Anti-Psychotic Drug (Risperidone) Inappropriately given to hundreds of Children
Following concerns raised about the clinical practice of a Non-Consultant Hospital Doctor and a Locum Consultant Child and Adolescent Psychiatrist in prescribing, care planning and diagnostics in the south Kerry area Child and Adolescent Mental Health Service (“CAMHS”) in or around July 2016 to April 2021 the Health Service Executive (“HSE”) commissioned Dr. Sean Maskey to conduct a Look-Back Review into the alleged incidences of malpractice. The review, which was published in January of this year, examined a total of 1,332 cases and investigated inter alia whether young people who attended mental health services in south Kerry were prescribed inappropriate or inappropriate dosages of medication.
The Maskey report found that hundreds of service users were exposed to a risk of significant harm while 46 service users were actually caused significant harm as a result of the drug misuse The harms included galactorrhoea (the production of breast milk), considerable weight gain, sedation during the day, and elevated blood pressure. Many service users were found to be diagnosed with Attention Deficit Hyperactive Disorder (“ADHD”) without any or any adequate assessment being carried out. In essence the report creates the impression that the young adults and adolescents were being simply routinely medicated rather than treated due to a lack of professional staff and specialists being available to the CAMHS service. The report did not rule out the possibility of the number of young adults who were caused significant harm increasing as more information becomes available from further meetings with the children, young adults and parents affected. It seems entirely plausible that given the paucity of professional resources available to the CAMHS service nationwide that the situation in Kerry might prove to be a countrywide problem.
The treatment concerns identified in the report included the frequent use of neuroleptic medication to control behaviour and / or subjective emotional distress in children when it is not indicated clinically; incorrect use of medication for the symptoms or diagnosis e.g. neuroleptics/atypical antipsychotics (Risperidone/Risperdal) instead of antidepressants or anxiolytics; unnecessary combinations of medications, either of the same or different types, e.g. tranquillisers and stimulants for ADHD; early use of medication, rather than waiting and providing support to allow distress to resolve with time, e.g. after a teenage relationship breakup; failure to adhere to the licenced indications for medication; failure to manage the potential adverse effects of medication through adequate monitoring and recording of physical changes, height, weight, pulse, blood pressure and potential endocrine and metabolic changes in blood profile and failure to obtain reports from the child’s teachers about the response to medication for children with an ADHD diagnosis.
One of the drugs the report found was prescribed inappropriately to children was Risperidone/Risperdal. Risperidone is an antipsychotic medicine that works by changing the effects of chemicals in the brain. Risperidone is commonly used to treat schizophrenia in adults and children who are at least 13 years old. Risperidone is also used to treat symptoms of bipolar disorder (manic depression) in adults and children who are at least 10 years old. Risperidone is also used to treat symptoms of irritability in autistic children who are 5 to 16 years old. Common risperidone side effects may include headache; dizziness, drowsiness, feeling tired; tremors, twitching or uncontrollable muscle movements; agitation, anxiety, restless feeling; depressed mood; dry mouth, upset stomach, diarrhoea, constipation; weight gain; or cold symptoms such as stuffy nose, sneezing, sore throat.
The report also made adverse findings in respect of a lack of supervision, informed consent, governance and administration.
Reacting to the report Taoiseach Micheál Martin commented that the findings were shocking, very serious in nature and unacceptable and recommended that a review be conducted in each of the 72 CAMHS areas nationwide to investigate if the incidences of malpractice in south Kerry were isolated events or more widely systemic in nature.
It is highly distressing for services users and their families who learn that they / their children were improperly diagnosed as a result of non-compliance with appropriate diagnostic processes, inappropriately medicated and suffered harm as a result of their treatment in the CAMHS.
In April 2022 Minister for Health, Mary Butler, announced that a compensation scheme will be made available for families affected by the incidences of malpractice in the CAMHS arising from the Maskey report. Our firm are currently acting for and taking enquiries from families of service users nationwide who believe they / their children may have been adversely affected as a result of their treatment in the CAMHS.
A copy of the report of Dr, Maskey is available at the below link:
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