ADHD Drug Holidays: Should Your Kid Take One?
Are you thinking about giving your child weekends off or even a summer-long break from his ADHD medications?
It may work just fine. Your child may regain his appetite and catch up on his growth. (Some ADHD drugs may slow this.)
Then again, a medication vacation may unleash the very behaviors that have been controlled by prescription drugs: hyperactivity, impulsivity, and inattention. That could put a strain on the child, you, and other caregivers. And there’s some evidence that keeping a child on his ADHD medications will ease symptoms better than stopping and starting.
There’s no one-size-fits-all answer. It comes down to what works best for you, your child, and your family. How you go about a medication break depends on what your child is taking.
"The bottom line: It isn't harmful and it's part of personalization of care -- not to have a standard that fits all, but to have a flexible approach that meets the needs of the individual child and family," says psychiatrist Benedetto Vitiello, MD, who leads the Child and Adolescent Treatment and Preventive Intervention Research Branch at the National Institute of Mental Health in Bethesda, MD.
Here's what you need to know about the pros and cons of drug holidays.
The Nature of ADHD Drugs
According to the CDC, about 6.1% of U.S. children ages 4-17 take medications to control symptoms of ADHD.
Most take stimulant medication. These include:
Others use nonstimulants, such as:
Stimulants and nonstimulants work differently.
Stimulants start working quickly and leave the body quickly. Because of that, doctors say it's easy to get on and off these medications. There are no withdrawal symptoms, so your child doesn't have to wean off of them.
But there are other things to consider. "On those meds, it's important to realize the treatments improve behavior and reduce symptoms," says Mark Wolraich, MD, a pediatrician in Oklahoma City who helped write ADHD treatment guidelines for the American Academy of Pediatrics. "If you stop taking them, you revert to behaviors you saw before. ... Stimulant medications don't build up in the bloodstream. That's why you can stop and start them.''
If a child is taking nonstimulants, you have to take longer breaks. ''You could do it [take a drug break] over the summer time, but not over the weekend,” Wolraich says. Nonstimulants shouldn’t be stopped for short periods because they take longer to go to work and far longer to leave the body. They can also have bad side effects if they are stopped suddenly.