Remembering the Rebecca Riley Medical Child Abuse Case

Psychiatrist Dr. Kayoko Kifuji of Tufts-New England Medical Center had prescribed 4-year old Rebecca Riley psychotropic drugs for more than a year prior to the child's drug-induced death in December 2006.

CBS News reported that Dr. Kifuji had authorized a prescription regimen of ten medications per day for her patient's symptoms.

Rebecca Riley's death prompted national attention because her parents were charged and convicted of murder. Dr. Kayoko Kifuji continues to practice medicine.

There has been no meaningful introspection on the part of the medical community regarding these polypharmaceutical practices and the FDA has not intervened .  Enter ADHD on the computer and one will find numerous practitioners promising quick diagnosis and treatment.

At the time of the 60 Minutes Rebecca Riley broadcast, one million children were receiving psychotropic drugs, today the figure is 6 million according to The New York Times. The number of deaths and impairments caused by these commonly-prescribed childhood drug cocktails are not dutifully tracked.

Some of the medications attributed to Rebecca's death were Depakote /750 mg, Seroquel /200 mg, and Clonidine /.35 mg. PhRMA members have repositioned these epileptic, depression, and hypertension control substances to treat ADHD and Bipolar disorders. These recycled drugs are not approved by the FDA for use in children under the age of six.

Adverse health repercussions not discovered during adult clinical trials for the listed drugs are: children of pregnant women prescribed Depakote have exhibited impaired I.Q's and major birth defects, Seroquel and clonidine elevate the risk of heart abnormalities.

NIH provides access to clinical trial data on the 13,504 children's studies completed or in progress. The pool of U.S. underage test subjects are drawn from parents or from state child protection agencies. In 2011 there were 400,540 children under states' care available for research.

Under federal law , state wards may be enrolled in test projects if Institutional Review Boards determine that the experiment poses "minimal risk, greater than minimal risk but with a prospect of direct benefit, and a minor increase over minimal risk without prospect of direct benefit."

Most Institutional Review Boards are now commercial entities and that status may taint members' risk/benefit judgments according to the Government Accountability Office.

It is instructive to look at the Double-Blind Placebo-Controlled Trial of Riluzole in Pediatric Bipolar Disorder sponsored by the National Institute of Mental Health (NIMH). This 5-6 month experiment involved 80 children, ages 9-17. To be enrolled, the children had to exhibit anxiety and bipolar symptoms. During the trial most of the children were confined to the Pediatric Behavioral Health Unit. Research format: blood and urine samples, reduction and cessation of current medications, then application of either a placebo or the test product. Riluzole is currently prescribed for ALS patients.

Ethicists argue that placing formally-mistreated children in clinical trials and prescribing wards of state psychotropic drugs are indefensible practices.

References:

" Atypical Antipsychotic Use Among Medicaid-Insured Children and Adolescents: Duration, Safety, and Monitoring Implications " —Journal of Child and Adolescent Psychopharmacology—April 2014

" Psychotropic Meds for Georgia Youth in Foster Care: Who Decides ? " — Georgia Supreme Court Committee on Justice for Children—January 2011