Taking a break from ADHD medication is common, and choosing to temporarily come off medication during a time when mental demand is lower can be a good strategy, such as during summer or winter break. For parents, though, the choice to take a ‘drug holiday’ is nuanced. On one hand, there are many benefits to be had when children take their medication as prescribed, and there can be behavioral issues when they don’t. But on the other hand, taking a short break from ADHD medication can help manage any side effects and help you evaluate your child’s baseline.
Let’s explore both sides of this debate and help you make an informed decision about whether or not to give your child a break from ADHD medication during school holidays.
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What’s a medication holiday?
A medication holiday is a planned period of time—for medical or personal purposes—when prescribed medication is temporarily suspended.
Because stimulant medications are fast-acting and fast to leave the body, there are usually no withdrawal symptoms. However, not all children are good candidates for a break in medication management for their ADHD symptoms. Parents should always consult with your child’s doctor before taking a medication break, especially to make sure he or she can safely transition off their medication.
If you’re considering discontinuing your child’s medication over the winter holidays, there are a few things to consider, both medically and personally.
Related: 10 Mental Health Activities to Do with Your Child
What should parents consider when taking a drug holiday?
ADHD medications, like Ritalin, Adderall, Focalin, and Concerta, and others, treat hyperactivity, distractibility or impulsivity. Therefore, when you start to weigh the benefits and risks of stopping medication, it’s important to consider how any behavioral changes might affect your child during any activities, gatherings, or family time you have planned.
- Will your child be able to get through the day, and without stressing out other family members?
- How well can they complete tasks and participate in family activities?
- What about possible meltdowns, trouble controlling emotions and behavior, or making poor decisions that result in an injury?
- If large family gatherings are planned, would ADHD symptoms make it difficult for your child to interact or relate?
- If the plan is for a relaxed, unstructured holiday at home, would ADHD behaviors make this difficult?
- If a road trip or plane ride is involved, would your child feel restless or have trouble sitting still for extended periods of time?
Read: At-Home Strategies to Treat ADHD without Medication
Pros of taking a break from ADHD medication
A temporary break from ADHD medication can be a helpful tool for both children and their parents, both in the short-term, and to manage treatment in the long-term.
For example, some people experience side effects from stimulant ADHD medications. Side effects in children can include a reduced appetite, delayed growth, sleep problems, and headaches (1). Parents should ask themselves if side effects are significant enough that a break would be beneficial.
Drug holidays from stimulant medication can help parents identify whether your child’s symptoms are actually due to the medication, or another factor.
Your child’s doctor may even recommend a break to assess their ADHD as your child grows. While most children experience rapid re-emergence of ADHD symptoms following stopping their medication, about 30% of kids don’t relapse or deteriorate when taken off their stimulant (2). Trying to taper off every year or two may be a helpful tool to come off medication as your child grows up.
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Possible complications from taking a medication break
As parents consider the pros and cons of a drug holiday, it’s important to note that discontinuing your child’s medication is likely to present some challenges.
ADHD medications are not only beneficial for performance in the classroom. Kids’ social and emotional regulation is part of healthy development. Discontinuing medication over a holiday may interrupt this development and possibly set them back in terms of mental health (3). For children with ADHD, staying on their medication likely helps them spend time with siblings, friends, and family in a healthy and relaxed way.
Additionally, with older children and teenagers with hyperactive or impulsive symptoms, it may be an issue of safety. These types of ADHD may lead to antagonizing family members, sensory issues, verbal attacks, or they may participate in risky behaviors due to poor decision-making.
For many kids with ADHD, staying on medication even when school is not in session makes them feel happier and more confident in social and team situations.
Medication helps kids outside the classroom, too
This will come as no surprise to any parents of a child with ADHD, but medication management is not to make life easier for caregivers, teachers, or other adults in a child’s life (even though that may very well be a side effect). It’s a tool to help children develop healthy social and emotional skills, and help your child have positive, successful life experiences.
