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An Update on Rebecca Riley and Toddler Bipolar Disorder

Of no particular surprise to anyone, on April 3 attorneys representing Rebecca Riley’s estate filed a lawsuit against the psychiatrist and Tufts Medical Center, where the psychiatrist practiced. Rebecca Riley, if you’ll remember, was the 4-year-old who died from an overdose of psychiatric drugs. The lawsuit was filed by a court-appointed guardian overseeing Riley’s estate, on behalf of Rebecca (for the pain and suffering she endured before her death) and Rebecca’s brother and sister. Riley’s parents are awaiting trial on second-degree murder charges related to their daughter’s death.

The psychiatrist who oversaw Rebecca’s care, Dr. Kayoko Kifuji, wasn’t fired, but has stopped seeing patients:

Kifuji could not be reached for comment yesterday. Since the child’s death, Kifuji remains on staff at Tufts Medical Center, but no longer treats patients. She has voluntarily agreed not to practice medicine, pending an investigation by the state Board of Registration in Medicine.

[…] Kifuji diagnosed Rebecca Riley with bipolar disorder and attention deficit and hyperactivity disorder and prescribed clonidine, a blood pressure medication that is sometimes used to calm aggressive children, Seroquel, an antipsychotic drug, and Depakote, an antiseizure drug, according to court records. The child died from an overdose of the prescription drugs, and, by itself, the amount of clonidine in her system was fatal, court records indicate. Clonidine and Depakote are approved by the FDA for adults only.

The parents seem to be the most responsible for their daughter’s death, however:

Carolyn Riley’s brother, who was living with the Rileys in Hull, told investigators that Rebecca was ill for days prior to her death and that he pleaded with her parents to take her to the hospital, but they refused, according to a State Police affidavit filed in the case.

Kifuji told police she was “shocked and very concerned” in October 2005 when Carolyn Riley told her she had gradually increased Rebecca’s nighttime dose of clonidine and warned her not to do so again because increasing the dosage could be fatal, according to the affidavit.

Diagnosing serious adult mental disorders like bipolar disorder or depression in children is fraught with risks. But treating a 2-year-old child with drugs not approved for childhood use is far worse. While we continue to empathize with anyone who’s children are dealing with significant mental health concerns, we remain concerned of the overdiagnosis and medicalization of ordinary childhood behavioral problems by medical doctors and parents.

Doctors and parents should always seek the treatment with the least potential for harm available, and take things very slowly if such interventions don’t work. And given the sensitive nature of a child’s brain development and lack of long-term studies done for these kinds of medications, doctors and parents should to prescribe such medications only as a treatment of last resort until such studies are done.

Read the full article: Doctor is sued in death of girl, 4

An Update on Rebecca Riley and Toddler Bipolar Disorder

John M. Grohol, Psy.D.

Dr. John Grohol is the founder of Psych Central. He is a psychologist, author, researcher, and expert in mental health online, and has been writing about online behavior, mental health and psychology issues since 1995. Dr. Grohol has a Master's degree and doctorate in clinical psychology from Nova Southeastern University. Dr. Grohol sits on the editorial board of the journal Computers in Human Behavior and is a founding board member of the Society for Participatory Medicine. You can learn more about Dr. John Grohol here.

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APA Reference
Grohol, J. (2018). An Update on Rebecca Riley and Toddler Bipolar Disorder. Psych Central. Retrieved on November 28, 2020, from
Scientifically Reviewed
Last updated: 8 Jul 2018 (Originally: 8 Apr 2008)
Last reviewed: By a member of our scientific advisory board on 8 Jul 2018
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