Sheila could not have had a psychotic breakdown as she was medicated

[Erik Narramore]

An assumption made is that Sheila could not have had a psychotic breakdown as she was medicated, and also that she would have been subjected to a consistent therapeutic dose over the full month.

However, there are a number of problems.  I won't exhaust them here, but one point to emphasise is that it's not a simple matter of saying that Sheila was under medication therefore psychosis is precluded.  When medical professionals refer to a 'therapeutic dose', they are not speaking of efficacy, they are merely saying what I have just noted, which is that the monthly intramuscular dosage is delivered in a way that tries to ensure a consistent medication over the full month.  The actual effect of the medication is not measurable in any linear fashion because it will vary greatly from one patient to another and across different environments, situations and circumstances.

Indeed, both Dr. Ferguson and Dr. Bradley at trial (both of them were defence witnesses) were keen to emphasise that:

(i). a patient can relapse, even under medication; and,
(ii). Sheila was early in her treatment and so the situation was still considered somewhat 'trial and error'.

From personal experience, I am aware that a paranoid schizophrenic under a monthly medication dosage can relapse, even after many years.  The person I am referring to, who was very close to me, had received monthly injections of Haloperidol, like Sheila, since perhaps his teens or early 20s (men are diagnosed with schizophrenia much earlier than women), but he would have relapses well into his 30s in which an ambulance and doctors would turn up to section him and take him away.  On its face, this seems odd because his dosages were not intra-oral and you would think he must have stabilised over such a lengthy period, coupled with the greater maturity of age.  This individual otherwise maintained stable employment throughout his life and was married with children.  Yet I can only tell you what occurred.

On the other hand, the medication was generally successful and he only went into a long-term 'permanent' relapse when he was taken off the Haldol (Haloperidol) at an elderly age, due to other medical risks of the side-effects.

Of course, this is just one example and one must be wary of generalisations, but it does suggest that in regard to Sheila, there is something in the argument that she was medicated therefore it is less likely she could have been psychotic, but nobody can say that she could not have been psychotic and we have the evidence from both Dr. Illiffe (March 1985) and Pam Boutflour (6th. August 1985) of a consistent mood pattern in Sheila.  We also have evidence from the other witnesses that there was something wrong with Sheila, in spite of being medicated.

Ironically, the evidence cited by guilters on here could be used to make a pretty compelling argument that Sheila was still afflicted with psychosis and the medication wasn't working, taking into account the cautious words of both Doctors Ferguson and Bradley that Sheila was still early on in her treatment.