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AP/The Vancouver Columbian

SEATTLE (AP) -- Stimulants, sedatives and anti-depressants no longer will be given to foster children without permission from a biological parent or a judge, state officials have decided.

The proposed rule, scheduled to take effect July 1 and similar to regulations in 24 other states, was adopted partly because of the death of 6-year-old Domico Presnell from amitriptyline poisoning last year. The anti-depressant, better known as Elavil, had been prescribed because the boy was hyperactive and had trouble sleeping.

"Given the risk and uncertainty with psychotropic medications, we're going to make them nonroutine," said Rosie Oreskovich, head of the Children's Administration in the state Department of Social and Health Services.

The boy's biological mother, a recovering drug addict who was working to regain custody, did not know her son was taking amitriptyline. She has sued the state and Dr. Daniel Stowens, who prescribed the anti-depressant. Officials said it would have been inappropriate for the state agency or social workers to second-guess a doctor's decision to prescribe medication.

The boy's death was featured in a Seattle Post-Intelligencer series examining state oversight of foster children who are given psychotropic drugs.

Stowens, a neurologist whose medical license was suspended after the death, said he had assumed the boy was being seen by a pediatrician. In reality, the boy went more than a year without seeing another doctor before he died April 21, 1996.

Stowens, 49, who treated dozens of Medicaid-covered foster children after opening a pediatric neurology office in 1993, said it was only after Presnell's death that he realized there was no assurance that the foster parents of troubled or fragile children would be able to administer potent medication properly.

"I assumed that there was some supervision of the foster home," Stowens said. "I assumed that there were case managers acting as advocates for children who would pull a child out of a home if there were some reason to worry about the foster parent," he said. "I assumed they had some way of determining which foster parents can handle medically fragile children."

Washington's new policy, similar to a 3-year-old Oregon law, covers Ritalin, Prozac, lithium and any other drug intended to "affect or alter thought processes, mood, sleep or behavior."

1997 May 11