How Do I Manage Medication Side Effects?

ADHD Medication Vacation Pros and Cons, According to ADDitude Readers

Thinking of an ADHD medication vacation for your child? You’re not alone. Caregivers tell ADDitude why they do (or don’t) encourage their child to take a drug holiday, and reflect on past experiences.

April 29, 2022

Medication vacations are a taboo topic. They are also extremely common. More than three-quarters of children who take medication for attention deficit hyperactivity disorder (ADHD or ADD) have paused their prescription for at least one week — and most for much longer, according to an ADDitude survey of 1,252 caregivers.

Nearly 86% of caregivers have considered giving their child a medication vacation, otherwise known as a temporary “drug holiday,” and only 35% have ruled out a medication vacation this summer.

“We’ve come to realize that the medication not only helps our son stay focused when doing a task, but it also helps with our quality of life as a family,” wrote the mother of a 10-year-old boy with ADHD who experiences appetite suppression.

Factors Driving ADHD Medication Vacations

The most common reasons cited for taking a medication vacation were:

  • 55%: Appetite suppression (I was hoping my child would catch up in growth)
  • 54%: School-only (I only give my child medication on school days)
  • 42%: Discomfort with meds (My child doesn’t like the way the medication makes them feel)
  • 42%: Other side effects (I wanted to troubleshoot side effects other than appetite suppression)
  • 42%: Annual break (I always take my child off medication in summer)
  • 38%: Assessment (I wanted to see if there had been any improvement in ADHD symptoms)

My child says he can’t be himself when he is on medication,” said the mother of a 14-year-old boy with ADHD. “He is at an important time in his life, figuring out who he is as a person, how to be respectful and responsible, and he wants to learn these things without the medication.”

[Get This Free Download: The Ultimate Guide to ADHD Medication]

ADHD Medication Vacation Timing

Of the caregivers who have given their children a medication vacation:

  • 42% did so in summer
  • 31% did so in winter
  • 58% consulted with the prescribing physicians first

“Because it was summer, we had more flexibility in our schedule so we could live with more chaos,” said the mother of a 15-year-old girl with ADHD. “She didn’t have expectations put on her that would require a higher level of attention.”

ADHD Medication Vacation Ratings

On average, caregivers rated the medication vacation as somewhat successful, and it varied with the child’s age. Here’s the breakdown for caregivers who said a medication vacation was somewhat to extremely successful:

  • Elementary school: 47%
  • Middle school: 49%
  • High school: 61%
  • College and beyond: 44%

“We attempted a medication vacation but two days without my son’s medication prompted us to resume,” wrote one caregiver. “It was in the best interests of our family for him to continue with his daily routine and medications.”

[Read: Are Drug Holidays Safe? Your ADHD Medication Vacation Questions — Answered]

Of those who took a summer break from medication, 53% called it a success. That number rose slightly to 56% among families who took medication vacations during the academic year. Of those who took a medication vacation in the fall, 16% said it had a positive effect on school performance; 12% said it had a negative impact.

“We took my son off medication for two months at the beginning of his junior year,  at the request of his doctor,” wrote the caregiver of a 17-year-old boy with ADHD and ODD who took a medication vacation to address side effects. “My son was more spontaneous. He displayed fewer motor tics. He was more verbally expressive, more sociable, and more concerned about hygiene issues. However, he went back on his medications because he was unable to concentrate and complete tasks, and his grades suffered. He also displayed a lot more hyperactivity.”

“We did a drug holiday during winter break,” wrote one parent of a 9-year-old boy with ADHD. “Behavior issues were anticipated and manageable at home.”

“It was successful for our purposes, which were to increase his appetite and to help him realize that he needed the medication,” wrote the mother of an 8-year-old boy with ADHD.

One parent said she felt she could no longer “force” her 16-year-old student to take his ADHD medication. “Ultimately, it is my child who makes the decision about whether and when he will take the medication, and what other treatment avenues he will pursue. This is a shift that happened when he reached high school, and began asserting more independence, as he should. He needs to understand that he is in control of his own body and treatment, and deal with the consequences of his decisions.”

“On the second day of a medication vacation, my child wanted her medication back,” wrote another parent. “She was tired of all the emotions, the thoughts running through her head, the mood swings, the lack of focus and concentration. She felt that she could never finish anything.”

The Role of Comorbid Conditions in Medication Vacations

Comorbidity factored into the decision for many families as well. Among survey respondents, the following co-occurring diagnoses were cited most often:

“My son quit taking his medication because he said it caused his anxiety to worsen,” wrote one Pennsylvania mother. “He has continued to do poorly in school since quitting, but at age 14, children are allowed to make their own mental health decisions.”

“Our medication holiday, in consultation with our child’s pediatrician, was a break from one of the stimulant medications she takes in order to determine suspected side effects,” wrote the mother of an 8-year-old girl with ADHD and anxiety. “It helped us pinpoint and determine that some behaviors occur more often when she takes that medication, and that has helped us understand how the stimulant works so we can make more informed choices about when she takes it. It helped us figure out some strategies to burn off some of that restless energy successfully and it’s given us a greater understanding on this journey.”

ADHD Medication Vacations for Children: Next Steps

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