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Terminology

Rebecca Riley

Attention Deficit Hyperactivity Disorder

Clonidine

Bipolar Disorder

Depakote

Seroquel

 

Psych drugs are a last resort

Most parents reluctant to medicate children, survey finds


The Patriot Ledger

The decision to give unproven psychiatric drugs to children is a last resort for most parents, a new survey says.

The Parent/Professional Advocacy League, a Massachusetts group for parents of children with mental illness, said 82 percent of families try other remedies before drugs.

The findings come amid a furor over charges that a Hull couple, Michael and Carolyn Riley, force-fed their 4-year-old daughter a combination of drugs that killed her.

The parent league report, which has not yet been published, shows that a majority of parents are reluctant to medicate their children.

“They had a lot of ambivalence about medications,” said Lisa Lambert, assistant director of the league.

The yet-to-be-published report found that parents preferred talk therapy, exercise and herbal remedies over psychiatric drugs.

Parents usually consulted two to five sources of information before allowing their children to take medications, indicating they researched the options, Lambert said.

The survey involved 300 responses from parents and 86 from children.

Lambert said most parents said it was a mental health professional who first recommended treating their children with psychiatric drugs.

“The public perception is that a lot of teachers suggest medication. That’s not what we found at all,” Lambert said.

Most grade school pupils are likely to know at least one classmate taking the stimulant Ritalin to treat symptoms of attention deficit hyperactivity disorder and increasing numbers of children are being treated with psychiatric drugs, few of them actually tested in children, experts say.

But more and more preschoolers are also toddling around with psychiatric drugs in their system, researchers have found.

A 2000 research paper written by Julie Zito of the University of Maryland and published in the Journal of the American Medical Association found that the use of psychotropic medications - such as stimulants, antidepressants, sedatives and antipsychotic drugs - tripled in populations of preschoolers they studied from 1991 to 1995.

The study is the most extensive to date of the prevalence of young children using psychiatric drugs.

In an editorial accompanying the article, Dr. Joseph T. Coyle of Harvard Medical School wrote that the trend was disturbing because the effects on children’s long-term development is unknown and because the prevalence of prescriptions could indicate fewer children are getting other types of mental-health services.

Coyle wrote that many state Medicaid programs had limited their reimbursement for the evaluation of behavioral disorders in children.

Consequently, he wrote, it appears that disturbed children “are now increasingly subjected to quick and inexpensive pharmacologic fixes.”

Frank Laski, executive director of Mental Health Legal Advisors Committee, a state-supported legal advocacy group for the mentally ill, said some children clearly have “behaviors that are uncontrollable,” but no reliable proof exists showing that adult drugs help them.

Children and families also need more than drugs, Laski said. “The prospect of treatment with medication alone is very, very questionable,” he said.

Drugs are rarely tested on children because ethical and commercial reasons.

The highest standard in drug testing is the double-blind test, in which neither the clinician nor the patient receiving the drug knows if it is real or a placebo.

“What guardian or parent is willing to put their child through a situation where they don’t know what they’re getting and the doctor doesn’t know what they’re getting?” said Dr. John Fromson, a child psychiatrist from Waltham.

Dr. Christopher Bellonci, a child psychiatrist in Needham, said drug companies have little incentive to test drugs on children.

“The pharmaceutical companies don’t have to (fund tests) because they know the pediatricians and child psychologists will use it anyway because they don’t have a choice,” he said.

Julie Jette may be reached at jjette@ledger.com.

Prescription history

One of the drugs prescribed for Rebecca Riley was clonidine to calm attention deficit hyperactivity. Experts say clonidine overdoses are “extremely dangerous to children.’’

An affidavit filed by State Police seeking to arrest Rebecca’s parents for murder details the following history of clonidine prescriptions for Rebecca. A supply of 35 pills should last for 10 days, the affidavit said.

Sept. 15 - 10-day supply

Sept. 22 - 10-day supply

Sept. 30 - 10-day supply

Oct. 7 - 10-day supply

Oct. 21 - Prescription filled, number of pills not specified

Oct. 29 - 10-day supply

Nov. 7 - 10-day supply

Nov. 12 - 10-day supply

Nov. 19 - 10-day supply

Nov. 27 - 10-day supply

Dec. 7 - 10-day supply

Rebecca was found dead on Dec. 13. There were 7 clonidine tablets in her medicine tray. If the medication was taken as scheduled, there should have been about 75 tablets left.