Loughner, who allegedly killed six people and wounded 13 in a spree aimed at U.S. Rep. Gabrielle Giffords, D-Ariz., has been found incompetent to stand trial. He is being held in the U.S. Medical Center for Federal Prisoners in Springfield, Mo.
At a hearing Friday in San Diego, U.S. District Judge Larry Burns cited evidence that Loughner deteriorated dramatically when he was taken off medication July 1, the Arizona Daily Star reported. Burns rejected a request by Loughner's lawyers to hold a hearing on the forcible medication.
A federal appeals court ruled Loughner could only be forcibly medicated in an emergency. A psychologist, testifying by telephone from Springfield, said Loughner began pacing compulsively, sometimes for as long as 50 hours. Christine Pietz said he refused antibiotics after his feet became infected.
The hospital put him back on medication July 18.
Giffords suffered severe head injuries in the shooting.