[ProAgonist]

I have PCS from getting 2 mild concussions 10 days apart from each other (the first one was in 27 October 2014).

I have a couple of questions regarding what I should do:

1. I'm taking Ritalin on a daily basis to treat my ADHD (this was not caused by the concussion as I've always had ADHD). Can this slow recovery and harm the chance of making a good recovery? I think it might slow my recovery (because Ritalin is a potent psychoactive drug which is a powerful stimulant), but I'm not sure. Can I keep taking it right now?

2. I'll have a field trip of my school in about 2 months from now. The trip's length is 2 days, and involves many physical activity and physical challenges (some climbing, walking on rocky mountains long distances and such). Is it safe for me to go to that trip? I'm afraid that the physical activity, such as walking and jumping on rocks and stones might be very bad for me because of my concussion.

So what do you guys think?

Thanks,
-ProAgonist

[DannyT]

Hey man,

Ritalin is in the psychoactive drug class known as phenethylamines which like you said are powerful central nervous stimulants. I'm no doctor so you should discuss this with a licensed physician.

That being said, my advice would be to discontinue use immediately. I'm not sure how your brain responds to the medication but plenty of young people are prescribed stimulants for conditions where they actually shouldn't be taking them.

For instance, when I take a stimulant drug, a rush of neurotransmitters known as dopamine and epinephrine rush through my neural synapses. This offsets the natural balance known as homeostasis and this problem is exactly what our injured brains are already dealings with. In my opinion, taking stimulants would be just feeding fuel to that fire and requiring your brain to work harder and in effect delaying your recovery.

[Mark in Idaho]

I can't comment on the Ritalin except to say experts disagree. Some say it is OK. Others say it stresses the brain.

You have two months to start being active enough to get a sense of your ability to safely do the activities of the field trip. The important things is to learn you own safe level of doing these activities. You need to establish an "I'm in charge of my own movements' attitude so you don't let others push you into situations that are beyond your safe physical abilities.

You might consider getting a helmet if you will need to be scampering across rocks with unstable footing. A bicycle or skate board helmet or mountaineering helmet may be worthwhile.

[DannyT]

Edit: it's actually norepinephrine and dopamine that are affected by stimulants not epinephrine and dopamine. I believe there is also serotonin activity. My post was submitted early!

Adding to that thought, if your brain is in the select few percent of the population that actually need stimulants than that is out of my knowledge. How long have you been taking Ritalin? How does it make you feel when you take it?

For the second question, there is no way for any of us to predict how you will be feeling in two months. The safe answer is an absolute no. Based on your previous posts, it would be best for your recovery both physically and psychologically to rest and not take any risks. Just think of how you would be second guessing yourself if there were any incidents. Your brain is probably not ready for jarring and moving around violently. Please take it easy until you have no symptoms.

Remembe don't take my advice as fact but I do have some limited knowledge from college and experience regarding the biochemistry of stimulants and I would like to help you as much as I can.

Be well.

-Danny

[Lara]

Regarding discontinuation of Ritalin -

Central nervous system stimulants should not be discontinued abruptly. It really does depend on the dose you're taking but usually Ritalin would be tapered rather than discontinued immediately.

Just be aware that if you've been taking Ritalin a long time and at a higher dose and you decide to stop it, you may have withdrawal symptoms.

[Mark in Idaho]

I agree with Danny. Very few who are prescribe Ritalin and such stimulants actually need them. They are not harmless drugs.

[ProAgonist]

Originally Posted by Mark in Idaho

I can't comment on the Ritalin except to say experts disagree. Some say it is OK. Others say it stresses the brain.

You have two months to start being active enough to get a sense of your ability to safely do the activities of the field trip. The important things is to learn you own safe level of doing these activities. You need to establish an "I'm in charge of my own movements' attitude so you don't let others push you into situations that are beyond your safe physical abilities.

You might consider getting a helmet if you will need to be scampering across rocks with unstable footing. A bicycle or skate board helmet or mountaineering helmet may be worthwhile.

Thank you, Mark. What you said does make sense, but I've heard cases of people that their symptoms completely disappeared after a few months, and then they went to do some physical activity which caused their symptoms to return and stay there for a very long time (one user in this forum said that he healed after 3 months, went snowmobiling, and his PCS symptoms returned for at least 2 years even though he didn't hit his head while snowmobiling). That sounds scary, so how much do you think I should wait? As I mentioned, symptoms can return after heavy physical activity, even if you feel fine. So how do I know in 2 months from now if I can go to that field trip or not?

