Thinking of a medication vacation for your child? Here’s what you should know

As we approach the year-end school holidays, many parents plan on giving their ADHD-diagnosed kids a medication break. If you’re considering that for your child as well, read this before you pack away the medication!

In a survey conducted by the US-based ADHD magazine, ADDitude, earlier this year, almost half of all parents planned on giving their child a break from their meds. Common reasons include concerns about appetite suppression and hoping that their child will pick up some weight, and they want to see if there’s any improvement in symptoms and evaluate the effectiveness of the medication. Some parents have opted to only use medication when the child is at school, or the child simply wants a break from the side-effects and the way it “makes them feel”.

To ensure that the medication holiday is a good experience for your child and the family, consider these points before you decide:

• Holidays are the best time to take a medication break, because if your child does struggle with symptoms, it won’t affect their academics and you can keep an eye on how they’re doing.
• Treatment reduces the core symptoms of ADHD, so when your child is no longer on the medication, those symptoms will return. Stimulant medication – methylphenidate and atomoxetine – can be started and stopped immediately. They start working within the hour and last several hours (an extended-release stimulant will last for up to 16 hours). And once you stop taking them, they’re gone from the system within hours. The major side effects – decreased appetite, weight loss, and slowed height growth – will be reduced when the medication is stopped, or the dosage is decreased.
• Unlike stimulants, nonstimulant medications – atomoxetine, guanfacine, and clonidine – take weeks to begin working. Atomoxetine, for instance, takes up to six weeks before it reaches maximum effectiveness, so for kids on atomoxetine, it’s recommended that they stay on their medication.
• Consider your child’s holiday activities. If their planned activities require concentration, extended periods of sitting still, or attendance at important events like family weddings or reunions, it may be wise to continue using the medication.
• Experts advise that a medication vacation should only be done with the approval of your doctor.
• Keep in mind that a medication break is not the only option. Discussing alternative strategies with your doctor, such as lowering the dosage, switching to a shorter-acting form, or trying a different medication, may be worth considering.

Furthermore, it’s important to know the pros and cons of a medication holiday.

Pros

• It alleviates side effects. For those who experience side effects (alongside improved symptoms), a medication holiday provides relief, such as less mood swings.
• It can work for children with inattentive-type ADHD, since they don’t need to focus on schoolwork.
• It can be used to evaluate the effect of medication. Doctors use a medication vacation to see the effects of medication, or in the case where someone has been symptom-free for several months, a medication holiday is used to gauge how much of that is due to the medication.
• It can also be used to manage drug tolerance, in the case where a medication isn’t as effective as it once was.

Cons

Of course, the biggest drawback of a medication holiday is the re-emergence of symptoms including impulsivity, lack of focus, emotional stress, and the potential disruption within the family and home. Remember, even if you initially choose a medication holiday, you can always re-assess and change your mind if needed. However, experts caution against extending the break into the school year, as children with ADHD are often sensitive to environmental changes and transitions.

Making an informed decision in consultation with a healthcare professional is essential when considering a medication break for children with ADHD. Weighing the potential benefits and drawbacks will help ensure the best outcome for the child’s well-being and overall family dynamics over the holidays.

References

1. Elliot, G. (n.d.). ADHD: The Pros and Cons of a Drug Holiday. CHC [Online]. Accessed on 24 November 2023.
2. Iannelli, V. (2023). ADHD Adderall Drug Holidays for Children. Very Well Mind [Online]. Accessed on 24 November 2023.
3. Ravitz, A. (2023). ADHD: The Pros and Cons of a Drug Holiday. Child Mind Institute [Online]. Accessed on 24 November 2023.
4. Sherman, C. (2019). Considering a Vacation from Your ADHD Medication?. ADDitude [Online]. Accessed on 24 November 2023.
5. Sherman, C. (2023). Should You Consider an ADHD Medication Vacation?. ADDitude [Online]. Accessed on 24 November 2023.
6. WebMD. (2022). Should Your Child Take an ADHD Medication Break?. WebMD. Accessed on 24 November 2023.