It’s cases like this that make the whole issue of medications difficult for those of us with kids with ADHD:
Rebecca — who had been diagnosed with attention deficit hyperactivity and bipolar disorder — died Dec. 13 of an overdose of prescribed drugs. Her parents have been arrested on murder charges, accused of intentionally overmedicating their daughter to keep her quiet and out of their hair.
Rebecca was 4 years old and on a cocktail of Clonidine, Depakote, a cough suppressant and an antihistamine. That’s just insane. To complicate matters more, there’s this:
Interviews and a review of court documents by The Associated Press make it clear that many of those who were supposed to protect Rebecca — teachers, social workers, other professionals — suspected something was wrong but never went quite far enough.
From what I’ve able to glean from news articles, Rebecca did have some behavior problems and had been diagnosed with bipolar disorder at 2 1/2. In June of last year, I commented on a debate about this very issue, and the ethical concerns surrounding the diagnosis and medication of such a young child. In this case, we can blame the doctors all day long, and the providers and the people who didn’t go far enough, but the folks that are really responsible for this are the parents. I don’t say that lightly — no parent should be held to account for their child’s death lightly — but in this case, it seems obvious that the only solution the parents sought and stuck to for their daughter’s difficulties were medication based.
The Rileys administered higher doses of the prescription drugs when Rebecca acted up or when they wanted her to sleep, police say in the 27-page affidavit. The affidavit says that investigators uncovered “an alarming pattern where the Rileys frequently seemed to run out of Rebecca’s medication” and Carolyn Riley sought additional supplies, even when they didn’t have a prescription. – full article
What bothers me the most about this case is the focus on psychiatric medications, when in fact, it was the Clonidine that appears to be the culprit. Clonidine is a blood pressure medication when prescribed for adults. It seems to have some minimal effect in helping kids with ADHD sleep. I never wanted to get into the cycle of stimulants for the ADHD offset by sleeping medication, so dealt with the sleep issues separately, without meds. There is no question that this should never have happened, that this child should have been taken off of all medications and evaluated again, and then carefully monitored. Instead, the parents were able to get more of the non-controlled medication, and at the time of her death, Rebecca had more than enough Clonidine in her system to kill her without the assistance of Depakote.
What or who is to blame? Here’s the official report:
The medical examiner’s report indicates Rebecca died of intoxication caused by a combination of valproic acid, an antiseizure drug sometimes used in children to calm aggression; a cough suppressant; an antihistamine; and clonidine. She had also been prescribed Seroquel for bipolar disorder, but that was not found in her body.
The parents didn’t educate themselves on the medications they were giving their daughter. In fact, they gave the same medications to their other two children. It looks like they have some issues of their own, but there are ways to learn about medications besides the Internet. They could have asked the pharmacist about them, they could have asked the doctor about them, they could have gone to the library and asked the librarian about them. The simple fact is that they gave their kids medication without a clue as to how they interacted.
Which brings me to the final culprit: Over the counter medications. In addition to the prescribed medications, they also were giving her an antihistamine and cough syrup for a bad cough. No article mentions how much of those medications she’d been given, but there’s plenty of evidence that it’s easy enough to overdose kids on over-the-counter medications inadvertently.
In the end, Rebecca was the victim of complacence, the belief that her behavior and her health could be controlled and improved by giving her medications with no other intervention. At the time she was diagnosed, she and her parents should have been referred to some kind of mandatory behavior modification program where they learned to cope with whatever behavior problems she had. Her parents were happy enough to believe that pills were some kind of magic bullet to cure not only her behavior problems, but their deficiencies in the parenting department, which appear to be numerous.
Everyone is sorry, but Rebecca is still dead and news reports are blaming psychiatric medications despite the fact that over-the-counter medications and non-psychiatric medications were, at the very least, 3/4ths of the cause. Her parents are charged with murder, and her doctor is charged with overprescribing medications.
It’s a tragedy that didn’t have to happen with a little bit of education, care, and yes, intervention.
Technorati Tags: ADHD, psychiatric medications, Rebecca Riley, parenting, bipolar disorder
