CO - The Stalking and Mysterious Death of Morgan Ingram #2

[JBean]

Most people I know that take flexeril use it as a muscle relaxer.Remember it was mentioned that her back hurt from sleeping in the closet. Perhaps someone recommended that she try a flexeril as that would certainly be a good use for it.
Until we know how much flexeril was in her system it is pretty inconclusive.

As for the ami it is so commonly prescribed for a migraine preventative I have no problem assuming that is what is was used and prescribed for previously.

If this was a murder then it seems it could have been injected unless that contradicts the data of course. It would answer the question as to why there were no pills in her belly and the relatively fast acting consequence of an OD. IT would be fast and quiet.

jmho of course.

 

[ATasteOfHoney]

A quick read of nortrip indicates that it should NOT be used together with ami. The bit I read gave 135 medications not to use Nortrip with, or, if using together, it would need close monitoring.

I doubt there was an rx for nortrip...most Drs would not rx those together unless there was a close monitoring system in place.

Add to that the flexeril (again, not rx'd), and you have some serious questions about where those drugs (in those amounts) came from.

Best-
Herding Cats

And just to add this: *neither* compound (Amitriptyline and/or Nortriptyline)are used for horses. Ami can be used for cats but rx at much lower doses.

 

[ATasteOfHoney]

Most people I know that take flexeril use it as a muscle relaxer.Remember it was mentioned that her back hurt from sleeping in the closet. Perhaps someone recommended that she try a flexeril as that would certainly be a good use for it.
Until we know how much flexeril was in her system it is pretty inconclusive.

As for the ami it is so commonly prescribed for a migraine preventative I have no problem assuming that is what is was used and prescribed for previously.

If this was a murder then it seems it could have been injected unless that contradicts the data of course. It would answer the question as to why there were no pills in her belly and the relatively fast acting consequence of an OD. IT would be fast and quiet.

jmho of course.

Does anyone know if murderers typically use multiple drugs to cause death and what is the most commonly used drug for that?

 

[JBean]

Does anyone know if murderers typically use multiple drugs to cause death and what is the most commonly used drug for that?

The more global question might be- do murderers generally use drugs at all? It is almost a professional hit style murder, if it is indeed murder.
I am opting to err on the side of caution and am taking mom's information at face value. if this was in fact a murder, and I do understand why she would think it to be so, this was a seemingly unusual method-jmho of course.

Interestingly I watched a horrible movie with Sandra Bullock and Ryan Gosling last night. But 2 HS students killed a random person mainly for the thrill of it and to see if they could create a perfect murder by anticipating what LE would look for and planting evidence to throw them off.

So the other thought is that this was just a sick person acting out- stalking, following, playing games and ultimately murdering for no reason. The movie made me think this was a possibility. Remote? I would think so.

 

[gitana1]

Does anyone know if murderers typically use multiple drugs to cause death and what is the most commonly used drug for that?

There have been cases of people who murder their spouses or children using a drug of some sort. I can't remember anyone using multiple drugs, though. But I can see that.

There was also a case of a serial killer using amitryptiline AFTER kidnapping a victim, to further incapacitate before raping and ultimately killing them.

There have also been cases of angel of death nurses using drugs to kill but I can't say they used more than one drug.

But to me what is key is that there have been no accounts of non-violent murders by any stalker that I am aware of.

This fits no known MO for any type of stalker murderer I have heard of.

 

[mnmomma]

First time poster - will do my very best to play by the rules!

I devoured mom's blog in a matter of a couple hours. A recurring theme is trying to determine if Morgan or her parents were the intended stalking victims. I wonder if anyone has put thought into Morgan being the initial target and her parents became a secondary target after they started 'taking her away' from her stalker. Make sense? If someone has already posted this theory, sorry!

 

[buffetoflies]

Most people I know that take flexeril use it as a muscle relaxer.Remember it was mentioned that her back hurt from sleeping in the closet.

