ADHD Weekly, May 18, 2023

Are you considering a medication holiday during the coming summer break? Many parents decide on this course of action for the summer months, when their child with ADHD doesn’t need to focus intently, as they do during school.

A medication holiday is a planned period of time, for medical or evaluation purposes, when prescribed medication therapy is put on hold for a limited time. Such medication breaks should be undertaken only with the guidance of the child’s prescribing medical practitioner.

Because stimulant medications are fast-acting and quick to leave the body, there are no withdrawal symptoms. When should you discuss a medication holiday with your child’s medical provider? What are the potential effects of such a pause, and what should you consider before the break from medication?

Why take a medication holiday?

Some people experience side effects from stimulant medications. These side effects can include a loss of appetite, sleep problems, delayed growth, and headaches, among others.

If your child is taking stimulant medication as part of his treatment plan and seems to be experiencing side effects, ask his doctor whether it would be helpful for him to take a break from the medication. Breaks can be undertaken when demand is less high: over a weekend, during a school vacation or summer break, or any combination of these changes in routine. They can help relieve side effects or demonstrate the need for continued medication if the child’s symptoms increase dramatically.

Are medication holidays recommended?

A review of studies that focused on the long-term outcomes of using stimulants to treat ADHD symptoms found they are a safe and effective treatment when used as prescribed. Optimal treatment includes careful dosage for the patient and consistent follow-up and dose adjustment when needed. For more information about effectively managing ADHD medications for young children and adolescents, visit Managing Medication for Children.

There are benefits and drawbacks to medication holidays for parents to keep in mind.

Some people believe such a break will give their children the opportunity for a regular appetite and growth spurt.
“By taking kids off [medication] during summers, you do allow some room so that a growth spurt can occur,” says Josephine Elia, MD, a pediatric psychiatry specialist at Nemours Children’s Hospital-Delaware. She recommends medication holidays to help with physical development.

Once medication treatment is halted or paused, ADHD symptoms return and can cause difficulties during the summer.

“Kids who are being treated for ADHD do better in more than just the classroom,” says child and adolescent psychiatrist Alan Ravitz, MD. “Medication has to do with managing behavior in a variety of different circumstances.”

What to consider

Weigh the benefits of alleviating medication side effects versus the risk of untreated symptoms:

Side Effects:

• • What side effects is your child experiencing from his medication?
  • Are they significant enough that you think a break would be beneficial?

ADHD Symptoms:

• • How severe are your child’s ADHD symptoms?
  • How difficult or disruptive would those symptoms be if they return during the summer?

Keep in mind what the potential outcomes of a medication holiday might be for your child. ADHD symptoms that have been controlled by the medication may increase significantly. This might result in problems during summer activities or care, at home with family members, and challenges related to social skills.

If your child will be attending a summer camp or other daily program that requires focus and social interaction, an increase in symptoms may have a negative impact on his happiness and self-esteem.

Finally, and most importantly, consider the advice of your child’s healthcare professional.

Time to take a holiday?

The bottom line: You know your child’s needs better than anyone. If the side effects of stimulant medication are significant—for example, he eats far too little food because the medication affects his appetite—it may help to take a break. If you understand the likely effect of taking a break and think that the benefits will outweigh the challenges, discuss the options with your child’s healthcare provider.

Read more on medication holidays and what to expect:

• What ADHD Medication Can and Can’t Do
• Summer Break, Treatment Break?
• Is a Medication Holiday an Option for Your Child with ADHD?
• What to Ask Your Child’s Doctor About New ADHD Medications
• Do Stimulant Medications Reduce Adult Height? Not Likely
• How to Talk with Your Child About Starting ADHD Meds
• Discontinuing ADHD Meds
• ADHD and the Decision to Medicate
• Podcast: Understanding the ABCs of ADHD Medications

Join the discussion: Has your child had a medication holiday? How was the experience?