Military kids taking more psychiatric drugs

[Guest guest]

http://www.armytimes.com/news/2011/01/military-children-taking-more-psychiatric-drugs-010211w/

Military kids taking more psychiatric drugs

Prescriptions increase as families struggle

with repeated deployments

By

Jowers and

Tilghman - Staff writers

Posted : Sunday Jan 2, 2011 11:02:27 EST

Before his father deployed to Iraq, Radenz was a

well-adjusted fifth-grader earning straight A’s and B’s in

school near Fort Hood, Texas.

But shortly after Army Lt. Col. Blaine Radenz left home in June

2008, his 11-year-old son became withdrawn and anxious. His

grades at school slipped and his mother noticed mood swings. The

child’s longtime pediatrician referred him for counseling.

A psychiatrist at Fort Hood’s Darnall Army Medical Center

prescribed the antidepressant Celexa. also saw a

psychologist there. Doctors added to and changed ’s drug

regimen, but his problems grew worse, said his mother, Tricia

Radenz.

started cutting himself and once used his own blood to

write “the end” on a bathroom wall at school. One day in band

class, he began hallucinating and ran into the hall, where

teachers found him crouched and hitting and scratching his face.

On June 9, 2009, hanged himself from a bunk bed in his

home.

“I really feel the drugs played a significant role in ’s

death,” said Tricia Radenz, a 41-year-old emergency-room nurse.

It’s impossible to know precisely why a 12-year-old chose to

take his own life. But the boy’s problems — and the use of

powerful psychiatric drugs to treat them — highlight a concern

for a growing number of military families who are struggling

with the impact of long, frequent deployments on their children

left at home.

The use of psychiatric medications by military children is on

the rise. Overall, in 2009, more than 300,000 prescriptions for

psychiatric drugs were provided to children under 18 who are

Tricare beneficiaries.

That’s up 18 percent since 2005, according to data provided to

Military Times — a period when the under-18 population increased

by less than 1 percent. And some drug categories have shown even

higher rates of increase — antipsychotic drugs are up about 50

percent and anti-anxiety drugs are up about 40 percent.

That mirrors a similar trend in the active-duty force, which

has seen a 76 percent increase in prescriptions for

psychiatric medications since the start of the war in

Afghanistan.

Dr. Lester, a psychiatrist at University of

California, Los Angeles, said the rise in drug use among

children tracks with studies she and others have done showing

how repeated deployments are taking a toll on military kids.

“There is a consistent story coming out showing that these kids

have more distress,” Lester said. “And it’s not just the period

of deployment. It appears to be during re-integration as well.”

Two studies link parents’ deployments to their children’s lower

academic achievement scores, and to increased mental and

behavioral health problems.

In one study, Rand Corp. researchers matched soldiers’ records

with children’s academic achievement records and found lower

scores among military children whose parents were cumulatively

deployed for 19 months or more since 2001.

In the mental health study, led by a professor of pediatrics at

the Uniformed Services University of the Health Sciences,

researchers found that when a parent was deployed, outpatient

visits among children ages 3 to 8 for pediatric behavioral

disorders rose 18 percent, and for stress disorders by 19

percent, compared with military children whose parents were not

deployed.

Prescription psychiatric drugs can help treat some of those

behavioral disorders. But many of those drugs come with

potential side effects, Lester said.

“Whenever one is prescribing medication, there is a

risk-benefit analysis that has to occur, and the parents and

patient need to be included in that,” Lester said.

Suicide risks

Tricia Radenz said nobody ever warned her about the suicide

risks associated with the drugs her son was taking.

“The psychiatrist never once told me Celexa was a risk. He said

he’d had great success with this drug,” Radenz said in an

interview.

“Any antidepressant carries the warning, but I didn’t find out

the seriousness until after he died,” she said.

Celexa, along with Wellbutrin, which was also taking at

the time of his death, carry “black box” warnings from the Food

and Drug Administration — the FDA’s most serious warning — about

increased risks for suicidal thoughts and behavior.

Moreover, neither drug is recommended for children, although

doctors may legally prescribe them after determining that they

may benefit individual patients.

Experts say any medication should be matched with intensive

therapy or counseling as a way to monitor for side effects and

treat underlying problems that drugs cannot address.

Radenz said saw the psychologist and psychiatrist once

or twice a month. She said the psychiatry department didn’t

respond to her pleas for help when she called after had

cut himself at school and used his blood to write on the

bathroom wall.

