is in a constant state of listlessness and lethargy.

[Jane]

Can you document that - who observed this?
It cannot have been Dr. Ferguson, since he claims that Sheila´s dose was not reduced, because she died before it was done.
"I can say from my records that Dr ANGELOU wrote to me on 15 July 1985 asking for me to cut Sheila´s doze from 200 mg to 100 mg a month, as Sheila felt she was recaiving too large a dose. Because of Sheila´s death nothing was done inrespect of this."

This is not correct. I don´t know how he then can go on to give an assessment of Sheila - he clearly didn´t know what was going on. + Why does Dr Angelou state that Dr Ferguson recommended that the drug be reduced to 150 mg, not 100 mg?
Those statements are very "hazy", I wonder why.

Alias, THIS looks as if it could bear out what we've been saying all along. Her GP asks for her meds to be halved but her consultant knows the danger of reducing anti psychotics too much in one hit. However, they halved it anyway, without his permission.

[scipio_usmc]

Oh, but it does. Don´t forget that he "feared for his life" - so did Freddie Emami during another psychotic attack.

This is just one of the areas which demonstrate how absurd you are.

Someone unreasonably fearing for their life proves nothing other than that they are unreasonable and whether he was just being facetious or actually an unreasonable clown is unclear.  You criticize her as unreasonabel to fear an intruder and scream for him to leave and yet suggest it is reaosnable he would fear for his life from a thin unarmed woman?  You have things backwards. In the meantime it wasn't even a psychotic episode she screamed at a perceived intruder. 

Freddie didn't fear for his life he said that during the episode he feared she might become violent but that she didn't.  So during an episode that lasted a long time and was reportedly her worst she still didn't resort to violence.  Saying people were scared she would means nothing, she didn't.

[Jane]

This is just one of the areas which demonstrate how absurd you are.

Someone unreasonably fearing for their life proves nothing other than that they are unreasonable and whether he was just being facetious or actually an unreasonable clown is unclear.  You criticize her as unreasonabel to fear an intruder and scream for him to leave and yet suggest it is reaosnable he would fear for his life from a thin unarmed woman?  You have things backwards. In the meantime it wasn't even a psychotic episode she screamed at a perceived intruder. 

Freddie didn't fear for his life he said that during the episode he feared she might become violent but that she didn't.  So during an episode that lasted a long time and was reportedly her worst she still didn't resort to violence.  Saying people were scared she would means nothing, she didn't.

So you're saying that those who said they feared for their life were just using throw away remarks. A bit like Jeremy when he said he was sleeping like a log, perhaps?

[scipio_usmc]

Alias, THIS looks as if it could bear out what we've been saying all along. Her GP asks for her meds to be halved but her consultant knows the danger of reducing anti psychotics too much in one hit. However, they halved it anyway, without his permission.

All it says is that her dosage was cut by the doctor who gave her the injeciton and that the doctor requested the dosage be permanantly reduced but she died before Ferguson got around to doing it.

[scipio_usmc]

Sheila was on more than 400 mg-s per month - and even more, since she got her injections every two weeks. The halving time of Haloperidol is 21 days. So  possibly Sheila was cut down from 400 to a 100 mg-s.
What scipio doesn´t seem to understand is that it can have devastating consequenses to cut down the dose drastically. It is recommended that patients are in a hospital setting, monitored during such a procedure; that the dosage is cut down 10mg at a time, monitor for a week - then cut down 10mg again, if the patient doesn´t show any signs of agitation - and so forth.
This was far from the reality in Sheila´s case, her dose was brutally reduced and she was left to herself.

Her dose was cut from an absurd amount to an amount that provided optimal effectiveness.  The danger of reduction of some medicines related to WITHDRAWAL.  Haldol is not addictive. Depending on the problems people can be ordered to go cold turkey from Haldol. 

Withdrawal happens right away not a month later anyway. She was on 100MG for nearly a month it wasn't as if the reduction happened right before the murders.  Any sign of the medication not working and her relapsing?  Nope.  There were no signs of psychotic episodes during that time period.  The main adjustment period would be the first week after the change was made yet nothing.

   

[Jane]

All it says is that her dosage was cut by the doctor who gave her the injeciton and that the doctor requested the dosage be permanantly reduced but she died before Ferguson got around to doing it.

But she didn't, did she? She was given the reduced dose without Ferguson's permission. If Dr Angelou wrote to him on July 15th it only leaves 3 weeks until her death which has to mean either that which I've already said OR because permission hadn't been given they repeated the 200mg dose OR because they expected an early response they decided to wait.

[Alias]

This is just one of the areas which demonstrate how absurd you are.

Someone unreasonably fearing for their life proves nothing other than that they are unreasonable and whether he was just being facetious or actually an unreasonable clown is unclear.  You criticize her as unreasonabel to fear an intruder and scream for him to leave and yet suggest it is reaosnable he would fear for his life from a thin unarmed woman?  You have things backwards. In the meantime it wasn't even a psychotic episode she screamed at a perceived intruder. 

Freddie didn't fear for his life he said that during the episode he feared she might become violent but that she didn't.  So during an episode that lasted a long time and was reportedly her worst she still didn't resort to violence.  Saying people were scared she would means nothing, she didn't.

 
You know you are being absurd here. Best defence is an attack, seems to be your MO.