Psychotropic Drugs Lawsuit Certified as Class Action for Missouri Foster Children

A federal judge has certified a class action lawsuit brought on behalf of children in the Missouri foster care system, involving allegations that psychotropic drugs, such as antipsychotics, are being overprescribed to the children. 

U.S. District Judge Nanette K. Laughrey, in the U.S. Consolidated Court for the Western District of Missouri, granted class action certification for a complaint (PDF) filed on behalf of all children in the Missouri foster care system.

The lawsuit indicates that the state failed to properly oversee the administration and prescription of psychotropic drugs to children in foster care for years, and Judge Laughrey indicated that class certification was merited, and that the children could be at risk of serious harm.

The complaint, filed in June 2017, names Jennifer Tidball, Interim Director of the Missouri Department of Social Services; and Tim Decker, Director of the Children’s Division (CD) of the Missouri Department of Social Services as defendants.

“Antipsychotics are one of the most powerful and frequently prescribed classes of psychotropic drugs given to children in foster care. They are often administered as chemical straight-jackets, used to control the behavior of foster children,” the lawsuit indicated. “Yet for many, if not most, of these foster children, psychotropic drugs are being administered to treat a diagnosis – e.g. conduct disorder, ADHD – that the drug was never even designed to address.”

Plaintiffs estimate there are about 13,000 children in the Missouri foster care program, with more than 3,100, nearly a quarter, being given psychotropic drugs.

In some cases, the children were given multiple antipsychotics, suffering serious psychiatric and physical adverse events. The lead plaintiff, identified only as M.B. was placed on more than six psychotropic drugs at once, according to the lawsuit, including lithium and two atypical antipsychotics.

The child’s current foster parent indicated that they were given custody of M.B., without any history or discussion of his previous use of the drugs. Instead, they were handed a brown grocery bag full of his medications with no explanation.

Child Antipsychotic Drug Concerns

A number of studies in recent years have highlighted concerns about the side effects of psychotropic drugs when overprescribed to children.

In April 2014, researchers from the University of Maryland concluded that many prescriptions for antipsychotics to children appears to be linked to socio-economic status and not good medical standards or science.

The study found that about three times as many children who are in foster care and who have ADHD were prescribed antipsychotics; the most common used being Risperdal, followed by Abilify and Seroquel.

These medications are not approved for use in treating ADHD, but the study suggests that a number of groups of children in lower socio-economic groups are being prescribed Risperdal, Abilify, Seroquel and other similar drugs at a higher rate than their more advantaged peers.

Known as “chemical restraint,” the practice of using antipsychotics for behavioral modification has been mostly highlighted due to its use in nursing homes that treat elderly dementia patients, where it is considered a form of nursing home abuse. The FDA has warned nursing homes that antipsychotics do not help most dementia patients while increasing their risk of death.

A 2012 study published in the Archives of General Psychiatry found that children are now being prescribed antipsychotics, like Seroquel, Risperdal, Zyprexa and Abilify, at higher rates than adults. The study found that 31% of youths visiting a psychiatrist were prescribed an antipsychotic, compared to 29% of adults.

Studies regarding the effects of such drugs for children, especially when prescribed for unapproved uses, found increased weight gain and quadruple the risk of developing diabetes in children under the age of 18. Additional studies have also found that many other side effects may also include urinary problems and even death.

With not much evidence concerning its efficacy on youths; yet a higher prescribing rate, many youth advocates and health experts question the necessity of such prescriptions.

In 2011, an outside panel of experts voted to recommend that the FDA continue safety monitoring of antipsychotics and the risks for children. Such medications may pose a serious long-term health risk for children. The advisory panel has urged the FDA to conduct further in-depth studies on the weight gain side effects of atypical antipsychotics since 2009, some of which have been prescribed to toddlers as young as two years-old.