Where is justice for Rebecca; diagnosed as bipolar at age 2, dead at 4 from overuse of meds

Rebecca Riley's parents brought her to a child psychiatrist when she was just two years old. Doctor Kayoko Kifuji of Tufts Medical Center promptly diagnosed the Springfield, Massachusetts girl with bipolar disorder and ADHD. Two years later Rebecca was dead and her parents were on trial for her murder.

Bipolar babies?

To anyone unfamiliar with the state of psychiatry today, two things may strike them as odd. One: How could a child—and certainly a toddler—be diagnosed with bipolar disorder? And two: What is the point in such a diagnosis—surely, no responsible doctor would give psychiatric medication to children of two, three, four, or five years of age? Or would they?

Unfortunately, there are no surprises here to those involved with pediatric psychiatry, as Dr. Kifuji could tell you. Twenty years after she “diagnosed” Rebecca and after the girl died of “prolonged abuse” (according to the medical examiner) of the drugs Kifuji prescribed, Kifuji is still in practice—she never lost her license, was never disciplined by the medical board, and even the payout made to Rebecca’s siblings following a civil lawsuit was covered by her insurance.

Murder by prescription

Rebecca’s parents, by contrast, are still in prison—her father was convicted of first-degree murder, her mother of second-degree murder. Both of them watched the girl deteriorate in her final days without taking her to see a doctor, despite the entreaties of worried neighbors. Kifuji gave evidence at their trials but was under immunity, a fact that shocked the jury members, several of whom expressed their wish to see her in the dock as well.

After all, Kifuji had seen Rebecca at many appointments and somehow failed to detect the signs of overmedication that nurses and teachers at her preschool program were concerned about. She also knew that Mrs. Riley was giving her young daughter far more than the recommended dose of the drugs she was taking (if one can consider these drugs “recommended” at all for children). Although she apparently rebuked Rebecca’s mother for upping the doses without first getting permission, Kifuji gave that permission retroactively.

No regrets

While giving evidence at the trial of Rebecca's father, Michael Riley, she was asked by his defense attorney whether, in retrospect, she would have done things differently.

[Attorney Darrell] Now that you’ve had this time for reflection, have you changed your mind about your diagnosis and treatment of Rebecca Riley?

[Kifuji] No, I have not.

This despite the doctor having being warned by the school nurse that Rebecca was better off with less drugs:

I did tell Dr. Kifuji that when Rebecca was a little more awake (after the clonidine wore off), she played nicely with the other children. She was more animated. She was a very sweet little girl.

One in ten American kids on psych drugs

According to the CDC, in 2022, 9.3 percent of children aged between 5 and 17 were taking drugs for their “mental health.” This translates to around five million children. As many anti-Pharma activists have pointed out, children are a very sought-after demographic for drugging, as they usually have little to no say as to whether to take the drugs or not, even when adverse events are disturbing, painful, and/or outright harmful. Furthermore, a childhood on drugs very often predicts adult life on more drugs—more of the same, plus others.

Who is looking out for these children? Not the FDA it seems. Just a few months ago, the FDA decided to expand its approval of an SSRI-class drug, Lexapro, to “treat anxiety” in children as young as seven years old.

The authors of the clinical trial upon which the approval was based wrote that Lexapro “reduced anxiety symptoms and was well tolerated,” adding that, “the benefits of the product outweigh the risks.”

One of the risks, apparently, is suicide—one child (out of 137) in the trial (in the Lexapro cohort) actually tried to commit suicide. None of the children in the trial had been actively suicidal prior to the study. The FDA approval does not mention the suicide risk. Perhaps it is considered sufficient that SSRIs in general come with a boxed warning that notes their associated risk of both homicidal and suicidal ideation.

“Angel” parents wanting angelic kids?

Those who criticize ADHD diagnoses for children who cannot seem to adapt to the demands of classroom life often claim that the “unnatural” rigidity of the school environment is to blame, rather than the child's “natural” nature. A similar claim is also often made of psychiatric diagnoses given to very young children who are basically just regular toddlers — only their parents are either unwilling to or incapable of dealing with them.

Seeking advice on an online parenting forum, “Angel MDSN” writes:

I'm having a really hard time with my stepson he is severely bipolar and has shown severe symptoms since he was 2 he is now over 5 1/2. We tried not medicating him for a long time but he just kept getting more and more out of control … Like tantrums for hours, telling lies all day, kicking/punching holes in walls. You get my drift and let me tell you we are a very strict boudry [sic.] set home and as consistent as you can get also have tried every discipline in the book. He has now been medicated for seven months We have tried various meds. and combinations. He is still so out of control though…

“Glesa,” answering “Angel,” apparently has experienced something quite similar (and she’s far from being alone). Although she mentions that what she calls “Red dye” in food clearly makes her son “defiant and moody with outbursts,” she also writes:

What you describe to me, sounds just like my DS when he was 2 and 3 ... it took constant pleading from me to get the dr to send him to see a behavioral specialist. Once she did our world changed. He has ADHD and Anxiety. DS has his moments still, but he knows that not having his meds, even in the summer, he is miserable and acts out. I really did not want to medicate him, but behavior modification alone was not working...

A bleak outlook

Commenting on the FDA’s approval of several “antipsychotic” drugs to treat children back in 2009, Vera Sharav, president of the Alliance for Human Research Protection, stressed that,

The FDA's expanded marketing approval process for antipsychotics, highly toxic drugs, is unaffected by evidence uncovered by the US Justice Department showing that the studies submitted by drug manufacturers were often flawed, if not fraudulent. 

Rather than focus on protecting children's safety, FDA officials are doing their utmost to legitimize irresponsible, off-label prescribing of exceedingly toxic antipsychotics for children--thereby ensuring that far greater numbers of children will be victimized and die.

Sharav was by no means exaggerating the dangers these drugs pose. In an editorial published in Psychotherapy and Psychosomatics, Dr. David Healy notes that,

For fifty years, the antipsychotics were viewed as too dangerous to use outside secondary care and were largely restricted to those with chronic psychotic disorders where the trade-off between hazards and benefits justified treatment.

Yet now a new generation of possibly even more problematic antipsychotics is being given to preschoolers, in North America, on the basis that they might have a disorder that most of the rest of the world does not believe happens in children.