^ This is another thing that I don't get. Why did she sleep on the floor for so long? She could have dragged her mattress in there (depends on size I guess) and slept on that, or bought a small blowup mattress.

 

[sascha]

at one point i remember her mom talking about M getting her dads old I-phone. If i remember right, it was after her not having a phone for a while .If my daughter was being stalked she wouldn't go a sec without a phone

 

[twinkiesmom]

From what I understand, there was peripheral blood used for that test. The gastric contents showed only flexeril.

Thus my belief that she either was injected with ami, or it was consumed before the flexeril (as the gastric contents are apparently clear of ami), and was fully absorbed prior to the flexeril being ingested (which would also account for the flexeril presence; the gi system would have been drastically slowed by the lethal amount of ami) and remaining in the stomach contents.

So, using the (purely estimated) body weight of 100 lbs/45 kgs, Twinkie, can you do the conversion math according to the study and charts you linked? Seems like it would be a huge dose...but how "huge" would it be in 25 mg tabs?

(And yes, I'm still leaning towards there being an injection of some sort...)

Thanks.

Best-
Herding Cats

I don't think we can pinpoint the exact dose she received without a lot of toxicology data on lethal doses correlated with plasma concentrations (which ethically wouldn't be available in humans). It wouldn't be valid to simply draw a line from the 800 ng/mL on the graph I shared up to 7900 ng/mL....at some point an excess of amy would simply exceed the ability of the liver to degrade it....so would be a curve, not a straight line...

Also, we know that some of the amy in her system was already converted to nortriptyline, so that would have to be figured in to any calculation.

The other fudge factor is oral doses are not 100% bioavailable, meaning it's not a 1:1 correlation what is swallowed with what turns up in plasma....For this drug oral bioavailability is only 30% to 60%. Intravenous drugs are by definition 100% bioavailable.


Re: equine...It is contraindicated in horses being raced but I haven't found it being described as not used in horses, just not officially labeled for horses.

Re NORTRIPTYLINE....Her body would have converted the ami to nor...it is the active metabolite of ami...This does NOT mean she took Pamadol.

 

[concernedmother]

Would these drugs had she been taking them for awhile without her parents knowing cause delusions? Impressed by the posters with all this med knowledge. Way over my head.

 

[ATasteOfHoney]

I don't think we can pinpoint the exact dose she received without a lot of toxicology data on lethal doses correlated with plasma concentrations (which ethically wouldn't be available in humans). It wouldn't be valid to simply draw a line from the 800 ng/mL on the graph I shared up to 7900 ng/mL....at some point an excess of amy would simply exceed the ability of the liver to degrade it....so would be a curve, not a straight line...

Also, we know that some of the amy in her system was already converted to nortriptyline, so that would have to be figured in to any calculation.

The other fudge factor is oral doses are not 100% bioavailable, meaning it's not a 1:1 correlation what is swallowed with what turns up in plasma....For this drug oral bioavailability is only 30% to 60%. Intravenous drugs are by definition 100% bioavailable.


Re: equine...It is contraindicated in horses being raced but I haven't found it being described as not used in horses, just not officially labeled for horses.

Re NORTRIPTYLINE....Her body would have converted the ami to nor...it is the active metabolite of ami...This does NOT mean she took Pamadol.

We do not know if the amitrytyline converted into nortriptyline.....they can be rx as two separate drugs. We can not assume.....anything but perhaps the original autopsy/toxicology report will specify but we haven't seen it yet.

 

[concernedmother]

Maybe someone would ask mom to post the original?

 

[twinkiesmom]

Not if they were ground up and swallowed with liquid.

I doubt they had that many pills in the house considering she was only on a 25 mg dose and had not taken any in 2 years, suggesting lack of refill of that prescription.

 

[JBean]

^ This is another thing that I don't get. Why did she sleep on the floor for so long? She could have dragged her mattress in there (depends on size I guess) and slept on that, or bought a small blowup mattress.

