People are pretty vocal about what they perceive to be the dangers of diagnosing and medicating children who have psychiatric disorders, and you can find plenty of horror stories, including the case of Rebecca Riley, but what about the dangers of not medicating children who fail to respond to non-medication interventions and could really benefit with the right diagnosis and medications?

These children and their families often live in their own torture chambers, through no fault of their own. Left untreated (or without effective treatment), the condition usually worsens, the suffering deepens, and all sorts of collateral damage may result. The child with the condition may fall behind in school, become a social outcast among his peers, and be more at risk for alcohol and substance abuse and getting into legal trouble. The frustration and anger he feels could compel him to abuse others – verbally and physically. His relationships with his parents and any siblings can become strained. He may be driven to self-mutilation or even suicide. The stress can wreak havoc on a family and drive a wedge between the parents. Feeling the strain, parents and siblings are at a greater risk of developing their own psychiatric and emotional disorders, especially if a genetic vulnerability runs in the family.

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A recent visitor to our Bipolar Blog wrote:

I have a question, I was diagnosed BP1 in July, I am struggling with the severe manic episodes involving self damage, screaming, it is pretty bad, the police were here last night, but thanks to God, they did not take me. My boyfriend is loving and supportive and a good person is taking care of me when I come down. But the physically intimate part of our relationship is gone. He always has an excuse. This only makes me feel more and more lonely and displaced. He refuses to make the connection of normalcy for me. To me it proves he cannot handle BP. Anyone else have this problem, can you overcome it and how??? Thanks for your thoughts!
Lori B.

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In court last week, during the murder trial of Rebecca Riley’s mom, Carolyn Riley, the prosecution presented evidence that questioned mom’s truthfulness. They questioned whether Carolyn lied when she told investigators how much medicine she had given to Rebecca the day before Rebecca died. To support their case that the mom doesn’t tell the truth, they introduced evidence that Rebecca’s parents tried to get the school counselor to help them get reimbursed for allegedly lost gift cards, which in fact the parents had already used.

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If it takes a village to raise a child, it might just take a village to kill one, too, which is what I believe happened to Rebecca Riley. Here are some facts about and testimony from some of Rebecca Riley’s “caregivers” as reported by Boston.com, The Patriot Ledger, and Carolyn Riley herself during her 60 Minutes interview with Katie Couric, along with some commentary.

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Patricia Wen of the Boston Globe posted an article today entitled “Psychiatrist admits she approved higher drug dosage in Riley trial. In it, she recounts the testimony given today by Dr. Kayoko Kifuji, the psychiatrist who had diagnosed and treated Rebecca Riley for bipolar disorder and attention deficit hyperactivity disorder (ADHD). I read the article cautiously, because there are so many facets to consider in watching this trial unfold, but the psychiatric testimony carries a lot of weight.

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Many people are shocked to hear that anyone as young as Rebecca Riley could be diagnosed as having bipolar disorder and prescribed powerful psychotropic medications. Following are several questions I have been hearing about the case recently that are related to early childhood diagnosis and treatment followed by my answers:

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The Patriot Ledger seems to be following Carolyn Riley’s murder trial closely. For Lane Lambert’s report on the second day of the trial (Wednesday), see “Teachers say Rebecca’s parents shed no tears.” On Patriot.com, you can also view a video of the prosecutor’s opening remarks delivered on Tuesday.

Rebecca Riley was four years old when she died three years ago. She had been diagnosed as having bipolar disorder and ADHD and was being treated with clonidine (a blood pressure medicine sometimes used as a sedative for ADHD) and Depakote (for bipolar). (See Department of Social Services (DSS) case file recounting the timeline of DSS involvement with the family of 4-year-old Rebecca Riley.)

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4-year old Rebecca Riley was diagnosed with ADHD and bipolar disorder and died allegedly due to an overdose of prescription meds. The parents are on trial for her death. The trial of Carolyn Riley (Rebecca’s mom) is scheduled to begin Tuesday in Brockton Superior Court. She is accused, with her husband, Michael, of abusing the drugs Rebecca Riley had been prescribed. See “Mom’s trial in Rebecca Riley’s drug death set to begin” where you can find links to additional information about the case.

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Mark Olfson, professor of clinical psychiatry at Columbia University, just published results of his study in the Journal of the American Academy of Child & Adolescent Psychiatry, in which he found that “the number of children aged 2 to 5 who have been diagnosed with bipolar disorder and prescribed powerful psychiatric medications has doubled over the past decade.” (To read more about the study, check out today’s story from Reuters reporter Ros Krasny entitled “Bipolar diagnosis jumps in young children: study.”)

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