Kevin, M.D - Medical Weblog

Parents overdose their child - is the physician in trouble?

Parents give their daughter increasing doses of Clonidine - although I think the newspaper report may have meant Klonopin instead - and the DA may be going after the prescribing psychiatrist.

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Comments

  1. Anonymous Anonymous  

    It is difficult to believe that a 4 year old would need so many drugs to control her behavior. Sounds like better parenting and few drugs were in order. Unfortunately, prescribing better parenting, short of hot-lining the parents, is not something the shrink can do. Sometimes, as painful as it is, we need to deal with un-drugged kids to get them to function within bounds of normalcy without crippling their brains.
  2. Anonymous Anonymous  

    Calling John Edwards! Callling John Edwards!!
  3. Clonidine is a drug being used to treat ADHD, so the name is probably correct.
  4. Anonymous RJS  

    Greg is likely correct. Clonidine is used in ADHD cases, though infrequently, and could cause the symptoms listed in the article if taken in super high doses.

    I still don't understand why the psychiatrist and the pharmacy are part of the probe? Clearly neglectful parenting was the ultimate culprit -- regardless of one's beliefs about medicating young children.

    It does sound like the mom thought the child had a cold:

    "She was also reportedly taking a cough suppressant, Dextromethorphan, and the antihistamine Chlorpheniramine, according to the coroner’s report."

    That sounds like something a pharmacist would recommend, since not many laypeople are familiar with chlorpheneramine and dextromethorphan by themselves. (DXM is usually combined with another drug, but nothing else is mentioned, which means that she was taking Delsym)

    Not that thinking the child has a cold excuses what happened.

    What an awful story.

    ...and I'm still confused about blaming the psychiatrist and the pharmacy. I'd love to hear the logic on that one.
  5. Anonymous Anonymous  

    Just guessing, but I would bet the prosecutor would tell you that as the person in charge of dispensing these drugs, and indeed given exclusive authority to prescribe them (as opposed to the layperson), they were criminally negligent in prescribing so much. That they have a duty to the patient to not overprescribe, particularly when that patient is a child, because patients rely on them for instructions as to dosage.
  6. Actually Doc, I see quite a few kids taking clonidine for ADHD, and at pretty high doses - .3-.4 mg.

    In my opinion, ADHD is diagnosed waaaay too often by physicians who are afraid to tell parents the truth - that their child suffers from Chronic Hickory Deficiency.

    ADHD may be a legitimate diagnosis, but far too often it's a panacea for bad parenting.
  7. Anonymous RJS  

    "Just guessing, but I would bet the prosecutor would tell you that as the person in charge of dispensing these drugs, and indeed given exclusive authority to prescribe them (as opposed to the layperson), they were criminally negligent in prescribing so much. That they have a duty to the patient to not overprescribe, particularly when that patient is a child, because patients rely on them for instructions as to dosage."

    That might be a tack they could try, but it's spurious at best. 0.1mg is not a huge dose of clonidine, and any good lawyer would shoot that down in a heartbeat.

    You can't control how medication is given in the living environment. To suggest it in a court of law is utterly laughable. I think the parents are going to take the heat on this one. I'll be really irritated if they go after the doc and/or the pharmacist. (Not that that means anything. :p)
  8. Anonymous Anonymous  

    I notice that I have an expert informing that that the drug is given only to adults. Where do they find these experts? Loads of kids are on clonidine.

    Most people are sort of morally offended at 4 year olds on psych meds. They may be going after the doc on no more than that. That would be an injustice. On the other hand, the article doesn't tell us what the prescribing directions were on that and the other meds. Also, even if the parents didn't follow instructions in giving the meds or monitoring them, the doc may be negligient if he knew or should have known they would be unreliable.

    This child had been medicated early in toddlerhood. A minimally competent parent can handle extreme behavior disturbance in a toddler without resorting to medication. Usually the only reason a 4 year old would need so many drugs to control behavior, would be that nothing else is being done to control it.
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