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  • BDD Moderators: Keif’ Richards | negrogesic

Ritalin tolerance + dopamine levels

emperorowl

Greenlighter
Joined
May 6, 2016
Messages
10
Okay this is a very odd combination of a question, and I'm not sure if it's best here in BDD or somewhere else, feel free to move if necessary!

My fiance has been on Ritalin for about 2 years now for adult ADD. It was overall a great change for him as he couldn't function well before. He was originally on 18mg Concerta, but after about a year he asked for his dose to be raised a bit as his tolerance was growing and the good effects were wearing off. He started to forget to even refill his meds on time... bad sign! He was switched to 20mg of some generic Ritalin XR... not much of a dose increase if you ask me but it did seem to work fine for another year, so whatever.

Now on year 2 he's fallen back to square one. The last 3 months or so have been awful for both of us. He's back to being spacey, forgetting basic things, work performance is suffering, his mood has been kinda down lately and he's not enjoying things as much, not eating much etc. He complains often of "brain fog" and feeling very overwhelmed. I didn't think it could be his tolerance until recently and now I'm looking into options. That's part 1 of my question for you guys.

I myself am on Vyvanse (and have tried Adderall XR). I have learned everything 6 ways to Sunday about reducing/mitigating amphetamine tolerance and neurotoxicity, including magnesium supplements, vitamin C, melatonin, dxm, l-theanine, l-tyrosine, etc etc all that stuff found here on lovely bluelight. But with Ritalin specifically... I can't seem to find much! It appears methylphenidate is not very neurotoxic which is a good thing (I might ask to be switched to that myself), but I can't find much about lowering tolerance, aside from the "take a month-long drug vacation" idea which I don't know if that would be a great idea for him, as he needs to be medicated just to function every day and he DOES NOT abuse his meds. He can't afford to continue going untreated for that long. Does magnesium, DXM and all those things simply not work for MPH tolerance? Would it be helpful AT ALL for him? I already take all that stuff almost nightly for myself so I have it available.

He won't have a doc appointment for a while so In the meantime I have let him try my leftover Adderall XRs, which I personally hated, and when he took them he suddenly felt a HUGE improvement at least over what his current baseline is. He said it felt different than the Ritalin and he might prefer it more due to the different effects (some of that might have been first-time-euphoria). I obviously can't tell the doc "hey btw I let him try my meds and he liked it, can he have more?" Lol. But TBH I would prefer he stay on Ritalin because it doesn't have as much risk for brain damage as amps anyway. So he can ask for an increased dose, or to switch meds, when he gets to the appointment.

My 2nd question is about bringing dopamine levels back up either with supplements like tyrosine/theanine (I think...) I have considered getting some piracetam too. All of which are supposed to help bring dopamine levels back up or help the brain replenish itself. And if his ADD is uncontrolled and his dopamine is low, perhaps this would help by supplementing for a month or so... and maybe his medication would work better then too with more dopamine in his brain. Any suggestions? I know the tyrosine/theanine stuff is supposed to help with amps but again MPH is a bit different as it inhibits the reuptake of dopamine, so I want to be on the safe side and not give him something that will damage his brain lol. I do also have various strains of kratom including whites which are energizing, as well as good old MJ, a shitload of DXM, and even gabapentin but I don't think that would be much use. I will purchase whatever supplements are suggested and try them out ASAP.
 
I dont think theraputic doses of amphetamine cause brain damage.
 
Have you considered something like DexMethylphenidate (Focalin-FocalinXR), the dextro rotary form of Methylphenidate that is more potent than the racemic (mixed) 50%dextro / 50% levo form he's taking now? It's a road that might not last forever but possibly buy some time for a more effective long term pharmacotherapy or treatment.
As far as potentiation of Methylphenidate, it's grim and only goes so far with supplements. Drastic measures like EtOH have been used but that's not a viable solution. There's been some effect from NMDA antagonists (Memantine, Agmantine)* but again this leads to a dead end as tolerance eventually continues to build and side effects increase, but if he was able to find a suitable benefit without having to exceed the therapeutic dosage limits the metaphoric "road" might be lengthened.

This is extending beyond internet advice and really requires a medical professional when getting into these territories, but these might be some ideas to discuss and have his doctor determine if any of them at all might be applicable. I wish you the best of luck as you are not alone with this problem.


v This applies to the the DXM as well but it can leave him altered as DXM becomes a dissociative at medium to high dosages(robotripping).

*Studies have been done on tolerance reversal using memantine to treat opiate tolerance. It is well documented that Memantine acts as the NMDA receptor antagonists. We know when there is an influx of calcium ions the body recognizes this to indicate tolerance to not only opiates but also amphetamines.BUT-It is important to note that Memantine is not a magic pill for reducing drug tolerance. There is nothing in our current chemical knowledge that is capable of reversing tolerance whilst escalating therapeutic dosages of chemicals

This is based on adderal and amphetamine salts but with the cross tolerance of methylphenidate some effect might be gained. Def not a permanent solution by any means and is a prescription medication.
 
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I have a question regarding Ritalin for anyone who's ever experienced it as in regards to increasing alertness during exams. Are there any pro's or cons for it? I have a friend who's son was discussing with him about others in his classes thinking of doing it during prelim and exam time this year. It's just he was asking me about it and all I really know about it is that it's prescribed for ADHD. Pretty ignorant to it really.
 
Unfortunately, the best way to lower tolerance is to not take the medication. Luckily, there's not anything medically dangerous about ceasing Methylphenidate (Ritalin, Concerta). This isn't a completely clandestine practice either. It's not uncommon for prescribers to initiate a drug holiday when the patient reports reduced efficacy. My advice would be to take a short break completely from taking the medication. Perhaps you could make it a 48hr break. That's long enough to get the feel for what a break is like, but if there are factors like serious depression/anxiety, you can always medicate.

I would start with that, probably best done on the weekend or when your significant other doesn't have anything intellectually complicated to do.
 
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