A Nurse’s Nightmare: Child Nearly Dies from ADHD Drug

M. Anthony
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5382

I was working a day shift in the ER.  We were rather slow in the pediatric department, where I was assigned for the day, so I took the opportunity to go to another area to help a nurse draw blood from a patient described as a “difficult stick.”  Not long after, the experienced R.N. in the peds (pronounced peeds) department called me over our communication system.  “I need you back over here now,” she said in a firm, serious tone.  I knew it must be something important, so I went back there immediately.

As I entered the area, I saw a young, thin, white boy being wheeled on a stretcher from a regular room to the “trauma” or “code” pediatric room next door, where additional medical emergency equipment is located.  Our ER tech had the ambu (breathing) bag over the boy’s mouth, administering oxygen to him but not squeezing the transparent plastic part that looks like a football. This meant he was still breathing on his own.  Just as we entered the room, the boy went unconscious, becoming very pale, with blue lips.  These symptoms are signs of lack of blood flow, so as other co-workers began to join us, he was placed on a heart monitor and I briefly attempted to find a pulse.  The monitor showed an abnormal rhythm called ventricular tachycardia (V-tach) and I could not find a pulse, so I began CPR with chest compressions.  Stick-on defibrillation pads were placed on the boy, and the defibrillator was charged to 50 joules in preparation for electronic defibrillation of the heart.

The boy’s stunned parents were left outside as we concentrated on treating their son.  The doctor hit charge on the monitor, which emitted the sustained, high-pitched “woo” sound indicating the machine was charging.  He called “clear,” I stopped the compressions, and we all stepped back.  The boy was shocked and his body jerked upward.  I could see on the monitor that his V-tach had broken, and a more normal-looking rhythm appeared as I immediately moved in to resume compressions.  The boy immediately “pinked up,” the color returning to his face, neck, and entire body. (This is called ROSC, or return of spontaneous circulation.)  We stopped compressions and checked the monitor.  His heartbeat was normal.  He began moving his head slightly as well.  Over the next few minutes, the boy remained in a normal rhythm on the heart monitor, only slightly fast, and had normal blood pressure.  He had responded well to being defibrillated.

The V-tach, which looks like tall, thin mountain peaks on the monitor, was gone for now.  Those thin, continuous mountain peaks indicate that there is a serious malfunction of the heart’s electrical system, which is usually, but not always, accompanied by pulselessness.  This young boy had had the more lethal variety of V-tach, which does not produce a pulse and therefore quickly results in brain and organ death.  The electrical shock in defibrillation stops the whole electrical system briefly in hopes that when the electricity “comes back on,” it will go through the normal pathways again, producing a normal rhythm.

As I carefully examined this young man whom we had just brought back from the brink of death (by the grace of God), I noticed that he was only moaning and not making any purposeful eye contact.  We brought his parents back in and they hovered over him, stroking his head and trying to console him.  They were in a state of shock, fear, and confusion, asking for answers that, for the most part, we could not give— at least not yet.  We listened to his lungs, which were clear, and checked his oxygenation, which was also normal with the supplemental oxygen we were giving him. He was breathing on his own without any difficulty.

However, 15 minutes later he was still moaning, occasionally thrashing on the bed, and not speaking coherently.  His eyes were rolling around aimlessly.  At one point he was coherent enough to communicate to his mother that he could not see anything.  “Oh dear God,” I thought to myself, “was he deprived of oxygen to his brain to an extent that he has suffered brain damage?” This tall, thin, 11-year-old boy reminded me of my tall, thin, 12-year-old son.  The parents mentioned that he had recently had a growth spurt.

The nurse who received the patient had informed me that he was speaking normally on arrival, and that the reason he’d been brought in was that he had had a couple of unconscious episodes at home and his mother had discovered him sweating and “passed out” on the couch earlier that day.  She had called 911, but he had awakened on his own (probably a self-limiting episode of this abnormal cardiac rhythm).

Since his condition was critical,  the doctors decided that he should be transferred to the children’s hospital in the nearby major city. Soon that hospital was preparing to send their helicopter up to us, about a 15-minute flight. However, getting everyone (the pilot/ doctor/nurse/ paramedic) on the helicopter took longer, so we knew there would be a bit of a wait.

