Let’s Not Kill Any More Rebecca Riley’s! Debate Over the Use of Psychiatric Drugs for Young Children

 

The New York Times reported that Rebecca Riley, a four year old girl from near Boston, was found dead on the morning of December 13, a victim of an apparent overdose of the psychiatric drugs Seroquel, an antipsychotic drug; Depakote, a powerful anti-seizure medicine used for mood control, and Clonidine, a blood pressure drug often prescribed to calm children. Rebecca had been diagnosed at having bipolar disorder at the age of two! So some overzealous psychiatrist had diagnosed her as been manic depressive at age 2.

Now this is pretty crazy. A child at two is a work in progress, and if is virtually impossible to diagnose anything at that age. The only exceptions are the developmental disorders, such as autism. Probably Rebecca was a difficult child, prone to moodiness and maybe even tantrums. So her parents, with a willing psychiatrist, gave her mind-numbing drugs to calm her, rather than learning better parenting skills. From the article: “A relative of her mother, Carolyn Riley, 32, told the police that Rebecca seemed “sleepy and drugged” most days, according to the charging documents. One preschool teacher said that at about 2 p.m. every day the girl came to life, “as if the medication Rebecca was on was wearing off,” according to the documents.”

This is more than sad, it is pitiful. How many other, nondrug interventions were tried before using medication? Was there parenting training? Was there a home visit, to see how Rebecca and her parents were interacting? The article does not say, but I’m guessing that none of these things were done. There’s an old saying, “Give a young boy a hammer, and everything becomes a nail.” In much the same way, bringing a child to a psychiatrist means that they are likely to get drugs. That’s why the first stop for children, especially young children, should be to a child psychologist, a psychologist who specializes in treating children and their families.

It should also be noted that most psychiatric medications are not and have never been approved for use in young children. There are no studies of using these drugs on toddlers. Although it might be occasionally reasonable to use drugs meant for adults on older teenagers, who are at least biologically similar to adults, it is irresponsible at best to use these drugs with young children.

The problem is that giving kids drugs is too easy. From the New York Times article, “Paraphrasing H. L. Mencken, Dr. Carlson added, ‘Every serious problem has an easy solution that is usually wrong.’” Behavioral problems in children can be very serious, and the behavioral interventions take time and commitment. Learning good parenting techniques, such as the proper use of time-outs and other interventions, takes dedication and a competent psychologist’s help.

As with adults, medications should always be reserved for after all other interventions have failed. And with children, only medications that have been tested on children, and used for years should be tried. If psychiatrists want to prescribe these medications for children, let them first run the research trials required by the FDA to test safety and effectiveness. Let’s not kill anymore Rebecca Riley’s!

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Dr. Andrew Gottlieb is a clinical psychologist in Palo Alto, California. His practice serves the greater Silicon Valley area, including the towns of San Jose, Cupertino, Santa Clara, Sunnyvale, Mountain View, Los Altos, Menlo Park, San Carlos, Redwood City, Belmont, and San Mateo. Dr. Gottlieb specializes in treating anxiety, depression, relationship problems, OCD, and other difficulties using evidence-based Cognitive Behavioral Therapy (CBT). CBT is a modern no-drug therapy approach that is targeted, skill-based, and proven effective by many research studies. Visit his website at CambridgeTherapy.com or watch Dr. Gottlieb on YouTube. He can be reached by phone at (650) 324-2666 and email at: Dr. Gottlieb Email.

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