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.)

The coroner at the time concluded that the death was caused by an overdose of those two medications along with other over the counter medications she was taking. Rebecca’s parents, Michael and Carolyn, have been accused of killing Rebecca purposefully for financial reasons. The parents claim Rebecca died of pneumonia and that they were following doctors’ orders regarding the clonidine dose.

This case has become a flash point in the growing debate about early diagnosis of psychiatric conditions, particularly bipolar disorder, in very young children, and it highlights the potential dangers of using psychiatric medications to treat these children.

It is true that many children – probably Rebecca Riley included – and their families suffer due to profound levels of mood and behavioral symptoms that disrupt and damage lives and interfere dramatically with child development. And some pre-schoolers may well need psychiatric medications. But this can only be done safely in the context of thorough psychiatric, developmental, and family assessments that lead to comprehensive approaches to these complex and challenging children and families.

I will watch the trial with interest – I will want to hear the expert testimony, the discussions of the diagnosis and treatment plans that were in place for Rebecca, and the family’s understanding of Rebecca’s condition and her treatment.

Regardless of the verdict, this case and everything revealed during this trial is likely to trigger important discussions about the diagnosis and treatment of children with emotional and behavioral problems and is likely to result in some serious repercussions for child psychiatrists and other professionals who work with these children.

As I monitor this trial, I will be posting my insights here.

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From Psych Central's website:
PsychCentral (January 20, 2010)

    Last reviewed: 20 Jan 2010