The mother left a phone message with the psychiatry department,

with details about what had happened, asking that someone call

back for an appointment. Nobody returned her call, she said.

“I was essentially staying with him 24/7,” Radenz said. “I was

outside the bathroom if he was in there. He was sleeping with

me.”

She said that after she was unable to get help from the child

psychiatry department, she e-mailed her husband in desperation,

and he came home from Iraq on emergency leave May 25.

was thrilled to see his father. For days as the family

spent time together, Radenz said, laughed and joked and

said many times: “I’m so glad Dad is home.”

’s father went to the local clinic and asked why his

wife’s phone calls had not been returned, even by June 1. He

told them he was on emergency leave because of his son’s

decline.

The clinic staff apologized, Tricia Radenz said, and explained

that no one was checking the answering machine because the staff

was overwhelmed.

Her son’s death a week later “was completely preventable, had

he received competent care instead of being herded through the

system like a piece of cattle at an auction,” she said. “I want

someone held accountable, and I don’t want anyone to ever have

to go through this again.”

Officials at Darnall Army Medical Center said they conducted an

investigation into ’s treatment, but a spokeswoman

declined to disclose any of its findings. However, the

spokeswoman said, “rest assured that all medical treatment was

thoroughly evaluated” and “any lessons learned as a result of

that review have been incorporated into our practices here at

Fort Hood.”

Tricia Radenz knows nothing can bring her son back.

“But why can’t they say they were wrong? That they’ve made

changes? All I want is to know they’ve corrected their process

that cost me my son.

“No other family should ever have to endure the agony my family

suffers daily. My husband made more than the ‘ultimate

sacrifice’ ... he sacrificed his son to serve.”

‘This keeps him safe’

Not all families have such tragic experiences. Some families

see psychiatric drugs as a life saver.

One Army wife and mother of a 12-year-old boy said the

medications her son takes are the only thing keeping him out of

an institution. Diagnosed with bipolar disorder, the child is a

stable seventh-grader who takes five different medications every

day.

“This keeps him at home. This keeps him safe,” said the mother,

who spoke with Military Times about her son’s treatment but

asked not to be identified.

The wife of a Special Forces soldier who has deployed often

during the past decade, the mother said her child’s problems

typically get worse, if only temporarily, after his father goes

overseas.

“When my husband leaves, the first seven days, seven to 11

days, are very hard on him. He’s very sad. He’s withdrawn. He

rages more frequently. But once we get past that period of time,

he is the same as he always is.”

The family’s frequent moves have taken a toll on her son. His

problems first surfaced when they moved to Japan when the child

was 6. And the move back, at age 9, led to an attempted suicide

and his initial diagnosis of early-onset bipolar disorder.

“That was the hardest move we’ve ever gone through,” the mother

recalled. “‘It was the loss of his friends. He said, ‘My world

was taken away from me.’ ”

Over the past five years, doctors have prescribed 34 different

drugs for the boy, she said.

“You just have to find the right combination. The problem is

that it takes so long. The doctors say, ‘Let’s try this one.

Let’s try that one. Let’s make this one a little stronger.’ It’s

craziness,” she said.

Her child’s current drugs include Abilify, an antipsychotic;

Wellbutrin, an antidepressant; Adderall, a stimulant; Tegretol,

an anticonvulsant; and Clonidine, a sedative.

Her son sees an off-base civilian therapist once a week and

receives better care and treatment than he did from the on-base

counselors, she said. In addition, he also sees an on-base

psychiatrist who typically sees the child for about 15 minutes

and focuses on medication.

“He doesn’t really know much about my son; he just gives out

medications. He relies on the parents. He’s asking me: ‘What

kind of medications is he on?’ I’m like, ‘You’re the doctor,

shouldn’t you know? Look at the file.’ ”

The mother is happy to say her son experiences few side effects

these days. But she said she has “long-term concerns. Will he

become dependent on these antidepressants and antipsychotics

because his young brain has been soaked in them for so many

years? My priority now is to keep my son stable so he’s not

suicidal.”

That view is familiar to many experts.

“Many members of the pediatric psychiatric community are

concerned about the increases [in the use of psychiatric drugs].

They have concerns about the side effects and the lack of data

showing their effectiveness of those medications in children,”

said phine ston, a researcher with the Hastings Center,

a New York-based research group.

“It’s just not as simple as you want it to be,” ston said.

“You can tell a story about how imperfect these drugs are, or

how the system doesn’t provide the kind of integrated care that

many families want. But the truth is, it’s hard for these

families to find anything that works really well.”

