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American Carnage: Woman killed family, herself in triple murder-suicide

(KEEGO HARBOR, Mich.) — Autopsies show a suburban Detroit woman fatally shot her husband, son and daughter before killing herself. ...


venerdì 24 marzo 2017

Girl in Facebook Live hanging was prescribed suicide drugs

When a Miami psychologist examined Naika Venant in June 2015, she found a “depressed, angry and fearful young girl” who thought often about death and dying.
“She expects people to abandon and betray her,” the psychologist wrote.
Terilee Wunderman diagnosed Naika with “significant depression,” and post-traumatic stress disorder, and recommended that she see a specially trained therapist to mend her broken psyche. Wunderman also warned against filling the 12-year-old with pills, because the medication she was taking “sometimes can cause the side-effect of depression.”
During the next 18 months, however, Naika’s doctors reached for the prescription pad again and again, increasing the dose of an ADHD medication, and adding another drug, Zoloft, records indicate. The anti-depressant comes with a critical warning: an increased risk of suicide in children.
Naika had been prescribed both drugs when she took her own life on Jan. 22, hanging herself in the bathroom of her foster home while streaming the suicide on Facebook Live. The Zoloft dose had been doubled on Dec. 8, records shows.

Another girl hangs herself while streaming it live CAROL MARBIN MILLER AND AUDRA D.S. BURCH  
JANUARY 24, 2017

In their report, members of the Gabriel Myers Work Group reiterated an oft-claimed criticism: Mental health drugs are, at times, prescribed more for the convenience of “parents, teachers and other caregivers” than for the treatment of children.
The panel found that foster children being given powerful psychiatric drugs often are not apprised of the risks they face, and are “not adequately monitored” for signs of unintended consequences. “This is particularly troubling for children on medications with ‘black box’ warnings,” the 39-page report said.
DCF, the panel said, “should ensure that those involved in a child’s care are required to complete training on psychotropic medications, including requirements for informed consent, monitoring of ‘black box’ medication warnings [and] signs and symptoms to be monitored for adverse reactions.”
Naika, however, lacked the kind of stability such oversight required. Since last April, when she returned to state care for the third time, Naika shuffled from home to home 14 times, state records indicate. During one week alone in October, Naika’s living arrangements changed four times.
Should Naika have been on a drug with a black box warning when she had no consistent caregiver who was able to recognize the signs of danger? “That’s an easy question,” said George Sheldon, the former DCF secretary who appointed the Gabriel Myers Work Group. “The answer is no.”
Attorney Howard Talenfeld, who represents Gina Alexis, Naika’s mother, said the combination of Naika’s instability and the drugs’ risks left the teen in danger. “You have to be very concerned,” Talenfeld said Thursday. “Naika went through 14 non-therapeutic foster homes, and she was being prescribed very powerful psychiatric medication. She could not possibly have been appropriately monitored.”
Alexis told the Herald she does not recall ever being told by a doctor — or anyone else — that Zoloft was linked to an increased risk of suicide among children. “No one talked to me about the drug, or the possible side effects of the drug,” she said Thursday.

Antidepressants and Violence: The Numbers August 23, 2015

Jessica Sims, DCF’s spokeswoman, said key initiatives that arose from the work group were implemented and strengthened: greater protection for parents through a more rigorous informed consent process; a review of prescribing for children younger than 11 by a team of University of Florida consultants; and real-time data collection within the state’s child welfare computer system, the Florida Safe Families Network.
Child welfare investigators and case managers are specially trained in the use of psychotropic medication, and they are empowered to seek a second opinion at any time after consultation with a supervisor, Sims said.

