Haloperidol as a sedative and Sheila's psychotropic regimen

[Erik Narramore]

Having looked into this further, it seems that Haloperidol is not regarded as an optimum sedative.  Sheila's complaint about it, which initiated the reduction in the monthly intramuscular dosage, was that the drug was making her sleepy, which is not quite the same thing; but even so, if that was regarded as the reason for the reduction in dosage, then it's difficult to see how the fact helps the Crown's case.  Whether the drug causes or contributes to violent thoughts, ideations and behaviour is a different question and those contraindications have a different relationship to dosage.  Could halving Sheila's dosage make her violent?

One crucial point in all this is that on reviewing the trial evidence of Dr. Wilkinson and Dr. Angeloglou, it seems that Dr. Ferguson was a continuing guiding influence in Sheila's treatment regimen.  Dr. Angeloglou states that Sheila was supposed to be taking Procyclidene to counteract the sleepiness and he had prescribed her some in April, but I think he assumed that she wasn't taking it.  Yet it seems that the defence psychiatric expert, Dr. Bradley, was sceptical about the decision to reduce Sheila's monthly Haloperidol dosage from 200mg.  Perhaps this is because Dr. Bradley had the benefit of hindsight and Haloperidol has serious interactions with illicit drugs, which can act as contraindications.  Wasn't Sheila involved in drugs?

Furthermore, Dr. Angeloglou states that the dosage should have been reduced to 150mg, not 100mg, implying that his colleague, Dr. Wilkinson, had errored.  It could equally be that Sheila had asked her to reduce the dosage still further, as there is a clinical bias towards conservatism with Haloperidol.  It's not clear, and it's not clear if the overall decision to reduce her dosage was an instruction from Dr. Ferguson or Dr. Angeloglou own's clinical judgement having received advice from Dr. Ferguson.  Dr. Angeloglou also mentions that Sheila was asked whether she was taking illicit drugs and she denied it; the clinical consequences of this are carefully left open but the implication seems to be that her treatment regimen was based on an assumption that she was not involved in drugs.

Dr Ferguson did give evidence at trial because this is referred to in the examination of Dr Bradley, who was present when the evidence was given, yet I don't see a transcript in the archive.  Is there one available?