The Drug Docs [Extras.MercuryNews.com]

Now, a Bay Area News Group investigation into the prescribing habits of the state’s foster care doctors reveals for the first time how a fraction of those physicians has been fueling the medicating of California’s most vulnerable kids.

A mere 10 percent of the state’s highest prescribers were responsible about 50 percent of the time when a foster child received an antipsychotic, the riskiest class of what are known as psychotropic drugs — with some of the most harmful side effects. The startling numbers are revealed as part of a new analysis of Medi-Cal pharmacy data, which the news organization obtained through a public records request.

These same doctors often relied on risky, unproven combinations of the drugs, a practice widely rejected by medical associations and other states. 

In San Bernardino County, one psychiatrist prescribed antipsychotics to 328 foster children — 85 percent of the young patients to whom he gave a psychiatric drug in the five years the investigation examined. And when one antipsychotic didn’t work — or wasn’t enough — Dr. Warris Walayat routinely prescribed another.

Many of the highest prescribers stand out for other practices that raise questions about their judgment or objectivity: A psychiatrist who oversees treatment at a Riverside County group home for troubled children is a self-proclaimed “spokesperson for pharmaceutical companies.” A doctor training psychiatry residents at a San Diego children’s center once prescribed an antipsychotic to an out-of-control kindergartner. And a veteran Visalia child psychiatrist touts a drug approved to treat mania and schizophrenia as an effective “sleep aid.”