Originally Posted by DannyT

Edit: it's actually norepinephrine and dopamine that are affected by stimulants not epinephrine and dopamine. I believe there is also serotonin activity. My post was submitted early!

Adding to that thought, if your brain is in the select few percent of the population that actually need stimulants than that is out of my knowledge. How long have you been taking Ritalin? How does it make you feel when you take it?

For the second question, there is no way for any of us to predict how you will be feeling in two months. The safe answer is an absolute no. Based on your previous posts, it would be best for your recovery both physically and psychologically to rest and not take any risks. Just think of how you would be second guessing yourself if there were any incidents. Your brain is probably not ready for jarring and moving around violently. Please take it easy until you have no symptoms.

Remembe don't take my advice as fact but I do have some limited knowledge from college and experience regarding the biochemistry of stimulants and I would like to help you as much as I can.

Be well.

-Danny

I was prescribed Ritalin for my ADHD. I have always had severe attention problems, so the Ritalin helps me manage my concentration and study.

When I take the Ritalin, I feel that it's very easy to focus on whatever I want. My appetite is really low for the most of the day (since it's sustained release Ritalin - Ritalin LA). Other than that, it also makes me feel good, optimistic and highly motivated. It gives me a lot of self confidence, and sadly sometimes it causes me chest pains.

Originally Posted by Lara

Regarding discontinuation of Ritalin -

Central nervous system stimulants should not be discontinued abruptly. It really does depend on the dose you're taking but usually Ritalin would be tapered rather than discontinued immediately.

Just be aware that if you've been taking Ritalin a long time and at a higher dose and you decide to stop it, you may have withdrawal symptoms.

I'm actually withdrawing from Ritalin right now (day 4 of withdrawal). I always stop cold turkey for different reasons (this time - I'm on vacation from school so it's just unnecessary to take it now). The withdrawal is not very nice - I feel very hungry, extremely tired, I get headaches and I can't focus at all and also I don't have any motivation. It's really uncomfortable, but tapering off would take a lot of time and I prefer stopping abruptly, even though it's tough.

I have withdrawal symptoms every time I stop, and the feeling is just terrible. If I go to school while withdrawing from Ritalin, I'll easily fall asleep there and won't even bother taking out my notebooks because I'm so lethargic.

I take Advil to manage the pain from the headaches during withdrawals - it is a great help. I also have to sleep much more, and I usually gain a few kilograms in the first week after stopping Ritalin (the length of the withdrawal is usually 6-7 days).

[Mark in Idaho]

ProAgonist,

You said "That sounds scary, so how much do you think I should wait? As I mentioned, symptoms can return after heavy physical activity, even if you feel fine. So how do I know in 2 months from now if I can go to that field trip or not?"

I suggested that you have 2 months to start being physically active. Start now with simple walks then progress to more strenuous walks or hikes. It symptoms manifest from the hikes, slow down. You can only find your tolerance for activity by doing it. Nobody can predict your tolerance.

[DannyT]

It sounds as though you could skip the Ritalin altogether for a while. You don't want to stop and start medications while you are recovering. The best thing to do is to decide whether you want to keep taking it or stop taking it and stick to your decision so that your brain can readjust to either condition. Switching it up is only gonna make it harder for your brain to heal itself.

I can't imagine going through withdrawal and having PCS at the same time. I feel for you, I really do. Hang in there buddy!

[mrsD]

ProAgonist.... I have been reading along here, and I do think we need to clear up something...

How old are you? Are you living at home with your parents?
Any decisions for a minor, should be made by your parents or guardians and your doctor.

It is true that long term methylphenidate use (and also amphetamines) for ADHD can result in depleted dopamine, and also depression. If you do a drug search you will find depression listed for both.

This link is a site that lists side effects to drugs reported to the FDA. The actual reports are not common, so the numbers are low.Most doctors do not report at all.

http://www.drugcite.com/?q=methylphenidate

You can click to enlarge/expand any item in both listings.

I really think you should spend some time reading the sites that explain side effects to methylphenidate.