Are Bipolar Drugs Safe For Kids?

A Child's Death Has Raised Questions About Diagnosing And Treating Bipolar Children

(CBS)  Rebecca Riley was a vibrant, smiling 4-year-old, but suffered from bipolar disorder and was placed on a cocktail of adult medications.

On the morning of Dec. 13, 2006, she died in her home in Hull, Mass., where was found lying on the floor next to her parents' bed.

Whether it was a horrible accident or something more may now be decided in a court of law. But the diagnosis and treatment of children for the disorder is highly controversial.

Valerie Berio lost more than her grandchild — her daughter, Carolyn Riley, and son-in-law, Michael Riley, are in jail, charged with Rebecca's murder. Prosecutors say they gave her an intentional overdose of drugs used to treat her disorder.

"It's still hard to believe she's gone," she told The Early Show national correspondent Tracy Smith. "It's impossible to believe she's gone. They (Rebecca's parents) adored her. They adore all of their children."

Rebecca was born into a family with a history of mental problems and was diagnosed as hyperactive at age 2 and as bipolar at 3. She was then put on several medications, which District Attorney Timothy Cruz, who is prosecuting the case, said were not properly administered.

"You're dealing with children and some children at the age of 2, 2 1/2," he said. "They may be nonverbal, so ask yourself this: Where is the doctor getting the information regarding this child?"

Cruz is asking that the Rileys be sentenced to life in prison if found guilty. The parents blame the doctor, the prosecutor blames the parents and overarching the whole story is the question of whether kids so young should be given such dire diagnoses and prescribed such dangerous drugs.

Many psychiatrists say that diagnosing children under the age of 8 is a very gray area. There is no data, very few case studies and they barely understand what bipolar disorder looks like in very young children, much less what these medications will do to them.

Dr. Janet Wozniak is not associated with the Riley case but is a leader in the field of diagnosing and treating bipolar disorder in children. She said she would rely on a parents' report and a short visit with the child to prescribe medication for a child.

"Because the symptoms of bipolar disorder are not always present in the office visit with the doctor," she said.

Rebecca was given a fatal dose of clonidine, a high blood pressure medication, which Wozniak says is commonly prescribed to bipolar kids.

"The medicine is often used because it has a sedating side effect," Wozniak said. "So it's used at bedtime to facilitate sleep, or it's used to decrease aggressive and hyperactive states during the day."

Dr. Kayoko Kifuji, who diagnosed Rebecca and prescribed the clonidine, has voluntarily stopped practicing, pending an investigation by the state licensing board. The Early Show's request for an interview was denied, but Tufts Medical Center, where Kifuji practices, released these statements: "Dr. Kifuji is on paid leave from the hospital and has voluntarily agreed not to practice medicine during this time," and "The care we provided was appropriate and within responsible professional standards."

Prosecutors argue the Rileys used Rebecca's bipolar diagnosis as an excuse to keep her sedated. Cruz said they were overmedicating her and Carolyn Riley often asked that a prescription be refilled early, because she'd lost or ruined some pills. In fact, within the last year more than 400 pills had been dispensed by the doctor to Rileys because they alleged that they lost pills, the pills were destroyed, the pills were contaminated or for other reasons.

"When they moved from Weymouth to hull they lost a bottle," Carolyn Riley's attorney said. "Is that unusual? Another bottle she said got wet. Is that unusual? Other pills that may have been lost may have been lost when they were broken in half because the pills are very, very tiny."

Bourbeau says they were only following doctor's orders and never gave Rebecca more pills than the doctor prescribed.

But a police report says Rebecca showed symptoms of overdose in the days leading up to her death. Berio disagrees.

"She never, ever appeared to be a child that ill," she said. "She had a cold! Kids get cold in the winter!"

Cruz argues that her parents should have known the difference between treating her and overmedicating her.

"For more than three days this little girl was dying at their home, at their premises, that other individuals present at the scene asked them, begged them to take this child to the hospital and they did not," he said.

But six days before Rebecca died, Bourbeau said she was seen by the doctor.

"Who else do you rely on but the doctor and the medical providers?" he said. "The parents are following the advice of the doctors."

Berio says that it comes down to a simple issue of trust. The Rileys believed what the doctors told them.

"They should have asked more questions, yeah," she said. "But like I say they simply trusted that the doctor knew the best answer because she was trained and they weren't."

