Healthcare News & Insights

Kids on psychotropics: A potentially fatal balancing act


A mother’s recent conviction in the death of her four-year-old daughter highlights the sometimes fine line between treating actual disorders and controlling children’s day-to-day behavior.

This week, Carolyn Riley was found guilty of second-degree murder in the death of her daughter Rebecca. She faces a life sentence with the possibility of parole in 15 years. Her husband will face trial shortly on the same charges.

Rebecca died in Dec. 2006 after being given a double dose of clonidine, a powerful sedative. Prosecutors painted Riley as a mother more concerned about keeping her children quiet than their physical well-being. Rebecca, and her two siblings were all prescribed clonidine, Depakote and Seroquel around the time they turned two.

Prosecutors alleged that Riley doubled up Rebecca’s dose on the night she died in order to keep her quiet and keep her from entering her parent’s room. Rebecca was found dead on the floor next to her parent’s bed at 6 a.m. the next morning.

But Riley’s defense attorney pointed out that the prescriptions were legally obtained from Dr. Kayoko Kifuji, a Tufts Medical Center child psychiatrist. Kifuji made liberal use of prescriptions in her practice, and endorsed a “flexible” dosing schedule with the Rileys.

During the trial, Dr. Kifuji testified that Riley sometimes increased or otherwise altered the doses she gave her children. Kifuji based her recommendations almost entirely on the parents’ descriptions of their children’s behavior, and didn’t solicit feedback from the childrens’ teachers.

But Kifuji also said that while she warned Riley against that practice, Kifuji sometimes modified her own prescription plan to match what Riley was actually doing. The original dose of clonidine for Rebecca was one tablet each night. Riley was soon giving the child two tablets — which Kifuji eventually authorized.

Kifuji testified only after being given immunity — she also faces a malpractice suit for her role in the death.

Psychotropic meds and preschoolers — a potentially lethal cocktail

As part of their case, prosecutors also alleged that Riley and her husband pushed for medication for their kids not out of medical necessity, but to justify receiving disability payments from the state.

The case uncovers how difficult it can be at times for medical professionals to determine the best way to treat mental illness in children. Where does one draw the line between a healthy energetic toddler and one with ADHD? And how can health professionals determine when a parent may be exaggerating a child’s symptoms and behavior for their own convenience?

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  1. This issue is criminal and someone should step up and place a parential control over children and safe guard their lives. We whom have raised children know this task is 24hrs a day 7dys a week and beyond for our live times. We should demand that individuals seeking care for all minor children have a psychiatric evaluation prior to the children being evaluated. Then the child should only be evaluated by a practicing CHILD psychiatrist after evaluation reports shouldbe reviewed by a govering board for recommendations as to when and how to treat our minor child. Being a women of 40 I seen this practice for far to many years go unchecked and lots of small children from as early as the eights have been self medicating with street drugs to support the child adictions that were created from a parent/teacher/social worker etc. LABEL. Stop the slaughter of our children and seek god grace in caring for them and their educations.

  2. The ADHD and ADD diagnoses are way overused and has run amuck. It, for the most part, is just a way for physicians to tell us what we already know to get paid for it and for parents to medicate their children so they won’t have to deal with them as much. My God people, children are are “HYPER”, you just have to deal with them. I am amazed that the physician got off so easily. If the report is correct, this individual should have been found guilty of second degree murder as well. It seems it was just as much the physician’s fault as the parents.

  3. Sometimes it’s not the parents, it the teachers. I was told I needed to get my daughter checked for ADHD, my husband and I didn’t think she had it. We took her in and were told by the Psychologist that she had ADHD. Medication was then prescribed by a Physician, it didn’t change her behavior, so a different medication was prescribed and then a different one. We finally said, enough is enough and took her off the meds. Fast forward 4 years, we were again told by her school to have her tested, we did by a different Psychologist who said well, she might have it, it’s hard to say. The school didn’t accept this opinion and insisted we go to a certain Psychologist (the same one she’d gone to now 5 years earlier). Guess what? He now says the tests indicate she doesn’t have ADHD. I’m out a ton of money for all these doctors and tests and even worse she was medicated for nothing! She’s actually gifted and has some anxiety problems. The whole thing is pretty scary and I don’t know who to listen to anymore.

  4. It turns out that most of the prescriptions for psychiatric drugs given to children and youth and submitted to Medicaid is Medicaid Fraud. See, PsychRights’ Medicaid Fraud Initiative Against Psychiatric Drugging of Children & Youth at

    One of these whistleblower lawsuits in Alaska against 32 defendants was recently unsealed regarding this illegal practice. See,

    There are cases percolating in other states in this effort by PsychRights to stop the carnage to America’s children and youth caused by the masive psychiatric drugging of children and youth, especially those in foster care.

    Every psychiatrist who continues the practice is opening him/herself up to financial ruin because each offending prescription carries a minimum penalty of $5,500.

  5. Abraham Ragudos says:

    Most of the time when kids especially toddlers started getting hyper, most parents especially here in the USA, bring their kids to a ” psychiatrist” which in turn prescribed medications to calm down the kids. Parents
    need to be responsible and at least know a little bit of child psychology to deal with a hyperactive child without resorting to all these prescription drugs. It is just but right that the above parents be charged with murder and hope that this will open the minds of parents and future parents to be more responsible and doctors alike to be more careful in their line of practice.