[Updated at 1:50 p.m. ET]

CENTENNIAL, Colo.—After a judge allowed Aurora, Colo., shooting suspect James Holmes to plead not guilty by reason of insanity on Tuesday, he dealt a major setback to the defense by granting the prosecution access to a key piece of evidence.

By Monday at the earliest, prosecutors will get to see a notebook and package Holmes mailed to his university psychiatrist, Dr. Lynne Fenton, days before the July 20, 2012, shooting spree. Fenton never received the package, and it has since been sealed.

Judge Carlos A. Samour ruled that any evidence pertaining to Holmes’ mental illness was no longer shielded by doctor-patient privilege now that the court has accepted the insanity plea. This includes the notebook, which defense attorney Daniel King argued was a unique piece of evidence that the prosecution shouldn’t see because Fenton herself hadn’t seen it, and it could have altered her opinion of Holmes’ mental health.

“The argument advanced by Mr. King is a creative one,” Samour said on Tuesday, “but I am not persuaded by it.”

Under Colorado statute, once a defendant pleads insanity, any evidence related to mental illness is no longer protected and is covered under an evidence waiver.

The release of the notebook and the insanity plea mark significant movement in the case, which has been mired in arguments over the notebook and Colorado’s laws related to capital punishment.

Holmes is accused of fatally shooting 12 Aurora movie theater patrons last summer during a midnight screening of “The Dark Knight Rises,” the latest Batman movie. Fifty-eight others were injured. The Arapahoe County district attorney is seeking the death penalty.

Marcus Weaver, a victim who was shot in the arm, hailed Tuesday’s developments.

“The trial is moving forward finally,” Weaver said after the hearing. “I feel it is a step forward for a lot of the victims. We’re happy there is momentum.”

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The decision is a defeat to Holmes’ defense team, which since August has sought to keep the prosecution and other witnesses from learning the contents of the notebook, which reportedly contains violent imagery and detailed descriptions of the attack. Law enforcement officials thumbed through the notebook in the University of Colorado’s mail room days after the shootings. But because the court ruled last fall that Holmes was under Fenton’s psychiatric care at the time, lawyers and witnesses couldn’t discuss or see the notebook’s contents.

Also at Tuesday’s hearing, Samour advised Holmes that the state will administer an evaluation at the Colorado Mental Health Institute in Pueblo, south of Denver. The exam will be finished by Aug. 2 after the doctors and clinicians conducting the exam sift through thousands of pages of evidence provided by prosecutors.

“Every person is presumed to be sane,” Samour said.

However, he noted that in Colorado, once an issue of insanity is raised, the burden is on the prosecution to prove the defendant is sane. The judge will allow Holmes’ defense team to have a doctor of its choice also evaluate Holmes.

In an order last week, Samour denied the defense’s request for more time to prepare to discuss the notebook in court.

“The privilege issue related to the [notebook] has been briefed and discussed before,” Samour wrote. “It is true, of course, that the defendant’s not guilty by reason of insanity plea, if accepted, may alter the analysis, but the parties have been aware of that for some time.”

Indeed, attorneys have discussed the notebook vis-a-vis Holmes’ mental state as far back as August, when prosecutors tried to convince the first judge in the case that Fenton was more akin to a general practitioner than a mental health professional and, thus, the notebook wasn’t privileged. The prosecution abandoned its quest for the notebook at the time.

Samour read a lengthy advisement to Holmes during the hearing that detailed what his insanity plea means, including what happens to Holmes should he not cooperate with the mental illness exam. The defense lost its bid last week to strike down portions of Colorado state law, arguing that government psych exams could violate Holmes’ right to a fair trial in a capital case.

The hearing, originally scheduled for last Thursday, was moved to Tuesday at the defense’s request. The prosecution agreed on the condition the hearing would address the notebook privilege issue.

The defense filed its objection to that compromise on Friday, noting that it was pulling “extremely long hours” to comply with the court’s Monday deadline on noncapital-punishment motions as well as work related to Holmes’ insanity plea.

“Counsel simply cannot complete all the work that needs to be done on those motions,” the defense wrote in that filing.

The defense filed dozens of motions late Monday, most related to noncapital issues, including a request to move the trial to a different Colorado county.