In adults, brain stimulant drugs such as amphetamines and methylphenidate have been used and abused for decades by adults to stimulate the brain to obtain greater wakefulness, more rapid thinking, and more fluent verbal ability, etc. Methylphenidate (MPH) and cocaine have similar mechanisms of action. Both block dopamine and norepinephrine transporters, thus preventing re-uptake into the pre-synaptic neuron. This leads to greater accumulation of both dopamine and norepinephrine within the synaptic space, amplifying the post-synaptic signal. (See Schematic Diagram Below) (37)

Above Image: pink DAT = Dopamine Transporters involved in reuptake of dopamine. D1 and D2 are dopamine receptors at the post-synaptic neuron.  Blue dots are dopamine contained within vesicles within presynaptic neuron or released freely into synaptic  space. Above image courtesy of :  Véronneau-Veilleux, Florence, et al,2022. (37) (3)

Header Image at top courtesy of Volkow, Nora,(2012): PET scan of brain using tracer agent which shows activity of Dopamine Transporters in Basal Ganglia. Note reduced activity in Basal Ganglia after I.V. methylphenidate infusion indicating the drug blocks dopamine transporters. PET scans before and after Intravenous MP shows reduced Dopamine receptor availability in striatum for both untreated (naive) and chronically treated patients, reflecting increased Dopamine availability at the synaptic spaces elicited by the drug. (2)

ADHD Drugs Therapeutic Efficacy in Children

ADHD Drugs Are Toxic to Children’s Sensitive Brains

As discussed in my previous newsletter, adults have been using brain stimulants such as amphetamines and cocaine since the 1940’s as performance enhancing drugs, either obtained over-the-counter, a doctor’s prescription or from the street. Methylphenidate can be considered similar to cocaine in mode of action on the brain, since both block the DAT, Dopamine Transporters involved in re-uptake of dopamine into the pre-synaptic neuron, thus increasing dopamine levels within the synaptic space, and amplifying the post-synaptic signal. Amphetamines also increase vesicular release of dopamine in addition to blocking DAT. Both drugs also increase nor-epinephrine levels.

A Triumph of Clever Advertising over Common Sense

Image: Note dramatic increasing ADHD prescription rates in the UK 1995–2015,courtesy of Renoux, Christel, et al. 2016. Fig 3. (38)

Stimulant drug use in children for ADHD is a new twist made possible by massive drug company advertising which increased methylphenidate use in the U.S. by 800 per cent from 1994 and 1999. Without the benefit of long term safety studies, drug company marketing convinced doctors, teachers and school psychologists that it is perfectly safe to prescribe highly addictive Schedule II brain stimulant drugs to children. DEA Schedule II is reserved for the most addictive and dangerous drugs in medicine, such as cocaine, fentanyl and oxycontin. In 2014, Dr. Allen Frances, the psychiatrist who chaired the DSM–IV task force, (the manual for mental health disorders, and the “bible” for psychiatrists), wrote:

Drug companies were given the means, the motive,and the message to disease monger ADHD and blow it up out of all proportion.They succeeded beyond all  expectations in achieving a triumph of clever advertising over common sense. (11-13)

Follow the Money – ADHD is a Growth Industry

In 2023, the global ADHD therapeutics market for  methylphenidate and amphetamines is 32 billion dollars and expected to grow to 50 billion by 2028. These huge profits are powered by deceptive drug marketing, rigged, faked, or biased drug studies and old fashioned greed. The ADHD drug epidemic is still expanding, damaging the young brains of three generations of children. (20)

Opposite Effect In Children

Brain stimulants have the desired effect in adults, in whom they stimulate the brain as expected, serving as performance enhancing drugs. However, when stimulant drugs are used in children, they have quite the opposite effect, causing depression of brain activity, an obvious indicator of toxic overdose. According to Dr. Peter Breggin, a child psychiatrist with extensive experience treating ADHD kids, this drug toxicity is the “therapeutic effect” of ADHD drugs in children, and the explanation for “suppression of spontaneous and social behaviors”, depression and apathy as drug effects. ADHD drugs are useful for controlling behavior. However, there is no improvement in academic performance for kids on ADHD brain stimulants. (21-24)

In 1999, Dr. Peter Breggin writes:

The “therapeutic” effects of stimulants are a direct expression of their toxicity. Animal and human research indicates that these drugs often suppress spontaneous and social behaviors while promoting obsessive/compulsive behaviors. These adverse drug effects make the psychostimulants seemingly useful for controlling the behavior of children, especially in highly structured environments that do not attend to their genuine needs.(4)