There is also research suggesting that drug holidays do not benefit children (unless there is a compelling reason for them) (4). Children with ADHD who stick with their medication treatment year-round have better outcomes than those who take periodic breaks. This is likely because ADHD symptoms affect more than just academic learning (5).
Outside of a school setting, your child may still have to deal with recurring failures during activities, unsuccessful interactions with their peers, or other misunderstandings which can be devastating for your child’s confidence and self-esteem.
Read: What Causes ADHD? The Link Between Diet, Chemistry, and Your Environment
Could taking a break benefit growth and development?
Proponents of taking a break from ADHD meds are concerned about evidence that taking stimulant medications can affect a child’s physical development.
One study showed children taking stimulant medication for ADHD showed reduced height and weight compared to their peers between a year and 5 years after being on their medication (6).
A long-term study in the journal Pediatrics followed 1,020 kids from childhood to adulthood and found that any height discrepancies were either negligible or non-existent between kids who had and hadn’t taken stimulants for ADHD (7). Other research points to taking a planned break in medication use—such as over winter break—to essentially negate any differences in childhood growth rates while taking stimulant medication (8).
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Non stimulant medication vs stimulant medications
For some kids, what may warrant a break in stimulant use is that these types of medications suppress appetite. Due to this fact, eating too little definitely has the potential to affect growth and development in children. If your child struggles with appetite while taking their ADHD medication, you may more strongly consider an ADHD drug holiday to help bolster appetite.
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Questions to ask your child’s doctor
Ultimately, you know your child best, and decisions about whether or not a drug holiday is the right choice should come after a conversation between your family and your child’s doctor. Your practitioner should make you feel comfortable enough to have an honest discussion about benefits, risks, and considerations, like:
- What side effects is your child experiencing from medication?
- Is my child on a short-acting or long-acting medication?
- How difficult or disruptive would symptoms become over the break?
- What kind of follow up should we have in place if a break doesn’t go well?
Even if you conclude that taking a break from medication isn’t right for your child, you may still be able to work in shorter breaks, depending on your circumstances. If your child uses short-acting medications, such as Adderall or Ritalin, you could look at targeting these types of medications toward the most challenging activities or events during your holiday.
If your child is prescribed a long-acting medication that lasts 24 hours, discuss with your prescribing physician a plan for safely transitioning off over a longer break, such as the summer or winter holiday.
Is a drug holiday right for your child?
Because ADHD affects social development as well as academic performance, the conservative approach is to avoid disrupting the prescribed treatment plan. However, there are no hard and fast rules on this issue, and each situation is different.
Before taking a treatment break, you should:
- Consider what type of medication your child is taking
- Consult with your child’s doctor
- Consider any behavioral issues that may arise from stopping medication
- Have a plan if the temporary break doesn’t go well
Schedule a new patient appointment or follow up for your child today.
Treatment for ADHD symptoms at CentreSpringMD
Our approach can help you, or your child, attain a fulfilling, balanced life with ADHD. With our holistic approach, our team of integrative providers will work with you to create an individualized ADHD treatment plan. This may include ADHD supplements and medication, diet & lifestyle changes, and more.
Schedule an appointment today with one of our licensed functional physicians. We can test various underlying digestive, cognitive, and hormone factors that play a role in ADHD symptoms, and create an individualized treatment plan for ADHD.
Along with conventional medication management, we offer nutritional therapy, detox & heavy metal evaluation, gut functional analysis, and more. Stop suffering and get treatment today to improve your child’s focus, behavior, and quality of life while learning to navigate ADHD symptoms.
Resources
- https://pubmed.ncbi.nlm.nih.gov/25253684/
- https://www.frontiersin.org/articles/10.3389/fpsyt.2021.642798/full
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5973442/
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6223995/
- https://childmind.org/article/adhd-pros-cons-drug-holiday/
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4624592/
- https://publications.aap.org/pediatrics/article-abstract/134/4/e935/77034/ADHD-Stimulant-Treatment-and-Growth-A-Longitudinal
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2821235/
