As bipolar diagnoses in foster children rise,informed consent becomes a bygone-Psychotropics given to wards without states ok

As bipolar diagnoses in foster children rise, informed consent becomes a bygone
Psychotropics given to wards without state's OK, Tribune analysis finds

Tribune Reporter

December 10, 2009


Powerful mood-altering drugs were prescribed to hundreds of Illinois foster children without the required consent of state child welfare officials, a Tribune analysis of government data has found.

And increasing numbers of young wards were diagnosed with bipolar disorder and given a class of anti-psychotic medicines that some physicians consider risky for youths because they can cause such side effects as metabolic abnormalities and pronounced weight gain.

The number of Illinois wards diagnosed with bipolar disorder nearly doubled between 2000 and 2007, when roughly 9 percent of the state's nearly 16,000 wards were diagnosed as bipolar, the Tribune found.

"This is a really concerning statistic," said Dr. Michael Naylor, a University of Illinois at Chicago psychiatrist who reviews psychotropic medicine regimens for the state Department of Children and Family Services. Naylor said he worries that drug firms' marketing efforts are driving the diagnoses.

Many doctors say psychotropic medicines give troubled youths a precious chance at normalcy. But the drugs can pose special risks for foster children, who often lack a consistent adult to monitor treatment over time.

Illinois has seen a steady increase in the number of state wards simultaneously prescribed four or more of the psychotropic medications. During 2007, the most recent year when complete data were immediately available, more than 10 percent of Illinois wards given any psychotropic drug were taking four or more simultaneously, the Tribune found.

The danger, said University of Maryland professor Julie Zito, is that youths are being given multiple medications because existing regimens prove fruitless, or because new medications must be added to counteract side effects from other drugs.

Illinois' system of providing informed consent for psychotropic medications to foster children and of oversight of prescribing is considered the gold standard for state child welfare agencies. But during 2007, psychotropic medicines were administered to some 240 foster children without the state's consent, the Tribune found. That year, DCFS consented to the psychotropic medication of 3,320 wards, while separate Medicaid prescription records show the drugs were administered to 3,564 wards.

Some doctors may be unaware that their patients are foster children, but other physicians are skirting the consent laws, Naylor said.

dyjackson@tribune.com
Copyright © 2009, Chicago Tribune


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