When and How Should We Adjust Treatment?

Q: “Should My Child Skip ADHD Medication on Weekends?”

“Medication vacations are the biggest no-no that I can think of.”

Photo by Myles Tan via Unsplash https://unsplash.com/photos/WNAO036c6FM
Photo by Myles Tan via Unsplash https://unsplash.com/photos/WNAO036c6FM

Q: “What do doctors think of ADHD medication vacations? What happens if we don’t give our child medication on the weekends? Can we stop medication during holidays, school closures, and any other time our child isn’t in school?”

ADHD medication vacations are the biggest no-no that I can think of. I say that as a clinician with decades of experience treating children with attention deficit hyperactivity disorder (ADHD).

Often, parents are driven to give their child breaks from medication because of appetite reduction, sleep difficulties, and other side effects associated with taking stimulants. But medication vacations, even just on weekends, only increases the likelihood that side effects will occur.

[Read: ADHD Medication Vacation Pros and Cons]

Here’s why: The body and brain need to gradually adjust to the side effects of ADHD medication, if there are any. That can only happen if medication levels are constant. Side effects like appetite reduction and sleep difficulties tend to dissipate after a few steady weeks on medication. Children will begin to sleep better, and their appetite often improves to what it was before taking medication.

I can’t emphasize enough that this process takes time. If a child stops taking medication every weekend, then it is as if that child is newly starting on ADHD medication every Monday morning. The brain does not have a chance to adjust to medication treatment — an effect that is even greater with longer medication vacations. As a result, children experience fewer side effects if they take medication seven days a week, 365 days a year.

Medication adherence is a problem among teens, who commonly think they only need medication for school-related matters. But ADHD, as we know from research, affects practically all domains of life, from social relationships to driving. Consider the teen who wants to drive to meet their friends over the weekend. If they’re unmedicated, their risk for getting into an accident is two to six times greater than if they were on medication.

The bottom line: Think twice and talk to your physician before you stop your child’s treatment plan, even for a short break.

How to Treat ADHD in Children: Next Questions

  1. What ADHD medications are used to treat children?
  2. Is ADHD medication right for my child?
  3. What are common side effects associated with ADHD medication?
  4. What natural treatments help kids with ADHD?
  5. What if the medication stops working?
  6. How can I find an ADHD specialist near me?

The content for this article was derived, in part, from the ADDitude ADHD Experts webinar titled, “ADHD Medication Options and Benefits for Children” [Video Replay & Podcast #438] with Walt Karniski, M.D., which was broadcast on January 19, 2023. Dr. Karniski is the author of ADHD Medication: Does It Work and Is It Safe?

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