At least five of us staff members stayed at the boy’s bedside, riveted with concern for this child.  More frequent PVCs (a possible precursor to that more serious problem) began to show up on the heart monitor, and then short runs of V-tach also occurred.  This all indicated potential trouble.  We called the doctor into the room just in time for a sustained V-tach to appear.  The boy’s body went limp and lifeless again, and again I performed chest compressions until the defibrillator could be charged and discharged.  He again responded well to one shock at 50 joules.  We tried giving him an emergency anti-arrhythmic drug called Amiodarone at a dose appropriate for a child, but for a third time, he went into this lethal dysrhythmia.  Thankfully, for a third time, he was shocked back from the brink of death.

We then tried another drug called Lidocaine, an older drug for this type of problem, and it may have been what helped stave off any further episodes until the team arrived from the children’s hospital.  Also thankfully, the boy’s vision returned after about 45 minutes, and as he left to go on the helicopter he was speaking normally to his mother.  During the wait for the children’s hospital team, we had performed an echocardiogram, which is an ultrasound that shows the general size and function of the heart.  His was perfectly normal, which ruled out a possible cause for his symptoms such as cardiomyopathy (enlarged heart) or valve disease, which could potentially trigger these types of lethal dysrhythmias.

This episode was one of the top five intense moments I have had in my more than 20 years of nursing.  Every “code” is intense, but caring for children in life-threatening situations is the most stressful for me and most nurses.  While we were treating this child, we sought to determine the cause of his problem.  Was he dehydrated?  No.  Were his electrolytes (potassium, magnesium, sodium) abnormal?  No.  Did he have any heart defects?  No.  Any other serious medical problems?  No.  Could he have ingested any drugs?  No…. except he did take one drug prescribed for his ADHD.  The drug is a central nervous system stimulant that has been known to cause sudden cardiac death.  There is a warning from the FDA about the increased risk of death from this type of drug if you have a known heart problem.

I later mentioned this case and the boy’s use of that particular stimulant to our staff psychiatrist.  He said, “That is probably what did it.”  (He is exceptionally candid about the negative effects of these drugs on kids).  However, our ER doctor was in some denial about this as a possible cause.  I did mention to the boy’s mother that the drug could cause this problem, so hopefully he will not be put back on it.  She voluntarily suggested that not taking it would be best for him.  I also talked to our ER pharmacist about the incident, and he, too, agreed it was probably the CNS stimulant that caused the problem, and the data source he checked confirmed that this particular drug has been linked to these lethal heart dysrhythmias.  What many people don’t realize is that these drugs are amphetamines, or derivatives of them, commonly known on the street as Speed.

However, the pharmacist also said that since we hospital staff had not administered the drug to the boy that day, we were not the appropriate ones to fill out a medication adverse-reaction report.  He suggested that I go online and file a report at FDA Medwatch, which I did, indicating in the section provided that I was a health care provider.  At the end of the submission, a pop-up appeared, stating that my report “has been submitted to a database.”  That was not very reassuring.  I felt like I had thrown a stone into a large reservoir never to be seen again.  There was also an option to be contacted by the manufacturer, and it said that by choosing “no,” I might be impeding their ability to monitor possible future adverse reactions.  I have a hard time believing that they are seriously motivated to learn about adverse reactions to profitable drugs. This warning also reminded me of the FDA’s practice of relying on drug companies themselves to monitor and report adverse reactions to their drugs to the agency.  I wondered what effect self-reporting might have on sales.

I also wondered how many times something like this had occurred and not been reported?  I am sure it must be in the thousands, or tens of thousands.  If I had not gone out of my way to make a report to the FDA, it would never have been done, and even so, it is doubtful that my report will be acted upon.  I think most people are under the impression that there is a more established method for monitoring and reporting adverse reactions to these types of drugs.  There isn’t.

