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Natural Serotonin from Seroctin
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Doctors Fail to Recognize Life-Threatening
Serotonin Syndrome
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A greater awareness of the combinations that trigger the syndrome could lead
to prevention, but a diagnostic challenge exists due to the fact that the
list not only includes prescription drugs, but also over-the-counter
medications and herbal supplements. The following are some of the products
known to be associated with serotonin syndrome:
Monoamine oxidase inhibitors (MAOIs)
Tricyclic antidepressants (TCAs)
Selective serotonin reuptake inhibitors (Zoloft, Prozac, Paxil, Lexapro,
Celexa)
Venlafaxine (Effexor)
Trazodone (Desyrel)
Nefazodone (Serzone)
Meperidine (Demerol)
Dextromethorphan (Cold Remedies)
Chlorpheniramine
Sumatriptan (Imitrex)
Atypical antipsychotic (Zyprexa, Risperdal, Seroquel)
L-dopa
Meridia
Lithium
Valproic acid (Depakene)
Linezolid (Zyvox)
St John's Wort
Ginkgo Biloba
Many experts blame the rise in cases of serotonin syndrome on the fact that
so many different drugs are being prescribed to patients at the same time in
combinations, or "drug cocktails," which have never been approved as safe
and effective by the FDA for any use and without considering the
over-the-counter medications that patients may be taking.
The syndrome has become more prevalent in children as the off-label use of
drug cocktails with children has increased. Some experts suspect serotonin
syndrome in the death of 4-year-old, Rebecca Riley in Massachusetts, on
December 13, 2006.
Critics say the Riley case highlights the need to put an end to the rampant
off-label prescribing of adult psychiatric drugs to children. "The general
public is unaware that almost no psychiatric drugs have ever truly been
tested for children," according to David Oaks, director of MindFreedom, an
international human rights organization.
"All psychiatric drugging of children," he says, "is essentially 'off label'
in the sense that doctors have an enormous range of discretion when
prescribing psychiatric drugs to young people."
"It's time for society to get hands-on with the mental health system," Mr
Oaks warns, "and rein in the immense tyrannical power that doctors now
have."
The State Police
investigator's report in this case said psychiatrist Dr Kayoko Kifuji, at
the Tufts-New
England
Medical Center, prescribed 3 medications for Rebecca: 750 milligrams a day
of Depakote; 200 milligrams a day of Seroquel; and .35 milligrams a day of
clonidine.
Rebecca was given Seroquel, for bipolar disorder, a drug only approved to
treat adults with schizophrenia or bipolar, Clonidine, for attention deficit
disorder, a drug approved only to treat adults with high blood pressure, and
Depakote, an anti-convulsant drug approved to treat epilepsy in adults.
She was kept on this 3-drug cocktail since she was 2 and a-half-years-old,
until she was found dead on the floor of her parent's home on December 13,
2006. At the time of her death, there were also over-the-counter cold
medications in her system including Children's Tylenol Cough and Runny Nose,
which contain acetaminophen, dextromethorphan and chlorpheniramine.
According to a report by investigators, Rebecca's teachers and a school
nurse repeatedly complained about the child's extreme lethargy and how she
seemed better when the drugs wore off, and the nurse also pointed out that
Rebecca did not exhibit the kind of behavior that might justify prescribing
these types of drugs.
A therapist who treated the children also told investigators she was
concerned about the medications prescribed to Rebecca because she never
noticed symptoms of attention deficit or bipolar disorder.
A state trooper's affidavit said a Walgreen's pharmacy filled a number of
clonidine prescriptions for the Riley's when they should have had an ample
supply and that several times, Dr Kifuji approved extra pills because
Carolyn Riley said she had run out or lost her supply.
Carolyn Riley told investigators that Dr Kifuji had authorized the extra
doses to help Rebecca get to sleep, the affidavit said. The trooper also
reported that Dr Kifuji received calls from a therapist and a nurse at Elden
Johnson Early Childhood Center, where Rebecca was a student, saying they
were concerned about her medication.
The affidavit shows that no testing was conducted on Rebecca in making the
diagnosis of attention deficit or bipolar disorder and that Dr Kifuji said
she diagnosed Rebecca based on the parents' statements and "brief visits" in
her office as frequently as twice a month and as seldom as once every two
months.
In July 2006, a social worker treating Rebecca filed a complaint with the
agency reporting that Carolyn Riley was "neglecting her children" and
"appeared heavily drugged and unable to respond" on one of her visits to the
family home.
Doctors Fail to Recognize Life-Threatening Serotonin
Syndrome - 2
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aTreaty
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