TUCSON, Ariz. -- The man accused of wounding Rep. Gabrielle Giffords in a deadly shooting rampage has arrived at a federal courthouse in Tucson for his first court appearance since an angry outburst got him kicked out of a May competency hearing.

Jared Lee Loughner's mental status is again the order of business at Wednesday's hearing, as a judge decides whether it's likely the 23-year-old can be made competent to stand trial.

But this time, Loughner will be under the effects of psychotropic drugs, which he has been forced to take the past 60 days.

U.S. District Judge Larry Burns will decide whether to grant prosecutors' request to extend Loughner's stay at a Missouri prison facility by another eight months. A psychologist has told the court the extended stay would give Loughner time to improve and become mentally fit for trial.
Burns may also discuss whether to hold another hearing on Loughner's forcible medication.

Loughner arrived at the downtown courthouse shortly before 8:30 a.m., KMSB-TV reported.
Experts have concluded he suffers from schizophrenia. Loughner has been at the Springfield, Mo., prison facility the past four months after Burns found him mentally unfit for trial at a May 25 hearing in Tucson.

Loughner interrupted that hearing with a loud rant. According to court transcripts, he said: "Thank you for the free kill. She died in front of me. Your cheesiness."
Federal marshals whisked him from the courtroand 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.