As I mentioned, the ER doctor was in denial about the ADHD med being the most likely cause of this child’s nearly dying, even though both the pharmacist and staff psychiatrist (who have more specific training in this area) thought that it was.  This is a very disturbing reality.  In any other situation where there had been an accidental or intentional ingestion of Speed, there would have been no doubt that it was the cause of the problem.  However, as many of us are aware and Robert Whitaker has insightfully pointed out, there is a cloud of delusion and collusion that hangs over the otherwise brilliant minds of many in the medical profession, and in society as a whole.  My hope and prayer is that this dramatic look at a negative effect of this class of drugs will help you understand that, in my professional assessment, the risks of these drugs outweigh their benefits.

 

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Mad in America hosts blogs by a diverse group of writers. These posts are designed to serve as a public forum for a discussion—broadly speaking—of psychiatry and its treatments. The opinions expressed are the writers’ own.

29 COMMENTS

  1. He’d had been better off dead. He lives now only for the sake of his parents and to withhold their grief. His damaged domaminergic system will ensure that he can experience no joy as an adult without illicit drugs, and he may or may not even develop sexually and be capable of going on to have a love life. His life is now a cruel fate.

    • When my son was young and hyperactive, the psychiatrist prescribed several ADHD drugs. None of them helped much, if any. Then he prescribed Prozac which caused him to become manic which led to a run-in with the law. The shrink said “Boys will be boys” and refused to accept any responsibility for ordering the Prozac. So I did my own research and found the “orthomolecular” approach to mental health. It’s wonderful. It felt so good firing the shrink. They’re all idiots who can’t cure anyone. Please see my FB page at “A Dose of Sanity” for more info if you’re interested. I use orthomolecular and homeopathy now for almost everything. Anyway, Nurse Anthony, thank you for posting about what this unfortunate boy had to endure.

    • Also, did you know there is NO law that says psychiatrists must treat mental disorders with synthetic drugs? Drugs are simply the approach the leaders of the American Psychiatric Association HAVE CHOSEN. The drug approach has a proven, government-audited recovery rate of .0005%. (King County Ordinance #13974, First and Second Annual Reports, 2002 and 2003). The APA and their business buddies, the drug companies, are raking in huge profits while curing no one. (Their definition of recovery does not mean “cured.” It means the patient’s symptoms are being well suppressed.) Mental healthcare is nothing but a racket, supported by our lawmakers. If we want to cure people with a mental illness/disorder we have to correct the causes. APA psychiatrists have no clue how to do that. They are only taught to prescribe chemical straightjackets to suppress symptoms until their victims, er, patients, die. That’s why we have such an epidemic of mental illness in the US. There’s no money in curing people.

  2. Thanks so much for this powerful essay on the negative effects of ADHD drugs. What a frightening scenario, and I’m not at all surprised that the ER doc was in denial about the effects of the drug. Most people think if a kid can’t pay attention or is distractible, they need drugs. And most people believe the drugs are safe. We need informed consent around ADHD drugs as much as we need informed consent around psych drugs. And more people need to know about the very short-term usefulness of stimulant drugs. As a special ed teacher, I’ve often thought that we try to change the kid more than we try to change the environment. So often, the kid with ADHD is very bright, very bored, or very troubled.

    • Bright, bored, or troubled. Exactly.

      At this point, I often bring up the fact that there is NO evidence, despite 50 years of biased research LOOKING for such evidence, that “ADHD” drugs improve ANY long term outcome, including delinquency rates, academic test scores, high school completion, college enrollment, mental/emotional well being, social skills ratings, teen pregnancy rates, drug abuse rates, or even self-esteem ratings. A number of long-term studies suggest diminished functioning in one or more of the above areas. So we are exposing millions of kids to the risks of stimulants, including psychosis, mania, weight/appetite loss, reduced adult height, alterations in personality, and a small but not insignificant chance of heart damage or death, to name just some. And yet there is no evidence to suggest that these risks are associated with ANY long-term benefits at all, in any area.

      So WHO has the “mental illness” here?

      • “So WHO has the ‘mental illness’ here?”

        The doctors who have a “cloud of delusion and collusion that hangs over [their] otherwise brilliant minds.”

        Thank you for sharing this, Mr. Anthony. I agree, “the risks of these drugs outweigh their benefits.” And I hope and pray we can some how get the doctors and psychiatrists to end their mass psychiatric drugging of our children – and everyone, actually.