Drug of Choice for ADHD

In ADHD kids, amphetamines and methylphenidate (Ritalin) are considered the drug of choice, transforming a misbehaved child exhibiting inattention, hyperactivity and impulsivity into a docile “zombie-like” child, now considered well-behaved by the teachers in the classroom.This seemingly miraculous remission in the child’s ADHD symptoms of hyperactivity, inattentiveness and impulsivity is a direct result of suppression of prefrontal cortical activity. This “therapeutic effect” of the ADHD drugs in children is actually a result of toxic over-dose which suppresses activity in the prefrontal cortex. In adults, ADHD drugs serve as performance enhancement drugs. In children, however, ADHD drugs merely affect behavior, without any enhancement in academic performance.(21-24)

Electrophysiology Studies in Mice of Pre-Frontal Cortex on Methylphenidate

In 2013, fourteen years after Dr. Peter Breggin’s observations about methylphenidate effects in ADHD kids, Dr. Kimberly Urban showed that Dr. Breggin was quite correct. Electrophysiology studies of prefontal cortex neurons in juvenile and adult mice treated with methylphenidate (Ritalin) showed that while adult mice respond normally to brain stimulants at commonly used therapeutic doses, juvenile mice with developing brains are hypersensitive to this same dosage, resulting in toxic over-dose which suppresses rather than stimulates brain activity. (1)

Even Extremely Small Doses Are Toxic in Children

Dr. Kimberly Urban even reduced the methylphenidate to extremely small dosages in juvenile mice, finding the same paradoxical effect. The neurons of the frontal cortex were still suppressed. See Dr. Kimberly Urban’s chart below: (1)

Above image from Fig 1 (Urban, 2013): MPH=Methylphenidate (Ritalin).

A) Juvenile Mice: Upper Frame Left side, Blue Ellipse and Arrow: Comparison of action potentials in prefrontal cortex neurons in juvenile mice (upper frame) and adult mice (lower frame) injected with single dose saline upper graph, and single dose methylphenidate lower chart. Notice decreased frequency of action potential spikes after MPH in juvenile mice, indicating depression of brain activity in PFC (PreFrontal Cortex) from single dose MPH.

A) Juvenile Mice: Upper Frame Right Side: Green Ellipse/Arrow shows action potential spikes after chronic saline (Green Ellipse and Arrow) or after chronic MPH (Red Ellipse and Arrow). Notice chronic MPH use decreases frequency of spikes, which then stops short, indicating severe depression of prefrontal cortex neurons in juvenile mice.

B) Adult Mice Lower Frame: Green Arrow and Ellipse shows chronic Saline given to Adult mice (serving as controls), while Red Arrow and Ellipse shows Chronic MPH administration to the adult mice. Notice chronic MPH dosage increases frequency of action potential spikes in adult mice compared to saline controls indicating increased stimulation of PFC neurons, the opposite of the depressive effect in juvenile mice.

Long Term Brain Alterations

In addition to confirming Dr. Breggin’s observations 14 years earlier, Dr. Urban found long term and possibly permanent alteration in brain chemistry, and function from chronic methylphenidate use in juvenile mice, raising the question of chronic brain alteration in children on ADHD drugs. This is also known as brain damage. Ample animal and human studies in the medical literature support this notion that long term use of ADHD drugs may cause alteration in brain chemistry, function, and behavior, some of which may remain permanent. (3-10)(14-19)

In 2017, Dr. Kimberly Urban writes:

Adolescent MPH [Methyphenidate] exposure was found to reduce social play, impair pattern learning and reversal learning, increase locomotor hyperactivity, and response to cocaine, sometimes lasting into adulthood. Early exposure to MPH has also been shown to result in increased anxiety lasting into adulthood and alter circadian rhythms. (18-19)

ADHD Child Brain Drug Tolerance – The Drugs Stop Working

Above images PET SCAN courtesy of Wang, (2013): Green Arrow shows baseline activity. Red arrow shows increased DAT activity in striatum after 1 year of MPH use in ADHD children. Averaged dopamine transporter availability (DAT) images. Averaged dopamine transporter availability images of ADHD (n = 18) and control (n = 11) subjects prior to and after 12 months oral MP  (Methylphenidate) treatment as well as baseline and 12 follow up scans of control subjects. (35)

