William Cooper, M.D., MPH, Cornelius Vanderbilt Professor of Pediatrics and Health Policy, testified Tuesday before the U.S. Senate Health, Education, Labor and Pensions (HELP) committee regarding psychotropic medications and treatments for Attention Deficit Hyperactivity Disorder (ADHD).
Cooper has conducted extensive population-based studies on the use and risks of antipsychotic drugs to treat ADHD and is an internationally recognized expert in medication safety in children.
He was among a panel of four expert witnesses who testified at the hearing, which examined treatment options and trends for mental health conditions as well as the growing diagnosis of such conditions and the increasing use of psychotropic medications versus behavioral interventions.
U.S. Sen. Tom Harkin, chair of the Senate HELP committee, offered data on alarming trends, specifically noting significant increases in the use of psychotropic medications while behavioral and psychological treatments have increased only slightly. Use of psychotropic medications in children saw an eightfold increase from 1993-2009, and a fivefold increase among adolescents during the same time period.
“I’d like to have a better understanding why this is happening, what we can do to make sure people are getting the right treatments — I didn’t say the right drugs; I said the right treatments,” Harkin said.
Cooper’s testimony focused on medication safety for children, prescribing habits and individualized modalities of treatment.
“It’s important to understand that medications used to treat mental health disorders are not magic pills,” Cooper said.
“Children with serious mental health disorders may benefit greatly from medications, but it is important to weigh their risks and benefits in the context of a comprehensive and individualized treatment plan, which typically includes other personalized interventions.”
He noted that making a diagnosis and finding the best treatments takes time and often requires cooperation and conversations among family, school officials and medical experts. A majority of mental health care for children happens in the primary care setting.
“We really have to think about the right treatment for the right child,” said Cooper. “We have to ensure that pediatricians and other primary care professionals have appropriate training and education in what is appropriate to diagnose a child and what the appropriate treatment is.
“Unfortunately, sometimes when a right diagnosis is made and a right treatment is made, there is still a lack of access to needed resources.”
U.S. Sen. Lamar Alexander, the ranking Republican member of the HELP committee, asked Cooper if he has come to his own conclusions as to why there has been an increase in diagnosis of children with ADHD, and if increased pressures on children and/or environmental factors could have contributed.
“It’s really perplexing. We need to do more research to understand and figure out if it’s an increase, or if it’s increased recognition, or if some of these external factors may be at play,” Cooper said.
During his testimony, Cooper also noted the importance of ensuring children are receiving the right medication if medications are needed as a part of the overall treatment approach.
“We need to ensure that children who really need antipsychotics get them, but there is little reason to believe that the incidence of these disorders justifies the fivefold increase in prescriptions for these drugs that has occurred in recent years,” he said.
The full video of the hearing can be viewed here.
