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Florida Medicaid Antipsychotics 3

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St. Petersburg Times The 'atypical' dilemma
Skyrocketing numbers of kids are prescribed powerful antipsychotic drugs. Is it safe? Nobody knows. By ROBERT FARLEY July 29, 2007
The ever-increasing number of kids who come through the doors of pediatrician Esther Gonzalez's office lead chaotic lives. There's more divorce and more drug use, more domestic violence and physical and sexual abuse. Working parents are overwhelmed.
"Some parents are so stressed out, they come in seeking a pill," Gonzalez said. It is easy to medicate kids; "it is very hard to change environment." At her practice in Crystal River, she starts with a thorough screening. A child might need occupational, physical or speech therapy. Sometimes, it
takes psychiatric drugs. Despite her concerns about prescribing such medications, Gonzalez has no doubt they have saved many a child from juvenile detention. Not prescribing drugs to a child who needs them, she said, "it's like seeing someone dying and not giving them CPR." Among her patients is
7-year-old Matthew Peck of Brooksville. His 13-year-old brother and 16-year-old sister show scars on their arms and legs where he has bitten them. He flies into rages, kicks, scratches and pulls hair. He destroys furniture and punches holes in the wall. His mom, Cathy Peck, said Matthew's doctors a
re "leaning toward" a diagnosis of oppositional defiance disorder. And he has attention-deficit hyperactivity disorder (ADHD). Matthew has taken a 5 mg dose of the atypical Abilify for over two months now. He says "the blue pill" makes him feel like a different person, someone nice. Peck, a single
mother on disability from the Army National Guard, says she worries the drugs may become addictive. And diabetes runs in the family, so that's a concern. Then again ... a few months ago Matthew got hold of a steak knife and destroyed a chair. "Am I afraid of what the medications might do to him? Y
es," Peck said. "But I am also afraid of what his life would be like without them." Matthew and his brother are playing. Suddenly Matthew raises a hand to hit him. "Gather!" Cathy Peck yells, the trigger word to help Matthew calm himself. He lowers his hand, shambles over to his mother, curls up
behind her. Crisis avoided. Matthew's 13-year-old sister, Marradith, said the Abilify works. "He's a different person. He's more fun to be around. He doesn't attack me anymore." The meds help, Mom says, but therapy is integral to Matthew's treatment. She was taking him to eight sessions a week of
occupational, speech and language therapy. Matthew recently had his last occupational therapy session - but not by choice. After six years, Sensations Pediatrics Therapy in Brooksville closed shop on June 15. That last day of business, Sensations owner Jeff Leonbruno lamented how hard it is for th
erapists to stay afloat. Particularly with pediatric therapy sessions, he said, there is a high cancellation and no-show rate, often four or five a day. If they don't show, he can't charge. "It's difficult to make a living at it," Leonbruno said. Insurance companies and Medicaid don't pay enough
for therapy, he said. They do, however, pay to reimburse for psychiatric medications. Over the years, he said, Medicaid priorities have shifted toward the elderly in nursing homes. That has put a pinch on services like occupational therapy for children with behavioral disorders. "There's no AARP f
or kids," he said.

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