Mark,

I'll start with the Ritalin - as I said, before starting the Ritalin I was a very bad student, and honestly I think that without the Ritalin I would have dropped from high school because of my bad grades. My severe inattention problems caused my grades to be low, and they just got lower every new year when things got more demanding. My ADHD does not allow me to perform normally in life, and that could seriously harm me in the future when I will look for a job and raise a family (it's not just school - ADHD is a real disorder, unlike many think, that creates difficulties in many areas in life). So, even if I don't take the Ritalin, I would have to use another medicine to control my symptoms - and sadly, apart from stimulants, not many medications are effective for treating ADHD symptoms. I sadly often find that ADHD is being underestimated - again, it's a REAL disorder with real consequences on the people who have it.

Regarding the dopamine system - it's right that Ritalin is bad for dopamine regulation and can harm the dopamine system, but most of the time, it's temporary.

If we get into details, the active ingredient in Ritalin is Methylphenidate - a potent CNS stimulant that works by inhibiting the reuptake of dopamine into the releasing cell. That means that after dopamine is released, instead of returning to its releasing cell, it continues binding to its receptor repeatedly for a long time. The higher amounts of dopamine in the synaptic cleft are translated into an increased ability to concentrate, increased self control, decreased hunger and motivation (the ability to concentrate is the primary effect which is necessary for ADHD treatment).

In the long term, the results of repeated administration would be an upregulation of dopamine reuptake receptors (more reuptake receptors means that more dopamine can be reuptaken at the same time, leaving you with lower amounts of dopamine), and a downregulation of dopamine D2 receptors (decreased sensitivity to dopamine molecules in the synaptic cleft). These consequences happen because of homeostasis (the body's attempt to keep it's internal environment balanced), which you probably have already heard about. It's just the body trying to balance the imbalances caused by Methylphenidate (Ritalin).

On the other hand, stimulants from the Amphetamines class (such as Adderall) are neurotoxic and can lead to permanent brain damage from long term, high dose consumption. They are neurotoxic because of their mechanism of action - unlike Methylphenidate that inhibits the reuptake of dopamine, Amphetamine (Adderall) reverses the reuptake process - that means, instead of dopamine being reuptaken, it's being continously released. This creates high levels of oxidative stress inside the synaptic cleft that leads to the death of dopamine neurons (at many cases this is irreversible). Apart from the oxidative stress, the Amphetamine molecule damages the cells by itself (it is a neurotoxin). That menans that Amphetamine destroys cells just by interacting with them.

So when talking about long-term permanent effects, the real danger here is with Amphetamine (and also all drugs from the Amphetamines class). Methylphenidate, unlike Amphetamine, is not neurotoxic (unless given in mega high doses). Research shows that rats and monkeys recover from long term Methylphenidate administration eventually (although some recover in a few weeks and some take months), but not all rats and monkeys recover 100% from repeated Amphetamine administration.

Also, in the website you posted I can see studies about Ritalin causing psychotic episodes and depression, but I couldn't find an article that concludes that these effects are permanent (if they're not permanent, it's not a problem because the medication can be stopped the moment they start appearing, and the person will recover).

And about the physical activity tolerance - if I push too hard and my symptoms return, isn't that a sign of new brain damage that I caused to myself? And even if I, by accident, push hard enough to cause my symptoms to return, it'll only delay my recovery, but not cause any further brain damage? I'm worried that it won't only delay my recovery, but also cause more brain damage (the field trip that involves physical activity and hiking). And if it doesn't cause new brain damage, what is the reason to the return of the symptoms after heavy physical activity? The delayed recovery sounds like it carries more risks with it (I hope not).

Thanks,
-ProAgonist