Informed parental consent

Among all 23,993 children in state care as of a week ago, about 2,640 currently are taking at least one psychotropic medication, DCF records show. Adolescents like Naika are far more likely than younger children to be prescribed mood-altering drugs: Among children in state care ages 13-17, 1,203 children — 26.3 percent — are taking at least one mental health drug. The number of children in out-of-home care on psychotropic medication has decreased by more than one-fourth since reporting began in 2009, Sims said.
In the case of Naika, mental health drugs first were prescribed by her own doctor while she was still in her mother’s care, and “each time the child’s medication regime was changed by a physician after coming into care in 2016, the required informed parental consent was obtained,” Sims wrote, meaning the mother who had been stripped of custody for mistreating her child still had say-so over the medications prescribed to her.
Last April, Alexis abandoned Naika with a child welfare agency, DCF records show, saying she had “had it” with the girl.
The parallels between 7-year-old Gabriel, born in January 2002, and 14-year-old Naika, born the following December, are striking: Authorities believed both children had been sexually victimized, and were showing signs of becoming aggressors themselves. Both children had experienced tremendous loss and displayed symptoms of significant depression. Both children had developed extraordinarily challenging behaviors that made it difficult to achieve any stability in caregiving. Both children had been prescribed psychiatric medications that were not approved by the FDA for use among children like them.
Naika received a diagnosis of ADHD by 2010 and doctors began prescribing Adderall for it in 5 mg doses. In 2014, a comprehensive behavioral assessment by Kristi House, a child sexual abuse treatment center, said that in February 2011, “it was alleged that Naika was having suicidal thoughts because she “can’t do anything right.”
In a June 2014 “bio-psychological assessment” prepared for Naika’s case-management agency, the Center for Family and Child Enrichment, a therapist noted one element of the girl’s thoughts, emotions and behavior that was most worrisome: “suicidal ideation.” That same month, a mental health assessment reported that “when angry, [Naika] has verbalized suicidal ideations.”
While a raft of doctors saw Naika as a young girl with severe hyperactivity and an unwillingness to control her own behavior, Terilee Wunderman, the psychologist, in 2015 described a child whose sadness was overwhelming her.
The then-12-year-old’s answers to a set of half-sentences are, in hindsight, more a siren than a cry for help: “The thing I want to do most of all is die happy,” Naika wrote. Other answers included: “My best friend is I don’t have a best friend,” “The people I like to have hug or touch me are nobody,” and “I would do anything to forget the time that I made my mom cry.”
Wunderman was convinced that Naika’s longstanding ADHD label was a mistake that could augur calamity. “Although Naika has been diagnosed with [ADHD],” she wrote, “there is much concern that her attention problems are due to anxiety and trauma, rather than true ADHD... . Her distractability appears primarily due to trauma-based intrusive thoughts, fears and worries.”
The psychologist warned: “Naika’s medication should be reevaluated due to her pronounced depression. Since Adderall sometimes can cause the side-effect of depression, and Naika is coping with considerable depression related to her traumas, her medication should be reevaluated to determine if another regimen might better address her emotional difficulties.”

‘Suicidal ideations’

How well were Wunderman’s warnings heeded? By four months later, October 2015, Naika’s Adderall dose rose from 15 mg to 20 mg. And, something new had been added — 25 mg of Zoloft, used to treat depression, obsessive compulsive disorders (OCD), panic attacks and post-traumatic stress disorder in adults. In teenagers, the FDA approved it only to address OCD.
Vyvanse, a different ADHD drug, appears for the first time in Seifan’s April 2016 medical report for prescribing psychotropic medication. Seifan prescribed Vyvanse in 50-mg doses and continued prescribing the Zoloft. When asked how long the drugs would be needed, Seifan wrote: “Indefinite.”
Seifan diagnosed the teen with ADHD and depression, and noted the drugs were intended to improve the child’s “mood.”
Under side effects for her caregiver to watch for, the doctor wrote: “suicidal ideations.”
Seifan checked off the box next to “I find that it’s likely any delay in taking this medication will cause significant harm to the child.” But, when asked to describe “the nature and extent of the harm the child will likely experience,” he left the space blank.
And to the question of other treatment options instead of using the psychotropic drugs he prescribed, Seifan checked off, “No.”
Though her living situation changed sometimes daily, medication was Naika’s constant: The Zoloft remained at 25 mg until a Dec. 8 appointment with Segal. Segal’s diagnosis included ADHD and “major depressive disorder, single episode, unspecified.” He raised the daily Vyvanse dosage, which had been briefly reduced to 30 mg, back to 50 mg and doubled the Zoloft to 50 mg daily.
Naika hanged herself 45 days later.

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