———

Staff writer n

McGarry contributed to this report.

[Guest guest]

http://www.armytimes.com/news/2011/01/military-children-taking-more-psychiatric-drugs-010211w/

Military kids taking more psychiatric drugs

Prescriptions increase as families struggle

with repeated deployments

By

Jowers and

Tilghman - Staff writers

Posted : Sunday Jan 2, 2011 11:02:27 EST

Before his father deployed to Iraq, Radenz was a

well-adjusted fifth-grader earning straight A’s and B’s in

school near Fort Hood, Texas.

But shortly after Army Lt. Col. Blaine Radenz left home in June

2008, his 11-year-old son became withdrawn and anxious. His

grades at school slipped and his mother noticed mood swings. The

child’s longtime pediatrician referred him for counseling.

A psychiatrist at Fort Hood’s Darnall Army Medical Center

prescribed the antidepressant Celexa. also saw a

psychologist there. Doctors added to and changed ’s drug

regimen, but his problems grew worse, said his mother, Tricia

Radenz.

started cutting himself and once used his own blood to

write “the end” on a bathroom wall at school. One day in band

class, he began hallucinating and ran into the hall, where

teachers found him crouched and hitting and scratching his face.

On June 9, 2009, hanged himself from a bunk bed in his

home.

“I really feel the drugs played a significant role in ’s

death,” said Tricia Radenz, a 41-year-old emergency-room nurse.

It’s impossible to know precisely why a 12-year-old chose to

take his own life. But the boy’s problems — and the use of

powerful psychiatric drugs to treat them — highlight a concern

for a growing number of military families who are struggling

with the impact of long, frequent deployments on their children

left at home.

The use of psychiatric medications by military children is on

the rise. Overall, in 2009, more than 300,000 prescriptions for

psychiatric drugs were provided to children under 18 who are

Tricare beneficiaries.

That’s up 18 percent since 2005, according to data provided to

Military Times — a period when the under-18 population increased

by less than 1 percent. And some drug categories have shown even

higher rates of increase — antipsychotic drugs are up about 50

percent and anti-anxiety drugs are up about 40 percent.

That mirrors a similar trend in the active-duty force, which

has seen a 76 percent increase in prescriptions for

psychiatric medications since the start of the war in

Afghanistan.

Dr. Lester, a psychiatrist at University of

California, Los Angeles, said the rise in drug use among

children tracks with studies she and others have done showing

how repeated deployments are taking a toll on military kids.

“There is a consistent story coming out showing that these kids

have more distress,” Lester said. “And it’s not just the period

of deployment. It appears to be during re-integration as well.”

Two studies link parents’ deployments to their children’s lower

academic achievement scores, and to increased mental and

behavioral health problems.

In one study, Rand Corp. researchers matched soldiers’ records

with children’s academic achievement records and found lower

scores among military children whose parents were cumulatively

deployed for 19 months or more since 2001.

In the mental health study, led by a professor of pediatrics at

the Uniformed Services University of the Health Sciences,

researchers found that when a parent was deployed, outpatient

visits among children ages 3 to 8 for pediatric behavioral

disorders rose 18 percent, and for stress disorders by 19

percent, compared with military children whose parents were not

deployed.

Prescription psychiatric drugs can help treat some of those

behavioral disorders. But many of those drugs come with

potential side effects, Lester said.

“Whenever one is prescribing medication, there is a

risk-benefit analysis that has to occur, and the parents and

patient need to be included in that,” Lester said.

Suicide risks

Tricia Radenz said nobody ever warned her about the suicide

risks associated with the drugs her son was taking.

“The psychiatrist never once told me Celexa was a risk. He said

he’d had great success with this drug,” Radenz said in an

interview.

“Any antidepressant carries the warning, but I didn’t find out

the seriousness until after he died,” she said.

Celexa, along with Wellbutrin, which was also taking at

the time of his death, carry “black box” warnings from the Food

and Drug Administration — the FDA’s most serious warning — about

increased risks for suicidal thoughts and behavior.

Moreover, neither drug is recommended for children, although

doctors may legally prescribe them after determining that they

may benefit individual patients.

Experts say any medication should be matched with intensive

therapy or counseling as a way to monitor for side effects and

treat underlying problems that drugs cannot address.

Radenz said saw the psychologist and psychiatrist once

or twice a month. She said the psychiatry department didn’t

respond to her pleas for help when she called after had

cut himself at school and used his blood to write on the

bathroom wall.

The mother left a phone message with the psychiatry department,

with details about what had happened, asking that someone call

back for an appointment. Nobody returned her call, she said.

