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June 19, 2009 permalink
Florida investigators looking into the events leading to the suicide of seven-year-old Gabriel Myers have heard from Kimberly Foster, treated with psychotropic drugs for ten years while held in a mental facility. What do the drugs to to children? In addition to cancer, they can induce sudden death. A scientific report shows children treated with Ratalin are more likely to die of sudden death (about five times more likely) than untreated children. The increase is real and not the result of bad luck in the sample. The American Journal of Psychiatry has an editorial and an article (both pdf) on the phenomenon. The second enclosed article is the CTV report on the study. About half of Ontario's crown wards are on psychotropic drugs, purportedly for treatment of mental health, actually to keep them in a permanently submissive mood.
Fla. officials struggle to reform foster system
By KELLI KENNEDY, Associated Press Writer
FORT LAUDERDALE, Fla. -- Kimberly Foster was on psychotropic medications every day during the decade she spent in foster care.
Locked in a mental facility with green walls, barred windows and four-point restraints from the age of eight, Foster said her actions were easy to explain: she was sad she couldn't be with her mother.
"They looked at me as a troublemaker instead of a child who is coming out of a troubled environment. If you cry, you're depressed. If you act out in school, you're a behavior problem. We're so quick to put these diagnoses on children," the 25-year-old Foster said Thursday in a meeting with officials from the Department of Children and Families. "Youth in foster care are overmedicated, overdiagnosed."
As state officials wade through the systemwide failures that led to the suicide of 7-year-old foster child Gabriel Myers in April, two issues come up repeatedly: the alarming use of psychotropic medications and the inability of doctors, foster parents and case workers to track problems with such powerful medications.
About 2,699 children in out-of-home foster care, or about 13 percent, are taking psychotropic drugs. That compares with about 4 percent to 5 percent of children in the general population, according to a recent DCF study.
Problems range from simply incorrectly entering basic information like a child's gender and age into a database to overloaded and inexperienced case workers who are expected to understand warning labels on psychotropic medications.
Even logistics of accompanying a foster child to a doctor's appointment fell short. Forty percent of the 112 foster children's files studied, were not accompanied to their appointment. Many were dropped off by medical transport, making it that much harder for an adult to communicate crucial details about the child's treatment.
Some officials proposed further training for foster parents and case workers, while others worried a four-hour training session on psychotropic drugs and what to look for would change little. Especially in a system with a nearly 50 percent turnover rate among case workers.
"Global training is important but I don't think it's going to get us to the level of specificity that we need," said William Janes, a member of the work group examining the boy's death. He stressed the importance of case managers.
"It's not about psychotropic medications solely," he said. "It's about the care that this boy did not get."
Basic analysis of medications for children in state care - such as what medication they were taking, why and when it was prescribed, and whether it worked - is not being completed in many cases. That information was supposed to be collected beginning in 2005.
"But it did not see the light of day," said Dr. Rajiv Tandon, a work group member who is a psychiatrist at the University of Florida. "This particular form was an integral part of that plan and it never happened."
In Gabriel's case, his foster parents and teachers reported disturbing behavior, including sexual advances toward classmates. At one point, the child admitted to trying to strangle himself.
Yet his doctor continued on the same treatment plan.
"The whole system broke down in the community," Janes said. "Everybody involved in this case was disconnected from that level that we would expect at some degree."
Mez Pierre, who entered the foster system at age 5, said he was given plenty of medication but very little emotional support.
"I felt like I was an animal in a farm being tested on," the 22-year-old told DCF officials Thursday. "Irresponsibility is just not worth a life. We need to do whatever we can to make sure another Gabriel does not happen again."
Source: Miami Herald
Findings questioned in ADHD drugs-heart risk study
Updated Tue. Jun. 16 2009 10:50 AM ET, CTV.ca News Staff
A new study has found that drugs used to treat attention deficit disorders may put kids at risk for of sudden death. But the U.S. Food and Drug Administration is warning the findings should not prompt parents to stop giving the medications to their children.
The study, published Monday in the American Journal of Psychiatry, found there may be an association between stimulant medications used to treat ADHD (attention deficit hyperactivity disorder), such as Ritalin, and sudden death in healthy children.
The drugs already carry warnings about risks of heart attack and stroke in children with underlying heart conditions. But in this new study, researchers found that children who were otherwise healthy and taking the meds were six to seven times more likely to die suddenly for unexplained reasons than those not taking the drug.
The study was partially funded by the FDA, but agency experts said the study methods -- which relied on interviews with parents and physicians years after the children's deaths -- is not the most reliable study method and may have caused errors.
"Since the deaths occurred a long time ago, all of this depended on the memory of people -- relatives and physicians -- involved with the victims," said Dr. Robert Temple, the FDA's director of drug review.
The agency urged parents to discuss safety concerns with their doctor, but to keep children on the treatments.
"FDA believes that this study should not serve as a basis for parents to stop a child's stimulant medication. Parents should discuss concerns about the use of these medicines with the prescribing healthcare professional," the statement said.
Researchers compared 564 children and teens who died of unexplained causes to 564 children and teens who had died in car accidents. The researchers used car accident victims as a comparison group because sudden childhood deaths are rare and difficult to track.
They found that among the unexplained deaths, 10 children were taking an ADHD drug compared with two of the patients killed in car accidents.
The researchers say they're confident the association is real, but the FDA noted the low rate of stimulant use in both study groups may limit the significance of the findings.
The FDA says it is working on a larger, more in-depth study on the potential risks of stimulant medication use in children.
"The data collection for this study will be complete later in 2009," the FDA said.