Managing Treatment

Are Drug Holidays Safe? Your Questions About ADHD Medication Vacations — Answered

Are drug holidays safe for children and teens with ADHD? Do they work? What happens when we re-start meds? Answers to your most common questions about medication vacations here.

A drug holiday is a “medication vacation” during which a patient deliberately and temporarily stops taking a prescription. It is also a controversial topic with strong opinions on both sides.

In my practice, I field many questions from parents of children with attention deficit hyperactivity disorder (ADHD or ADD) about drug holidays, especially over the summer. They often ask: Without homework or a school schedule, does my child need to continue to take their ADHD medication?

My answer is almost always the same: It depends.

Below are detailed answers to common questions regarding ADHD drug holidays to help you make an informed decision about your child or teen.

Drug Holidays: Questions About ADHD Medication Vacations

1. Are there cumulative effects of taking ADHD stimulants?

Methylphenidate and amphetamine are the most commonly prescribed stimulants for children with ADHD. They do not have cumulative effects over time. If your child takes one on a Monday, it works on Monday only. There’s not enough left in the blood to work on Tuesday.

[Get This Free Download: ADHD Medications Comparison Chart]

2. If my child only needs ADHD medication for school, why shouldn’t we take a drug holiday?

ADHD, by definition, doesn’t affect people in just one situation, like school or work. Disorganization, impulsive behavior, forgetfulness, difficulty paying attention, etc., also happen in many other circumstances. Some parents may decide they can manage their child’s behavior during a medication vacation while others may not. Some parents may feel the negative impact of ADHD symptoms outweighs any potential benefits of a drug holiday.

3. Will taking a drug holiday help us to figure out whether my child still needs ADHD medication?

If your summer vacation is spent lounging on the beach and playing video games, that scenario would not help you determine whether your children still need medication to thrive at school. You will only be able to answer that question if your children stop the medication while in school.

4. When my children re-start their medication, will they experience side effects?

Most people don’t, but some do. Usually, any side effects improve over time. Caregivers might want to discuss with their pediatrician how to help their children adjust to taking medication after a lapse.

5. Are there medical reasons to support taking a drug holiday?

For most people, no. ADHD medications are generally very safe. However, for children who have lost weight due to the side effect of appetite suppression, it may make sense to take a break from medication to regain weight.

[Read: The 5 Most Common ADHD Medication Side Effects — and Their Fixes]

Parents are often concerned that medication use may affect height. Studies are not conclusive on that, including whether brief times off the medication will mitigate any negative effects on height, or to what extent.1 Many doctors feel that, if weight gain is appropriate, height will not be affected.

If you are considering a drug holiday because your child is experiencing side effects, such as a loss of appetite or headaches, or if you’re avoiding giving your child ADHD medication because of potential side effects, be sure to let your doctor know. Many new and different stimulants are on the market now; you and your child’s doctor can work together to find one that is effective with minimal side effects.

6. Are there risks to taking a drug holiday?

Yes, especially for teens with ADHD. If your teen is too impulsive, hyperactive, or distractible behind the wheel of a car, for example, then a drug holiday can be dangerous. A driver who has severe ADHD, and who is not taking medication to manage those symptoms, can be a danger to himself and to others.

For some teens with severe ADHD, going without medication may mean engaging in or returning to other behaviors that are risky, including substance use or unprotected sex. For younger children with ADHD, the risks of ceasing medication may include behavior infractions and social challenges at summer camp, for example.

Drug Holiday: The Bottom Line on ADHD Medication Vacations

As a medical doctor, I can tell you that the decision to give your child a drug holiday is largely not a medical decision. It is a family decision. It’s important to talk with your child’s doctor before making a drug holiday decision, whatever the circumstances. Ultimately, you will want to think about the benefits your child experiences while taking medications, and whether they outweigh any side effects.

Drug Holidays for ADHD Medications: Next Steps


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Sources

1 Ibrahim, K., & Donyai, P. (2015). Drug Holidays From ADHD Medication: International Experience Over the Past Four Decades. Journal of Attention Disorders, 19(7), 551–568. https://doi.org/10.1177/1087054714548035

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