“I was essentially staying with him 24/7,” Radenz said. “I was

outside the bathroom if he was in there. He was sleeping with

me.”

She said that after she was unable to get help from the child

psychiatry department, she e-mailed her husband in desperation,

and he came home from Iraq on emergency leave May 25.

was thrilled to see his father. For days as the family

spent time together, Radenz said, laughed and joked and

said many times: “I’m so glad Dad is home.”

’s father went to the local clinic and asked why his

wife’s phone calls had not been returned, even by June 1. He

told them he was on emergency leave because of his son’s

decline.

The clinic staff apologized, Tricia Radenz said, and explained

that no one was checking the answering machine because the staff

was overwhelmed.

Her son’s death a week later “was completely preventable, had

he received competent care instead of being herded through the

system like a piece of cattle at an auction,” she said. “I want

someone held accountable, and I don’t want anyone to ever have

to go through this again.”

Officials at Darnall Army Medical Center said they conducted an

investigation into ’s treatment, but a spokeswoman

declined to disclose any of its findings. However, the

spokeswoman said, “rest assured that all medical treatment was

thoroughly evaluated” and “any lessons learned as a result of

that review have been incorporated into our practices here at

Fort Hood.”

Tricia Radenz knows nothing can bring her son back.

“But why can’t they say they were wrong? That they’ve made

changes? All I want is to know they’ve corrected their process

that cost me my son.

“No other family should ever have to endure the agony my family

suffers daily. My husband made more than the ‘ultimate

sacrifice’ ... he sacrificed his son to serve.”

‘This keeps him safe’

Not all families have such tragic experiences. Some families

see psychiatric drugs as a life saver.

One Army wife and mother of a 12-year-old boy said the

medications her son takes are the only thing keeping him out of

an institution. Diagnosed with bipolar disorder, the child is a

stable seventh-grader who takes five different medications every

day.

“This keeps him at home. This keeps him safe,” said the mother,

who spoke with Military Times about her son’s treatment but

asked not to be identified.

The wife of a Special Forces soldier who has deployed often

during the past decade, the mother said her child’s problems

typically get worse, if only temporarily, after his father goes

overseas.

“When my husband leaves, the first seven days, seven to 11

days, are very hard on him. He’s very sad. He’s withdrawn. He

rages more frequently. But once we get past that period of time,

he is the same as he always is.”

The family’s frequent moves have taken a toll on her son. His

problems first surfaced when they moved to Japan when the child

was 6. And the move back, at age 9, led to an attempted suicide

and his initial diagnosis of early-onset bipolar disorder.

“That was the hardest move we’ve ever gone through,” the mother

recalled. “‘It was the loss of his friends. He said, ‘My world

was taken away from me.’ ”

Over the past five years, doctors have prescribed 34 different

drugs for the boy, she said.

“You just have to find the right combination. The problem is

that it takes so long. The doctors say, ‘Let’s try this one.

Let’s try that one. Let’s make this one a little stronger.’ It’s

craziness,” she said.

Her child’s current drugs include Abilify, an antipsychotic;

Wellbutrin, an antidepressant; Adderall, a stimulant; Tegretol,

an anticonvulsant; and Clonidine, a sedative.

Her son sees an off-base civilian therapist once a week and

receives better care and treatment than he did from the on-base

counselors, she said. In addition, he also sees an on-base

psychiatrist who typically sees the child for about 15 minutes

and focuses on medication.

“He doesn’t really know much about my son; he just gives out

medications. He relies on the parents. He’s asking me: ‘What

kind of medications is he on?’ I’m like, ‘You’re the doctor,

shouldn’t you know? Look at the file.’ ”

The mother is happy to say her son experiences few side effects

these days. But she said she has “long-term concerns. Will he

become dependent on these antidepressants and antipsychotics

because his young brain has been soaked in them for so many

years? My priority now is to keep my son stable so he’s not

suicidal.”

That view is familiar to many experts.

“Many members of the pediatric psychiatric community are

concerned about the increases [in the use of psychiatric drugs].

They have concerns about the side effects and the lack of data

showing their effectiveness of those medications in children,”

said phine ston, a researcher with the Hastings Center,

a New York-based research group.

“It’s just not as simple as you want it to be,” ston said.

“You can tell a story about how imperfect these drugs are, or

how the system doesn’t provide the kind of integrated care that

many families want. But the truth is, it’s hard for these

families to find anything that works really well.”

———

Staff writer n

McGarry contributed to this report.