Developing Drug Tolerance

In 2019, Dr. James M. Swanson, professor of pediatrics at University of California, Irvine, an expert on methylphenidate (MPH) in ADHD writes that ADHD children build up a tolerance to MPH in the long term (1-3 years), and require larger doses of MPH (or drug holiday) to overcome tolerance and restore efficacy. Note drug tolerance for MPH is similar to tolerance for other addictive drugs such as opiates requiring larger doses over time or drug holidays to restore efficacy. (36)

Dr. Gene-Jack Wang’s PET Scan Study in AHDH Children on MPH

The explanation for drug tolerance to methylphenidate (MPH) over time is shown by the 2013 PET study by Dr. Gene-Jack Wang (see above images). The PET scans use a tracer that shows DAT (Dopamine Transporter) availability in the brain. Note most of activity is in the striatum (basal ganglia). Note upper right images: follow up visit scan after 12 months of MPH use, the ADHD children using MPH show increased activity for DAT in the striatum (Red Arrow) compared to baseline (Green Arrow) and controls.  This means DAT (Dopamine Transporters) have increased. The brains of ADHD children on MPH compensate by increasing the number of Dopamine Transporters, serving to reduce the amount of excess dopamine at the synaptic cleft. This creates drug tolerance over time, and explains why MPH beneficial effects on ADHD behavior are only short term. The drug stops working in the long term (1-3 years). (35)

Methylphenidate Increased DAT in Mice

In 2013, Dr. Erin Calipari confirmed in studies using mice, Methylphenidate increased DAT (Dopamine Transporter) expression. (52)

Increased DAT Causes Dopamine Toxicity and Neuron Loss

When Dopamine Transporters are increased for any reason, toxic dopamine levels accumulate in the terminal end of the neuron causing neuron cell death. Dopamine is a mitochondrial toxin and inhibits Complex I of the mitochondrial respiratory chain. Males are more susceptible to this adverse effect, compared to females protected by higher estrogen levels. (45) (52-59)

Damage to Dopaminergic Nerve Endings in the Striatum

In addition to upregulation of DAT (Dopamine Transporters) in the striatum, something much worse happens. In 2005, Dr. George Ricaurte studied amphetamine use in non-human primates (monkeys) at doses equivalent to those used for Adult ADHD, finding  damage to the terminal endings of dopaminergic neurons in the striatum (basal ganglia), writing:

Here we demonstrate that amphetamine treatment, similar to that used clinically for adult ADHD, damages dopaminergic nerve endings in the striatum of adult nonhuman primates. (42-43)

In 2012, Dr. Shankar Sadasivan studied methylphenidate use in mice finding similar loss of dopaminergic neurons in the basal ganglia. In addition there was microglia activation indicating inflammatory response. (59)

Adderall Addiction Treatment Centers Are Very Busy

If ADHD drugs are so safe, then why do we have tens of thousands of busy Adderal Addiction Treatment Centers? A Google search for Adderal Addiction Center yields two hundred million hits. Take a Look.

Analogy with the Opioid Epidemic

I see the current ADHD drug epidemic analogous to the Opioid epidemic. Opiates were abused for decades, and finally the pendulum swung the other way finally reigning in Oxycontin sales by Purdue Pharmaceuticals, owned by the Sackler family. The ADHD drug marketing playbook bears a striking resemblance to the Purdue/Oxycontin marketing playbook. Eventually, the massive iatrogenic harm to our children will be recognized and the ADHD drug epidemic will come to an end. We will look back and wonder how this could have gone on so long. (25-36)

The Scourge of the 21st Century

In 2018, Dr. Rima Gaidamowicz called ADHD “the scourge of the 21st century”, invented by doctors and pharmacists to tame misbehaving children while maximizing profit from drug treatments. Dr. Rima Gaidamowicz writes:

Those who question ADHD existence argue that this disorder is likely temperament and parenting matter, rather than the illness, and that the diagnosis and treatment of this illness can be a matter invented by doctors and pharmacists, the aim of which is to tame individuals disregarding public standards of conduct and get the maximum profit from medicines in the treatment of this illness. (60)

Methylphenidate and Cocaine have same mechanism of action. Note below image shows the mechanism of action of cocaine is identical to methylphenidate. They both block the Dopamine Transporters.

