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Loughner’s lawyers have been seeking to have the judge, rather than the prison, decide whether Loughner should be medicated.

Loughner was first forcibly medicated between June 21 and July 1, but an appeals court temporarily halted the medications after defense lawyers objected.

The forced medication resumed July 19 after prison officials concluded Loughner’s psychological condition was deteriorating, noting he had been pacing in circles near his cell door, screaming and crying for hours at a time.

Defense lawyers have repeatedly asked Burns and a federal appeals court to halt the forced medications.

Loughner’s medications include the sedative lorazepam, the antidepressant Wellbutrin and Risperidone, a drug used for people with schizophrenia, bipolar disorder and severe behavior problems.

Pietz has said Loughner has recently made progress in making more eye contact with people, improving his personal hygiene and pacing less.

But defense attorneys said none of the changes confront Loughner’s delusions and noted he remains on suicide watch.

If Loughner is later determined to be competent enough to understand the case against him, the court proceedings will resume. If he isn’t deemed mentally fit at the end of his treatment, Loughner’s stay at the facility can be extended. There are no limits on the number of times such extensions can be granted.

If doctors conclude they can’t restore Loughner’s mental competency, the judge must make another decision. If he finds there’s no likelihood of Loughner being restored to competency, he can dismiss the charges.

In that case, state and federal authorities can petition to have Loughner civilly committed and could seek to extend that commitment repeatedly.