[Guest guest]

http://www.armytimes.com/news/2011/01/military-children-taking-more-psychiatric-drugs-010211w/

Military kids taking more psychiatric drugs

Prescriptions increase as families struggle

with repeated deployments

By

Jowers and

Tilghman - Staff writers

Posted : Sunday Jan 2, 2011 11:02:27 EST

Before his father deployed to Iraq, Radenz was a

well-adjusted fifth-grader earning straight A’s and B’s in

school near Fort Hood, Texas.

But shortly after Army Lt. Col. Blaine Radenz left home in June

2008, his 11-year-old son became withdrawn and anxious. His

grades at school slipped and his mother noticed mood swings. The

child’s longtime pediatrician referred him for counseling.

A psychiatrist at Fort Hood’s Darnall Army Medical Center

prescribed the antidepressant Celexa. also saw a

psychologist there. Doctors added to and changed ’s drug

regimen, but his problems grew worse, said his mother, Tricia

Radenz.

started cutting himself and once used his own blood to

write “the end” on a bathroom wall at school. One day in band

class, he began hallucinating and ran into the hall, where

teachers found him crouched and hitting and scratching his face.

On June 9, 2009, hanged himself from a bunk bed in his

home.

“I really feel the drugs played a significant role in ’s

death,” said Tricia Radenz, a 41-year-old emergency-room nurse.

It’s impossible to know precisely why a 12-year-old chose to

take his own life. But the boy’s problems — and the use of

powerful psychiatric drugs to treat them — highlight a concern

for a growing number of military families who are struggling

with the impact of long, frequent deployments on their children

left at home.

The use of psychiatric medications by military children is on

the rise. Overall, in 2009, more than 300,000 prescriptions for

psychiatric drugs were provided to children under 18 who are

Tricare beneficiaries.

That’s up 18 percent since 2005, according to data provided to

Military Times — a period when the under-18 population increased

by less than 1 percent. And some drug categories have shown even

higher rates of increase — antipsychotic drugs are up about 50

percent and anti-anxiety drugs are up about 40 percent.

That mirrors a similar trend in the active-duty force, which

has seen a 76 percent increase in prescriptions for

psychiatric medications since the start of the war in

Afghanistan.

Dr. Lester, a psychiatrist at University of

California, Los Angeles, said the rise in drug use among

children tracks with studies she and others have done showing

how repeated deployments are taking a toll on military kids.

“There is a consistent story coming out showing that these kids

have more distress,” Lester said. “And it’s not just the period

of deployment. It appears to be during re-integration as well.”

Two studies link parents’ deployments to their children’s lower

academic achievement scores, and to increased mental and

behavioral health problems.

In one study, Rand Corp. researchers matched soldiers’ records

with children’s academic achievement records and found lower

scores among military children whose parents were cumulatively

deployed for 19 months or more since 2001.

In the mental health study, led by a professor of pediatrics at

the Uniformed Services University of the Health Sciences,

researchers found that when a parent was deployed, outpatient

visits among children ages 3 to 8 for pediatric behavioral

disorders rose 18 percent, and for stress disorders by 19

percent, compared with military children whose parents were not

deployed.

Prescription psychiatric drugs can help treat some of those

behavioral disorders. But many of those drugs come with

potential side effects, Lester said.

“Whenever one is prescribing medication, there is a

risk-benefit analysis that has to occur, and the parents and

patient need to be included in that,” Lester said.

Suicide risks

Tricia Radenz said nobody ever warned her about the suicide

risks associated with the drugs her son was taking.

“The psychiatrist never once told me Celexa was a risk. He said

he’d had great success with this drug,” Radenz said in an

interview.

“Any antidepressant carries the warning, but I didn’t find out

the seriousness until after he died,” she said.

Celexa, along with Wellbutrin, which was also taking at

the time of his death, carry “black box” warnings from the Food

and Drug Administration — the FDA’s most serious warning — about

increased risks for suicidal thoughts and behavior.

Moreover, neither drug is recommended for children, although

doctors may legally prescribe them after determining that they

may benefit individual patients.

Experts say any medication should be matched with intensive

therapy or counseling as a way to monitor for side effects and

treat underlying problems that drugs cannot address.

Radenz said saw the psychologist and psychiatrist once

or twice a month. She said the psychiatry department didn’t

respond to her pleas for help when she called after had

cut himself at school and used his blood to write on the

bathroom wall.

The mother left a phone message with the psychiatry department,

with details about what had happened, asking that someone call

back for an appointment. Nobody returned her call, she said.