Perhaps from a psychological standpoint- to make the closet more "permanent" would be giving in to the stalker. IOW, sleeping on the floor is clearly a temporary solution which implies it is going to be over soon.
Just a thought.

 

[MayraMM]

A quick read of nortrip indicates that it should NOT be used together with ami. The bit I read gave 135 medications not to use Nortrip with, or, if using together, it would need close monitoring.

I doubt there was an rx for nortrip...most Drs would not rx those together unless there was a close monitoring system in place.

Add to that the flexeril (again, not rx'd), and you have some serious questions about where those drugs (in those amounts) came from.

Best-
Herding Cats

Nortrip is a metabolite of Amy, so it's probably a direct byproduct of the amy and not a separate medication.

Sorry, didn't realize it was already answered!

 

[twinkiesmom]

We do not know if the amitrytyline converted into nortriptyline.....they can be rx as two separate drugs. We can not assume.....anything but perhaps the original autopsy/toxicology report will specify but we haven't seen it yet.

No, it is known that ami is rapidly and extensively metabolized by first-pass metabolism in the liver, and she had a massive amount of ami in her bloodstream...Therefore, the relatively small amount of nor by comparison is almost certainly the result of ami metabolism.

 

[ATasteOfHoney]

No, it is known that ami is rapidly and extensively metabolized by first-pass metabolism in the liver, and she had a massive amount of ami in her bloodstream...Therefore, the relatively small amount of nor by comparison is almost certainly the result of ami metabolism.

So what would you consider a small amount of Nortrptyline?

 

[twinkiesmom]

This fits no known MO for any type of stalker murderer I have heard of.

There was that case of the neighbor who poisoned a family with cynanide (arsenic?) by slipping it into their coke bottles which they stored outside the house. LE thought for sure it was an inside job, but it turned out to be the neighbor...believe this was on Forensic Files (or one of the CourtTV shows of yore). The family was targeted because their teenagers were noisy. I think there was stalking involved as well as well as some vehicle vandalism (if I remember correctly)....and the culprit was a middle-aged man.

 

[Confusion]

I don't think we can pinpoint the exact dose she received without a lot of toxicology data on lethal doses correlated with plasma concentrations (which ethically wouldn't be available in humans). It wouldn't be valid to simply draw a line from the 800 ng/mL on the graph I shared up to 7900 ng/mL....at some point an excess of amy would simply exceed the ability of the liver to degrade it....so would be a curve, not a straight line...

Also, we know that some of the amy in her system was already converted to nortriptyline, so that would have to be figured in to any calculation.

The other fudge factor is oral doses are not 100% bioavailable, meaning it's not a 1:1 correlation what is swallowed with what turns up in plasma....For this drug oral bioavailability is only 30% to 60%. Intravenous drugs are by definition 100% bioavailable.

Also, we know that some of the amy in her system was already converted to nortriptyline, so that would have to be figured in to any calculation.

Re NORTRIPTYLINE....Her body would have converted the ami to nor...it is the active metabolite of ami...This does NOT mean she took Pamadol.

Another factor is that Flexeril, and possibly something else she may have taken, would cause death faster than the same dosage of ami alone. If she died before the expected amount had been metabolized, it would show at a higher level in her plasma than what would normally be there for the dose taken. There's also the possibility that her body had built up some tolerance for it while she was taking it, and it may have taken more to knock her out than it would for someone who had never taken it (I'm not positive about this; some meds work that way and some don't.) The point is that it's nearly impossible to know for sure without more extensive testing, which seems out of the question now.

Would these drugs had she been taking them for awhile without her parents knowing cause delusions?

I'm not sure about delusions, but it could cause hallucinations. That wouldn't account for what the parents saw and heard though, unless they were all taking it. MOO

 

[twinkiesmom]

So what would you consider a small amount of Nortrptyline?

It was less than half of the amount of ami if I remember correctly.