>*"Does the ritalin affect your stuttering one way or the other now?"* Perhaps [this](https://www.reddit.com/r/Stutter/comments/14t0946/comment/jr0qi6j/?utm_source=share&utm_medium=web2x&context=3) research study (2021) could - at least partially - explain why ritalin increases fluency in a subgroup of PWS, while it has no effect or worsens in the second subgroup: >*"Surprisingly, the study by Langova and Moravek actually found that clutterers and ‘stutterer-clutterers’ symptoms actually improved on antipsychotics, whereas ‘pure stutterers’ (without cluttering) symptoms tended to improve on stimulants (like ritalin)* *It highlights the possibility that stuttering symptoms may be ameliorated in the ‘attention deficit’ subgroup of stutterers by stimulants that increase dopamine metabolism (like Ritalin) - increasing the attentional control and reducing the hyperactivity.* > >*How could antipsychotic drugs lead to an amelioration of stuttering symptoms?* > >*Answer: it may increase the ‘signal-to-noise ratio” of speech plans; and their effect of blocking D2 dopamine receptors causes a general reduction in responsivity. When the speaker realises that he is eliciting fewer negative responses from his listeners, the level at which his release threshold is set falls, and he finds that he can execute planned words more easily. As a result, the speaker will perceive the speech plan to be more appropriate and to contain fewer errors; it dampens our sensitivity so that the rises in synaptic dopamine are no longer so rewarding (pleasurable) and the falls are no longer so punishing. Additionally, PWS may misperceive the initial rise in dopamine which is really only signalling the detection of a novel stimulus as signalling a positive evaluation. It could lead us to perceiving people's responses more positive than they really are, but if some PWS start to realise this and start worrying, then it may result in more disfluencies."*