“I was essentially staying with him 24/7,” Radenz said. “I was

outside the bathroom if he was in there. He was sleeping with

me.”

She said that after she was unable to get help from the child

psychiatry department, she e-mailed her husband in desperation,

and he came home from Iraq on emergency leave May 25.

was thrilled to see his father. For days as the family

spent time together, Radenz said, laughed and joked and

said many times: “I’m so glad Dad is home.”

’s father went to the local clinic and asked why his

wife’s phone calls had not been returned, even by June 1. He

told them he was on emergency leave because of his son’s

decline.

The clinic staff apologized, Tricia Radenz said, and explained

that no one was checking the answering machine because the staff

was overwhelmed.

Her son’s death a week later “was completely preventable, had

he received competent care instead of being herded through the

system like a piece of cattle at an auction,” she said. “I want

someone held accountable, and I don’t want anyone to ever have

to go through this again.”

Officials at Darnall Army Medical Center said they conducted an

investigation into ’s treatment, but a spokeswoman

declined to disclose any of its findings. However, the

spokeswoman said, “rest assured that all medical treatment was

thoroughly evaluated” and “any lessons learned as a result of

that review have been incorporated into our practices here at

Fort Hood.”

Tricia Radenz knows nothing can bring her son back.

“But why can’t they say they were wrong? That they’ve made

changes? All I want is to know they’ve corrected their process

that cost me my son.

“No other family should ever have to endure the agony my family

suffers daily. My husband made more than the ‘ultimate

sacrifice’ ... he sacrificed his son to serve.”

‘This keeps him safe’

Not all families have such tragic experiences. Some families

see psychiatric drugs as a life saver.

One Army wife and mother of a 12-year-old boy said the

medications her son takes are the only thing keeping him out of

an institution. Diagnosed with bipolar disorder, the child is a

stable seventh-grader who takes five different medications every

day.

“This keeps him at home. This keeps him safe,” said the mother,

who spoke with Military Times about her son’s treatment but

asked not to be identified.

The wife of a Special Forces soldier who has deployed often

during the past decade, the mother said her child’s problems

typically get worse, if only temporarily, after his father goes

overseas.

“When my husband leaves, the first seven days, seven to 11

days, are very hard on him. He’s very sad. He’s withdrawn. He

rages more frequently. But once we get past that period of time,

he is the same as he always is.”

The family’s frequent moves have taken a toll on her son. His

problems first surfaced when they moved to Japan when the child

was 6. And the move back, at age 9, led to an attempted suicide

and his initial diagnosis of early-onset bipolar disorder.

“That was the hardest move we’ve ever gone through,” the mother

recalled. “‘It was the loss of his friends. He said, ‘My world

was taken away from me.’ ”

Over the past five years, doctors have prescribed 34 different

drugs for the boy, she said.

“You just have to find the right combination. The problem is

that it takes so long. The doctors say, ‘Let’s try this one.

Let’s try that one. Let’s make this one a little stronger.’ It’s

craziness,” she said.

Her child’s current drugs include Abilify, an antipsychotic;

Wellbutrin, an antidepressant; Adderall, a stimulant; Tegretol,

an anticonvulsant; and Clonidine, a sedative.

Her son sees an off-base civilian therapist once a week and

receives better care and treatment than he did from the on-base

counselors, she said. In addition, he also sees an on-base

psychiatrist who typically sees the child for about 15 minutes

and focuses on medication.

“He doesn’t really know much about my son; he just gives out

medications. He relies on the parents. He’s asking me: ‘What

kind of medications is he on?’ I’m like, ‘You’re the doctor,

shouldn’t you know? Look at the file.’ ”

The mother is happy to say her son experiences few side effects

these days. But she said she has “long-term concerns. Will he

become dependent on these antidepressants and antipsychotics

because his young brain has been soaked in them for so many

years? My priority now is to keep my son stable so he’s not

suicidal.”

That view is familiar to many experts.

“Many members of the pediatric psychiatric community are

concerned about the increases [in the use of psychiatric drugs].

They have concerns about the side effects and the lack of data

showing their effectiveness of those medications in children,”

said phine ston, a researcher with the Hastings Center,

a New York-based research group.

“It’s just not as simple as you want it to be,” ston said.

“You can tell a story about how imperfect these drugs are, or

how the system doesn’t provide the kind of integrated care that

many families want. But the truth is, it’s hard for these

families to find anything that works really well.”

———

Staff writer n

McGarry contributed to this report.

