Pick the right time
Don't try it during tax season, for example, or before a big project at work. "Do it during a period of stability, not stress," says Lenard Adler, M.D., director of the adult ADHD program at New York University. "If there's a lot going on — trouble at home, major life changes, like buying a new house or changing jobs — that's not the time. You won't know what's influencing symptoms." For children, summer is often the safest time for a trial discontinuation. Of course, ADHD symptoms can be disruptive in a school setting, and a child who does well off medication in July may have problems once September rolls around. In some cases, late fall is the best time.
Don't go cold turkey
Although discontinuing ADHD drugs generally does not cause withdrawal symptoms, physicians often recommend tapering. "I'll try cutting the dose in half for a week or so," says Timothy Wilens, M.D. associate professor of psychiatry at Harvard Medical School. "If things are going well, then I'll take the rest away." If symptoms return at the halfway point, there's no need to wait for a "crash" to know the medication really is necessary. If problems don't surface until all the meds are gone, says Wilens, "you've learned that maybe you can get away with a lower dose."
Enlist the help of a therapist or ADHD coach
Work together to add structure and coping strategies that will help control symptoms that arise. "Exercise has been a godsend," says Robert Jergen, Ph.D., associate professor of special education at the University of Wisconsin in Oshkosh. "There are times when I can't focus well enough to read or write, but as soon as I jump on a treadmill and break a sweat, my mind clears. I've also learned to construct environments with certain lights and sounds that help me calm down."
Stay in close touch with your doctor
"You need more contact when you discontinue medication, not less," says Margaret D. Weiss, M.D., Ph.D., director of the ADHD Clinic at Children's and Women's Health Centre in Vancouver. She prefers weekly visits (though other professionals say once a month is sufficient). Alert your doctor to problems as soon as they arise. Don't wait until they reach crisis proportions.
Ask friends and family members to keep an eye on you
Teachers and co-workers can provide valuable feedback as well, although whom and how much to tell are often delicate questions. In his junior year of high school, Jason Wood, of Chesapeake, Virginia, wanted a break from the medication he had been taking since the first grade. So he and his mother took a novel approach. "We didn't tell anyone for a month," he says. The idea - endorsed by Jason's doctor — was to see if others noticed, and to go back on meds if he experienced problems. "But all the responses we got were positive," he recalls. "People said I seemed happier, peppier, easier to get along with." A year later, he's still doing well and getting ready for college.