  3. Anthony, Thank you so much for this.
    I hope someone reading this will pass it on.
    Now the good thing is, he did not come in with “weird behaviour”,
    which of course would have been deemed as his “mental brainy stuff”.
    I guess the ER doc might have even ruled his death just a symptom of his “ADHD”.

    I guess they see death or near deaths as the more important “side effects”,
    not the actual brain changes that are taking place. Obviously
    human life is cheap.

    ALL children should be free from psychiatric
    assaults.

  4. This is just another tragic story. We have way too many of these stories. I remember as a child and as a teenager how we were warned about diet drugs, i.e. speed (amphetamines) In those days, young women, especially, died from these drugs. They only wanted to be “thin.” And, yes, these drugs are related to those drugs manufactured in “meth-labs.” In those days, they sold these drugs at the back of magazines bought at gas stations and drug stores. You know, those magazines that gave you your horoscope or gave you the gossip on the latest celebrity. So, when later, some years later, I read in popular “women’s” magazines how these stimulant drugs made allegedly highly stimulant people less stimulated. Huh? I tried one of these drugs, once, “adderall” at the “suggestion” of my psychiatrist for a work-related issue. Luckily, for me, it was a worthless drug, because I told the psychiatrist it did nothing for me. These drugs are very dangerous? And, I question, why must a young boy, his family, and a very empathetic nurse and staff go through this so unnecessarily for just a “horrible and addictive diet drug” that should never ever be prescribed and given to a person of any age and especially to one so very young. Thank you.

  5. A very sad story. When as many as 13% of US boys have been diagnosed with ADHD you know something is wrong, not with the kids, but with psychologists, psychiatrists and educators. Why do so many boys supposedly have ADHD? Because boys are more difficult to control in school and drugging them is an easy fix. Psychiatrists and the pharmaceutical industry make money off an ADHD diagnosis and support short sighted educators in promoting this dubious condition. This article points out the dangers of being so irresponsible.

  6. Thank you Mr. Anthony for this blog and for reporting this to the FDA to promote patient safety and awareness of the harm of these drugs. Now if only all medical professionals could have this level of integrity and candor to always speak out in the best interests of patients. Unfortunately there is a big “cloud of delusion and collusion” and cover-up when a patient is harmed.

  7. Scientists at the Amen Clinic have found that one cause of ADHD is a brain injury. The ADHD symptoms can show up months or even years after the injury. If the ADHD symptoms come on suddenly it’s important to consider if there has been a brain injury. That’s what happened to my son. The pediatrician said it was just a bump on the head and not a problem. But it was still too much for his little, soft head. Nine months later his ADHD symptoms came on suddenly. One day he was a calm, happy little guy and the very next day he was hyperactive. He remained hyperactive until I found REAL medical care for him, not synthetic drugs. I’m not saying a head injury causes all cases of ADHD but it’s something to look into if the child has had a bump on his forehead. For a brain injury, homeopathic Arnica (not the cream but the pellets taken internally) are extremely healing, even when the injury took place years prior. The 6c and 30c sold in health food stores are probably not strong enough. You’d have to buy the 200c or 1m from Amazon or from a homeopathic pharmacy. Homeopathic Nat sulph is another remedy for brain injuries that might help.

    • Also, keep in mind that homeopathy doesn’t treat illness: it treats the person who has the illness. So, while a remedy may work for one person, it won’t necessarily work for someone else. However, Aurum (for depression) and Arsenicum (for anxiety) are still very commonly used for a whole lot of people – worldwide. Amazon sells these remedies in a 200c and a 1m. We should never touch any of the pellets, just twist the cap, let one drop into the lid and drop the pellet under the tongue. Even though the container says to use 5 pellets, one is enough. (If I take 5, it gives me heartburn.) I gave my son Aur-ars 200c but it did nothing to help him. But the 1m worked miracles. That one dose (1 pellet) lasted almost 2 years. When he started having symptoms again, I either gave him the same remedy in a 200c or a 1m, I don’t remember which. Homeopathy is the medicine of the future. –Linda from Facebook “A Dose of Sanity”

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