[zonulin]

Thank you for following this story and bringing up the issue of children being put on dangerous psych. drugs. As you know the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) is used to "diagnose" mental illness. It is a horrendous compilation of LISTS of subjective, observed behaviors. There is nothing "scientific" whatsoever about it - the only mental illness which can be proven with any type of lab test is Alzheimer's Disease.
About 7 million children in the U.S. are treated with addictive, dangerous and potentially deadly drugs without demonstration of "disease."
The medical community must be held accountable. The parents must be shown that they have the right to question authority. Meanwhile, the children suffer.

[jdmon56]

My children were diagnosed as ADHD at a very early age. Before any medication was agreed to my husband and I carefully researched every option. The lowest therapeutic dose was always recommended by our physician/or child psychiatrist. Tests were given to provide a measure of the child's ability as opposed to lack of focus. Later our son was diagnosed as bipolar, our psychiatrist was very careful about precribing mood stabilizers and antidepressants until he was old enough (in our case, we waited until our son was 14). My point in all this is, you must give your child a chance to be a child; drugs are not always the answer. Love, acceptance and patience go a long way with these children until they are old enough to be treated with more stabilizing drugs. It is difficult to realized that these children have no control over their mood swings, attention span and cannot articulate their feelings. But when moments of clarity come to the kids, tell them of your love and have some good times that your whole family can treasure. This is something they can understand.

[bica2]

This is a very complex illness and there are no easy answers. In some cases medication can help but it is not the cure. I agree with Zonulin the medical community should be held accountable and parents need to question their doctors and do research to educate themselves. Too many people put their complete trust in doctors and don't realize they don't have all the answers. I think people need to realize also how serious these drugs are and how to use them responsibly.

[tallena1019]

I have a son who is 9 years old and has severe ADHD. I trusted my doctor in giving him different medicines. The doctor was changing and uping the dosages on the medicines. He ended up being on 3 different medicines and it caused my son to have a psychotic beakdown and be hospitalized. I was told from the hospital that he was given adult dosages but it was comparable to the dosages he was on previously before changing and playing the "guessing game". I never thought to question my doctor.

[kcteddybear]

My 10 year old Son is bipolar and his Dr had him on high doses of several medicines. When I questioned the Dr. he told me he was the one with the degree not me and that he knew what he was doing! After several months of him telling me this I changed Dr.'s and then problems arose at home and the new Dr. did not want to change anything. After 6 months now my Son is in the hospital again for medicine adjustment and the first Dr. was the one they wanted to admit him under and I said no way. I had to sign a statement stating I did not want him treating my son and you should know he was on call for the weekend and treated him anyway. He put him back on medicine that another Dr. took him off of and when I questioned it the first Dr. sent me a message by my son stating that he was not the one that changed his medicine and that he would see him at anytime and there was nothing I could do about this!!!!!!!!!!!!
So what do I do next? I am supose to trust the Dr.'s and the hospitals but at this point I don't know what to do are which way to turn.

[djntc123]

Hudson Falls, N.Y.
I do research on & ask questions about meds my child is put on then intimidated for asking, with remarks letting me know he's the Dr, & insinuating child neglect for not wanting her on the meds he prescribes. My child was 12 when she started seeing Dr. N. she%u2019s 15 now & has been on many drugs the past 3 years. Dr.N has stated it's like fine tuning a radio, you have to keep playing with the dial until it's right. Diagnosed her as bipolar. Diagnosed: seeing him for 15 minutes,once a month. Asked about the Lithium he prescribed & was told she would be thirstier than usual. Wrong answer ! This child went into mania, a side effect if you are not bipolar. I took her off the Lithium & the Dr. got offended. He put her on Prozac, said it would even out her moods, Wrong answer again ! Taking this for a few weeks she cut her throat & didn't know what she had done. Dr.N was upset because I decreased the Prozac. Just 2 of the many horror stories with Dr.N, Then I saw this little girl on the news had been given Clonidine, Dr.N recently put my child on Clonidine. Asked about this drug & was told it was just a very mild sedative to help her sleep. He never mentioned it was a high blood pressure medication. There are too many Dr.N's experimenting on innocent children. I research the meds & ask questions, this offends the Dr.& parents can be charged with child abuse for not following Drs. orders. I was disgusted hearing the parents of this child were liable. Wrong person !