[Guest guest]

http://www.armytimes.com/news/2011/01/military-children-taking-more-psychiatric-drugs-010211w/

Military kids taking more psychiatric drugs

Prescriptions increase as families struggle

with repeated deployments

By

Jowers and

Tilghman - Staff writers

Posted : Sunday Jan 2, 2011 11:02:27 EST

Before his father deployed to Iraq, Radenz was a

well-adjusted fifth-grader earning straight A’s and B’s in

school near Fort Hood, Texas.

But shortly after Army Lt. Col. Blaine Radenz left home in June

2008, his 11-year-old son became withdrawn and anxious. His

grades at school slipped and his mother noticed mood swings. The

child’s longtime pediatrician referred him for counseling.

A psychiatrist at Fort Hood’s Darnall Army Medical Center

prescribed the antidepressant Celexa. also saw a

psychologist there. Doctors added to and changed ’s drug

regimen, but his problems grew worse, said his mother, Tricia

Radenz.

started cutting himself and once used his own blood to

write “the end” on a bathroom wall at school. One day in band

class, he began hallucinating and ran into the hall, where

teachers found him crouched and hitting and scratching his face.

On June 9, 2009, hanged himself from a bunk bed in his

home.

“I really feel the drugs played a significant role in ’s

death,” said Tricia Radenz, a 41-year-old emergency-room nurse.

It’s impossible to know precisely why a 12-year-old chose to

take his own life. But the boy’s problems — and the use of

powerful psychiatric drugs to treat them — highlight a concern

for a growing number of military families who are struggling

with the impact of long, frequent deployments on their children

left at home.

The use of psychiatric medications by military children is on

the rise. Overall, in 2009, more than 300,000 prescriptions for

psychiatric drugs were provided to children under 18 who are

Tricare beneficiaries.

That’s up 18 percent since 2005, according to data provided to

Military Times — a period when the under-18 population increased

by less than 1 percent. And some drug categories have shown even

higher rates of increase — antipsychotic drugs are up about 50

percent and anti-anxiety drugs are up about 40 percent.

That mirrors a similar trend in the active-duty force, which

has seen a 76 percent increase in prescriptions for

psychiatric medications since the start of the war in

Afghanistan.

Dr. Lester, a psychiatrist at University of

California, Los Angeles, said the rise in drug use among

children tracks with studies she and others have done showing

how repeated deployments are taking a toll on military kids.

“There is a consistent story coming out showing that these kids

have more distress,” Lester said. “And it’s not just the period

of deployment. It appears to be during re-integration as well.”

Two studies link parents’ deployments to their children’s lower

academic achievement scores, and to increased mental and

behavioral health problems.

In one study, Rand Corp. researchers matched soldiers’ records

with children’s academic achievement records and found lower

scores among military children whose parents were cumulatively

deployed for 19 months or more since 2001.

In the mental health study, led by a professor of pediatrics at

the Uniformed Services University of the Health Sciences,

researchers found that when a parent was deployed, outpatient

visits among children ages 3 to 8 for pediatric behavioral

disorders rose 18 percent, and for stress disorders by 19

percent, compared with military children whose parents were not

deployed.

Prescription psychiatric drugs can help treat some of those

behavioral disorders. But many of those drugs come with

potential side effects, Lester said.

“Whenever one is prescribing medication, there is a

risk-benefit analysis that has to occur, and the parents and

patient need to be included in that,” Lester said.

Suicide risks

Tricia Radenz said nobody ever warned her about the suicide

risks associated with the drugs her son was taking.

“The psychiatrist never once told me Celexa was a risk. He said

he’d had great success with this drug,” Radenz said in an

interview.

“Any antidepressant carries the warning, but I didn’t find out

the seriousness until after he died,” she said.

Celexa, along with Wellbutrin, which was also taking at

the time of his death, carry “black box” warnings from the Food

and Drug Administration — the FDA’s most serious warning — about

increased risks for suicidal thoughts and behavior.

Moreover, neither drug is recommended for children, although

doctors may legally prescribe them after determining that they

may benefit individual patients.

Experts say any medication should be matched with intensive

therapy or counseling as a way to monitor for side effects and

treat underlying problems that drugs cannot address.

Radenz said saw the psychologist and psychiatrist once

or twice a month. She said the psychiatry department didn’t

respond to her pleas for help when she called after had

cut himself at school and used his blood to write on the

bathroom wall.

The mother left a phone message with the psychiatry department,

with details about what had happened, asking that someone call

back for an appointment. Nobody returned her call, she said.