Above image: Cocaine in the brain: In the normal neural communication process, dopamine is released by a neuron into the synapse, where it can bind to dopamine receptors on neighboring neurons. Normally, dopamine is then recycled back into the transmitting neuron by a specialized protein called the dopamine transporter. If cocaine is present, it attaches to the dopamine transporter and blocks the normal recycling process, resulting in a buildup of dopamine in the synapse, which contributes to the pleasurable effects of cocaine. courtesy of the NIDA of NIH:

Stimulants, CV Events and Ventricular Arrythmias in Older Adults

In 2021, Dr. James R Latronica studied cardiovascular events (CV) in older patients using amphetamines, finding a 600 percent increase in CV events compared to matched controls. Reference: Latronica, James R., et al. “Are amphetamines associated with adverse cardiovascular events among elderly individuals?.” The Journal of the American Board of Family Medicine 34.6 (2021): 1074-1081.

In 2021, Dr. Mina Tadrous compared a matched cohort control group  to older patients prescribed stimulants, finding a 40% increase in cardiovascular events, 300% increase in ventricular arrythmia, and 60 percent increase in stroke or TIA. Reference: Tadrous, Mina, et al. “Assessment of stimulant use and cardiovascular event risks among older adults.” JAMA network open 4.10 (2021): e2130795-e2130795.

Zhang, Le, et al. “Attention-Deficit/Hyperactivity Disorder Medications and Long-Term Risk of Cardiovascular Diseases.” JAMA Psychiatry 81.2 (2024): 178.

Eroglu, Talip E., et al. “Use of methylphenidate is associated with increased risk of out-of-hospital cardiac arrest in the general population: a nationwide nested case-control study.” European heart journal. Cardiovascular pharmacotherapy 9.7 (2023): 658-665.

Conclusion: In 1999, Dr Peter Breggin made observations about the effects of brain stimulants on ADHD children, namely the therapeutic effect is a direct result of drug toxicity. Later in 2013, Dr. Breggin was shown to be quite correct by Dr. Kimberly Urban’s painstaking electrophysiology studies in mice. These studies and others show that the juvenile brain is hypersensitive to the effect of brain stimulants, producing the paradoxical effect of brain suppression. When stimulant drugs are given to adults, they stimulate the brain and serve as performance enhancers. However, when given to children, these drugs have the opposite effect, suppressing and depressing brain function. This is the definition of drug toxicity. Even small doses of ADHD brain stimulant drugs are toxic to children. This toxicity accounts for the “therapeutic effect” in ADHD children, and may result in long-term and even permanent alterations in brain chemistry and function. Another disturbing observation was made by Dr. Wang using PET scans showing Dopamine Transporter activity increases after chronic MPH administration. The ADHD child brain develops MPH tolerance by upregulating Dopamine Transporters. Knowing this, why would any parent want to do this to their child’s brain?  Think of it this way. Would you give your child cocaine to manage his/her behavior in the classroom, which will only work short term for a year or so? Ritalin (methylphenidate) is essentially the same drug as cocaine. They both block dopamine transporters. In my opinion, the medical use of brain stimulants in children is an iatrogenic catastrophe which should be halted immediately. (1-41)

ADHD is BS – “Mockumentary” Starring Australian Comedian Peter Rowsthorn

TRIGGER WARNING – If you are certain that amphetamines are good for impulsive/inattentive children DON’T WATCH ADHD is BS. This mockumentary stars Australian comedian Peter Rowsthorn (aka Brett for Kath and Kim) as American ‘ADHD expert’ Professor Chip Cash. Prof Cash parrots all the usual BS that will help the ADHD Industry sell US$22.5billion+ in drugs (primarily amphetamines for use by children) in 2021. Watch ADHD is BS, have a laugh, and then get serious and do something to help end this profitable, hypocritical, pseudo-scientific, twenty-first century form of child abuse.

Recommended Books:

Finally Focused: The Breakthrough Natural Treatment Plan for ADHD That Restores Attention, Minimizes Hyperactivity, and Helps Eliminate Drug Side Effects Paperback – May 9, 2017  by James Greenblatt MD (A Psychiatrist who treats ADHD children)

Talking Back to Ritalin: What Doctors Aren’t Telling You About Stimulants and ADHD Paperback – September 1, 2001 by Peter R. Breggin MD (A Psychiatrist who treats ADHD children)

An Anatomy of Addiction: Sigmund Freud, William Halsted, and the Miracle Drug, Cocaine Paperback – Illustrated, July 3, 2012 by Howard Markel (Author)Seitler, Burton Norman. “ADHD: What We’ve Been Told Ain’t Necessarily So.” Deconstructing ADHD: Mental Disorder or Social Construct? 3 (2022): 119.