More than 6 million children have been diagnosed with attention deficit/hyperactivity disorder (ADHD), according to the U.S. Centers for Disease Control and Prevention (CDC). And a 2016 study revealed that 62% of children with ADHD took medication to manage their symptoms.
Stimulant medications, such as Adderall and Ritalin, help children with ADHD to focus—especially at school. Without those prescriptions, kids with ADHD might have trouble paying attention to lessons, staying in their seats, or completing assignments. Some parents consider stopping medication when kids aren’t in school, sometimes referred to as a “ADHD drug holiday,” under the impression that the same level of focus isn’t needed.
What is a drug holiday?
An ADHD drug holiday is the practice of stopping ADHD medication for a period of time, usually during a vacation from work or school, when it’s perceived that focus and concentration aren’t required. Some of the stimulant medications used to treat ADHD wear off quickly, leaving the system within hours. Some children experience a flare of symptoms as medication wears off, referred to as rebound.
Why consider an ADHD drug holiday?
There are many reasons that parents consider stopping ADHD medication. Among the most common are side effects and assessment if medication is still necessary.
Physical development concerns are the main reason parents want their children to get a break from their meds, says Sara A. Spencer, Pharm.D., clinical instructor of pharmacy practice at the Binghamton University School of Pharmacy and Pharmaceutical Sciences in Binghamton, New York. Appetite loss is a common side effect of stimulant medication, which can cause some children to lose weight. Some “studies have shown that children on stimulant ADHD medications tend to lag in height and weight compared to their peers,” Dr. Spenser says. However, other research by the American Academy of Pediatrics maintains that ADHD medication does not stunt children’s long-term growth. Worries about height and weight can lead many parents to discontinue medication in school breaks.
Also at play is basic ADHD management, Dr. Spencer explains. Parents want to see if there’s still a need for medication, and a summer break is the best time to check-in. But that doesn’t mean that a medication vacation is right for everyone.
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Risks of an ADHD drug holiday
Many children with ADHD will still need to control their symptoms with medication, even outside of school. “ADHD can affect many other aspects of a child’s life,” says Dr. Richard Silver, director of the Thrive Center in Columbia, Maryland. “Can the child control their impulses in social situations? Can they manage their emotions? The child may have tasks to complete that aren’t academic, like chores at home or tasks at camp. Stimulant medications can help with those as well.”
ADHD is associated with a big increase in deaths, mostly from accidents, but suicides and drug overdoses are also more common in both kids and adults with ADHD. This issue should also be discussed when considering a treatment holiday.
Dr. Silver goes on to say that parents should consider the end result of their children’s medications, not just on school performance, but on functioning in life. These medications often help the child do better and feel better in many settings. Therefore, you should only consider a drug holiday if your child is using the medicine strictly for focusing at school. And above all, you shouldn’t make this decision alone.
“Discontinuing any medication, even temporarily, warrants a discussion between the provider and patient/caregiver,” Dr. Spencer says. “Parents and children should be aware that discontinuation of ADHD medications may lead to symptoms of withdrawal, decreased energy, or depression.”
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The bottom line is, there is not one right answer that will fit every child with ADHD. If you think your child might benefit from an ADHD medication vacation this summer, talk to your doctor.