Thank you, everyone, for the warm welcome to the board following my first post last night. It is a pleasure to be part of such a considered and well informed discussion.
I noticed that the possible impact of Helen's menopause on her health and behaviour has been touched upon in the course of this thread, and as someone who has recently been through this transition (mops brow and fans herself with a folded Woman's Weekly) I have a couple of observations to make.
Firstly, the symptoms of menopause vary widely from woman to woman - some, like me, suffer terribly from hot flushes, whilst others would say that menstrual problems, headaches or insomnia dominate their experience. Menopause can also cause issues with concentration, energy, and mood - these are generally quite mild, but most women suffer these symptoms at some point. Memory loss is frequently remarked upon, but tends to be at the "where did I leave my keys?" end of the scale, rather than "where did I leave my beloved dog, on the beach?"
The point I'm making is that in our culture at least - rightly or wrongly - menopausal women do not expect to feel 100% well. Some women simply soldier on, hoping that the symptoms will pass - and they eventually do. Others, after months or even a couple of years of struggling, are driven to visit their GP and discuss HRT or a similar remedy. There is also a middle way, where women do their own research (usually on the internet) and go on to purchase and use natural remedies based on herbs, vitamins etc.
It would seem, from comments made by IS, that Helen was a fan of natural remedies generally, and this makes it likely that she tried some over the counter remedies for any menopausal symptoms she was experiencing, including any increased anxiety or shift in mood. Helen seems to have been susceptible to stress, and menopause is known for both raising anxiety and deepening any tendency to depression.
This could have had an interesting, double bearing on her unwitting ingestion of zopliclone. Firstly, in the early stages of being apparently fed the drug by IS , she might have blamed any forgetfulness, tiredness etc on the menopause. The menopause could also have been blamed for any mood swings, dizziness, and the changes in blood pressure which had worried her. Secondly, her known preference for herbal remedies and "vitamins" may well have led her to the two remedies most commonly recommended for menopausal symptoms - Black Cohosh and St John's Wort.
Black cohosh is widely promoted as a catch-all treatment for all menopausal symptoms, but it is quite a strong "drug" and suspected of causing liver damage in long term use. However, it is easily available over the counter or the internet. St John's Wort has been well known as a natural anti-depressant for a long time, but it is becoming prescription-only in some some European countries, as it is quite powerful and can have some strong side-effects. In menopause it is mainly recommended for hot flushes and mood swings.
These are interesting supplements to consider with regard to Helen's demise, as each has a known, but contrasting, interaction with zopiclone, as follows:
St John's Wort REDUCES the effect of zopiclone, meaning that higher doses are necessary to obtain the desired effect.
Black Cohosh can interact with zopiclone to cause disorientation, confusion, and problems with cognition - actually enhancing it's more negative side effects.
If IS was feeding her the pills, and Helen was taking either or possibly even both of these (very commonly used) over the counter remedies for her menopausal symptoms, he would have found it impossible to administer a calculated or steady dose. She in her turn might have experimented with quantities or types of supplement, especially once her tiredness and forgetfulness began to cause her such distress.
It is also worth noting that zopiclone carries a definite contraindication to alcohol - it can increase all side-effects, most notably a deep sleep from which the patient cannot be aroused, and sleepwalking with memory loss afterwards.
I did notice that an off-licence proprietor in Broadstairs spoke of Helen as being a customer, and said that she was a "lovely lady". Helen mentions drinking red wine in Planet Grief. There is absolutely no suggestion, anywhere that she was a heavy or even a habitual drinker, but if she enjoyed a glass of wine once or twice a week - with food or just whilst relaxing - it would once again have complicated and indeed intensified the effect of zoplicone on her system.
Zopiclone and alcohol and/or black cohosh and alcohol could also have interfered with her ability to drive, causing the distress and anxiety around driving that seems to have been a new feature of her life in Royston. (She seems to have been a fairly happy driver in London).
I have hiccuppy internet today, and am struggling to paste links into this post, however I am happy to add them in a separate post if other websleuthers are interested in reading them.