Pills over the years: how children in care are sedated

“You were sedated with pills” – this is how an Augsburger describes his childhood in the home. BR-Research shows that children in care are repeatedly sedated with psychotropic drugs for a long time. This raises questions – also for the legislature.

When it’s time for dinner, Fabian is sitting at the table in a daze. Two loaves of bread are ready for him. But he’s hardly hungry anymore. A side effect of the pill he always gets before dinner.

Even worse for Fabian is the sedating effect. He has to support his head on his hands, his eyes keep closing. “Sometimes I’ve already asked if I can go to bed? Then it was: ‘Nope!'” This is how the young family man remembers his time in a children’s home in Augsburg, where he came at the age of twelve.

“I received Dipiperon for a year or two,” says Fabian. The drug is a neuroleptic that made the headlines about a year ago. The doctor Michael Winterhoff, dubbed the “star psychiatrist”, is said to have irresponsibly sedated children with it for years.

No real justification

Fabian also felt “absolutely calmed” by the drug. He was cheeky as a child, but neither aggressive nor in any other way so conspicuous that the remedy would have been justified. “And nothing has been done for a long time that I get less.”

This is exactly what belongs to the responsible use of psychotropic drugs, says psychiatrist Renate Schepker: “That pills are also reduced, that there are attempts to stop them. I know from my consultation hours that children ask about it,” says the professor, who is on the board of directors of the German Society for Child and Adolescent Psychiatry.

Schepker makes it clear: Psychotropic drugs are also a blessing for young patients and can reduce a lot of suffering. But only if they were used responsibly: “That not uncritically a long-term medication – which I consider to be the most problematic in youth welfare – is carried on and on and on.”

Several cases of long-term medication

A long-term medication that Fabian is not the only one to report. A former home director and a psychologist who looks after several homes report similar things. Since both reveal internals, their names should not be mentioned. To the BR written evidence of their activities is available.

“There was a situation when a seven-year-old child was taken from the family and brought to our facility. The child freaked out,” reports the former director. “From my point of view, this is an expected situation. Nevertheless, the child was treated with Dipiperon over a longer period of time. I don’t think that makes sense for a seven-year-old child.”

Nonsensical prescription of sex hormones

The psychologist even reports on a child in care who was prescribed sex hormones. That was “completely nonsensical for the indication and was tantamount to possible bodily harm”. The therapist considered filing a complaint, but decided to try a different approach.

Tablets are prescribed too often and for too long instead of relying on therapeutic discussions, the former manager concludes: “Medication makes sense in an emergency and of course it works faster. But it often only cures symptoms. The causes also have to be dealt with.”

Psychiatrist Schepker also emphasizes how important psychotherapy is. However, children in care would be structurally disadvantaged. For some facilities, the journey is too far, especially in rural areas. However, she criticizes a regulation from the Social Security Code much more.

Pill administration excludes psychotherapy

Specifically, it is about children in care who are treated with tablets in a child and adolescent psychiatric outpatient clinic. A common practice. The problem: “These children cannot do outpatient psychotherapy at the same time,” says Schepker. The reason is the social law. “That’s nonsensical,” criticizes Schepker. “The children often need both medication and psychotherapy.” He has multiple times BR the competent Federal Ministry of Health was asked about this. But there is no answer.

In addition, there are side effects of the psychotropic drugs that have hardly ever been researched in studies in children. According to experts, many drugs are used “off-label”, i.e. in age groups for which the drugs are not actually approved. It is all the more important to recognize and report any side effects in good time. Renate Schepker demands that employees in child and youth welfare should be much better trained.

Humiliating breast formation from drugs

Yannik shows what happens when action is taken too late. He lived in the Augsburg home with Fabian. When Yannik was 13 years old, he was prescribed the sedative drugs olanzapine and risperidone. Soon after, his breasts begin to grow.

Nobody takes their shame seriously, remembers Yannik, who often wears several T-shirts on top of each other at the time so that nobody notices his breasts. On the swimming trip that he had to take part in, he then had to bare her: “Yannik, are you a man or a woman? I had to listen to such sayings. I just felt helpless.”

With a side effect like in the case of Yannik, you should have stopped taking the pills, says psychiatrist Schepker. Timely intervention could have prevented permanent breast formation: “It has not yet happened to me that an operation was necessary afterwards,” Schepker continued.

Clinic does not comment on allegations

The Augsburg children’s clinic, which prescribed the medication to Yannik, wants to open up BR– Do not comment on the allegations. The tablets were prescribed because of the “suspicion of an incipient psychosis” and a “combined disorder of social behavior and emotions”. Because of the “complexity” of the treatment, the Yannik clinic offers a personal interview. Yannik has had to fight for years for the operation to shrink the breasts. A “pronounced gynecomastia” is documented in the operation report.

Much remains unclear for Fabian, too: the pediatrician who is said to have prescribed tablets for him and others in the home has given up her practice. Attempts to locate her fail. Inquiries at the home also end in vain: the files of Yannik and Fabian were destroyed after ten years “in compliance with data protection”, it says BR-Inquiry. And you can’t say anything about the doctor’s work without her express consent.

The home also explains in writing: “The use of medication is accompanied in our facility with the greatest care.” Residents, guardians, supervisors and doctors would coordinate “professionally and personally”. With regard to the medication, the children and young people were asked about their condition and their self-perception, and doctors were informed immediately of any changes in behavior.

Fabian has now met Yannik. Together they talk about their experiences. Yannik’s life affects Fabian. “He was a boy with problems. But it shouldn’t have come to that,” is his conclusion.