Two readers expressed valid but opposite views regarding management of children (and, for that matter, adults) with attention deficit hyperactivity disorder in the March 1 Voice of the people. One view supported the use of Ritalin, and the other view was somewhat anti-Ritalin, in support of psychological therapy.
As an allergist who has been involved in the treatment of these children for more than 30 years, I appreciate both views. Hundreds of physicians have at times improved these patients by addressing allergies to foods, chemicals and inhalants, and by correcting nutritional deficiencies and imbalances. As an example, a subpopulation of these children and adults has been shown to respond to eating less sugar, preservatives, artificial coloring and flavoring.
Although Ritalin may not always be the best solution, in some instances it may be the only realistic solution. Unfortunately there are pressures on parents and physicians from well-meaning teachers, along with limitations imposed by managed care.
To many, the best approach addresses allergies or intolerances to unsuspected foods or additives, expert nutritional counseling, psychiatric and psychological diagnosis and treatment, and evaluation and correction of unsuspected hearing and visual defects. In some instances, patients have responded favorably to treatment aimed at decreasing exposure or sensitivity to inhalants, such as pollens, mold spores, house dust, mites and animal danders. The above does not exclude the appropriate usage of Ritalin in some instances.
