What would you think of treating a toothache with painkillers and nothing else? Or of giving Tylenol to a burn victim and then sending him right back into the flames?

In their instructional letter to physicians, the manufacturers of Ritalin wrote: "When psychosocial and behavioural remedial help is not enough then Ritalin should be prescribed� " Unfortunately, thousands of my colleagues prescribe Ritalin as soon as frustrated parents demand "treatment" (a parental request often prompted by a teacher who wants peace and quiet in the classroom).

In the decades of my psychiatric practice, many children with symptoms of AD/HD have been presented to me. In almost every case, I could see factors in the family context, which needed to be dealt with BEFORE medication should have been considered. Of course, Ritalin (a powerful stimulant) enhances performance and concentration in children. It would do the same for you and me.

What's next? Treating unhappiness with cocaine? Oops� we�ve already tried that! Unfortunately, the misuse (and overuse) of medication happens every day.

Felix Yaroshevsky, M.D.

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