“I was essentially staying with him 24/7,” Radenz said. “I was

outside the bathroom if he was in there. He was sleeping with

me.”

She said that after she was unable to get help from the child

psychiatry department, she e-mailed her husband in desperation,

and he came home from Iraq on emergency leave May 25.

was thrilled to see his father. For days as the family

spent time together, Radenz said, laughed and joked and

said many times: “I’m so glad Dad is home.”

’s father went to the local clinic and asked why his

wife’s phone calls had not been returned, even by June 1. He

told them he was on emergency leave because of his son’s

decline.

The clinic staff apologized, Tricia Radenz said, and explained

that no one was checking the answering machine because the staff

was overwhelmed.

Her son’s death a week later “was completely preventable, had

he received competent care instead of being herded through the

system like a piece of cattle at an auction,” she said. “I want

someone held accountable, and I don’t want anyone to ever have

to go through this again.”

Officials at Darnall Army Medical Center said they conducted an

investigation into ’s treatment, but a spokeswoman

declined to disclose any of its findings. However, the

spokeswoman said, “rest assured that all medical treatment was

thoroughly evaluated” and “any lessons learned as a result of

that review have been incorporated into our practices here at

Fort Hood.”

Tricia Radenz knows nothing can bring her son back.

“But why can’t they say they were wrong? That they’ve made

changes? All I want is to know they’ve corrected their process

that cost me my son.

“No other family should ever have to endure the agony my family

suffers daily. My husband made more than the ‘ultimate

sacrifice’ ... he sacrificed his son to serve.”

‘This keeps him safe’

Not all families have such tragic experiences. Some families

see psychiatric drugs as a life saver.

One Army wife and mother of a 12-year-old boy said the

medications her son takes are the only thing keeping him out of

an institution. Diagnosed with bipolar disorder, the child is a

stable seventh-grader who takes five different medications every

day.

“This keeps him at home. This keeps him safe,” said the mother,

who spoke with Military Times about her son’s treatment but

asked not to be identified.

The wife of a Special Forces soldier who has deployed often

during the past decade, the mother said her child’s problems

typically get worse, if only temporarily, after his father goes

overseas.

“When my husband leaves, the first seven days, seven to 11

days, are very hard on him. He’s very sad. He’s withdrawn. He

rages more frequently. But once we get past that period of time,

he is the same as he always is.”

The family’s frequent moves have taken a toll on her son. His

problems first surfaced when they moved to Japan when the child

was 6. And the move back, at age 9, led to an attempted suicide

and his initial diagnosis of early-onset bipolar disorder.

“That was the hardest move we’ve ever gone through,” the mother

recalled. “‘It was the loss of his friends. He said, ‘My world

was taken away from me.’ ”

Over the past five years, doctors have prescribed 34 different

drugs for the boy, she said.

“You just have to find the right combination. The problem is

that it takes so long. The doctors say, ‘Let’s try this one.

Let’s try that one. Let’s make this one a little stronger.’ It’s

craziness,” she said.

Her child’s current drugs include Abilify, an antipsychotic;

Wellbutrin, an antidepressant; Adderall, a stimulant; Tegretol,

an anticonvulsant; and Clonidine, a sedative.

Her son sees an off-base civilian therapist once a week and

receives better care and treatment than he did from the on-base

counselors, she said. In addition, he also sees an on-base

psychiatrist who typically sees the child for about 15 minutes

and focuses on medication.

“He doesn’t really know much about my son; he just gives out

medications. He relies on the parents. He’s asking me: ‘What

kind of medications is he on?’ I’m like, ‘You’re the doctor,

shouldn’t you know? Look at the file.’ ”

The mother is happy to say her son experiences few side effects

these days. But she said she has “long-term concerns. Will he

become dependent on these antidepressants and antipsychotics

because his young brain has been soaked in them for so many

years? My priority now is to keep my son stable so he’s not

suicidal.”

That view is familiar to many experts.

“Many members of the pediatric psychiatric community are

concerned about the increases [in the use of psychiatric drugs].

They have concerns about the side effects and the lack of data

showing their effectiveness of those medications in children,”

said phine ston, a researcher with the Hastings Center,

a New York-based research group.

“It’s just not as simple as you want it to be,” ston said.

“You can tell a story about how imperfect these drugs are, or

how the system doesn’t provide the kind of integrated care that

many families want. But the truth is, it’s hard for these

families to find anything that works really well.”

———

Staff writer n

McGarry contributed to this report.