Should You Consider an ADHD Medication Vacation?

For many of us, ADHD medication is a fact of life. So is going off medication — or at least wanting to. Taking pills day in and day out can be a burden for adults, parents, and kids — but so can the resurgence in symptoms that often accompanies a decrease in or cessation of ADHD medication. How you approach the decision to take a drug holiday, however, makes all the difference in your ADHD treatment. Here's what you should know.

In a recent ADDitude survey, 48% of parents said they plan to give their child a break from ADHD medication that summer. The reasons were as varied as the 200 individuals surveyed, however common motivations included the following:

• 64%: Appetite suppression ("I was hoping he/she would catch up.")
• 60%: Symptom assessment ("I wanted to see if there was any improvement.")
• 58%: For learning only ("I only give my child meds on school days.")
• 52%: School holiday ("I always take my child off medication in the summer.")
• 38%: Side effects ("My child doesn't like the way medication makes him/her feel.")

Of the 59% of parents who said they stopped or decreased ADHD meds for their child last summer, just over half called the drug holiday a success. 41% said a decrease in ADHD medication caused more problems than it solved; 59% viewed the break positively. Many parents reported "impulse-control issues," "lack of focus," "emotional stress" and general household chaos that caused them to cut short the drug holiday or settle on a reduced dose.

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Nearly 10 percent of those surveyed said the ADHD drug holiday was such a success they "didn't even think about medication until fall.") Cited benefits of the medication vacation included improved growth, fewer mood swings, and less defiance. Other parents with children diagnosed with inattentive-type ADHD said that, without schoolwork to focus on, the medication wasn't necessary in the summer.

Many people choose to stop meds because they "feel good." They wonder: Would I feel just as good if I stopped the drugs?

It's not a bad question, says Timothy Wilens, M.D. But, there's a right way and a wrong way to discontinue meds. "I suggest a trial discontinuation if someone has been symptom-free for several months," says Wilens. "What you want to know is whether the medication has been responsible for all the improvement, or if the disorder itself is better."

ADHD is a chronic neurological disorder, but sometimes it does seem to go away. Studies suggest that many kids with ADHD outgrow aspects of the disorder before reaching adulthood. Why?

Some researchers theorize that the decades-long maturation process of the brain gradually repairs the errant brain circuitry associated with ADHD. Others attribute improvement to the gradual acquisition of coping skills. If symptoms are mild, and coping skills have indeed been burnished, says Wilens, meds may become unnecessary.

Even in cases where meds still work, side effects can become unbearable. This is one common reason that both ADHD children and ADHD adults take a break from meds when they can afford to. "I've gone off meds a number of times," says Robert Jergen, Ph.D., 36, associate professor of special education at the University of Wisconsin in Oshkosh. "Some drugs caused intense intestinal pains. Some made my heart race. One was effective at reducing my hyperactivity, but I couldn't sleep. The last medication I was on made it difficult to achieve and maintain erections, and caused vocal tics."

If you're considering going off medication, experts advise doing so only with the approval of your doctor. She may give you the green light, or she may suggest other options, such as adding psychotherapy or ADHD coaching to your drug regimen.

Your doctor may be able to ease your concerns by adjusting the drug's dosage or switching you to a new drug. "A lot of people don't realize how many drugs there are for ADHD," says Michele Novotni, Ph.D., a psychologist in Pennsylvania.

Don't stop your child's ADHD medication because of a news report or Facebook post about drug safety. Talk to your doctor about your concerns before making a change. Dr. Adesman tells of one patient's dad who wanted to take his kid off Ritalin. "The dad was troubled by a report suggesting that kids who take Ritalin are more likely to get cancer," says Adesman. This claim hasn't been proven. Once Adesman explained that, the father gave up his bid to take his child off meds, which had been highly effective.

Don't be too quick to declare success or failure. Stimulants are gone from the system in hours, but drugs like Strattera may continue to control symptoms for days, perhaps weeks, after the last dose. Hyperactivity will show up quickly, but impaired concentration and organizational problems can take up to six months to become evident. You may decide to go back on meds. If so, keep the experience in perspective. You've learned something valuable.

[Click to Read: Considering a Vacation from Your ADHD Medication?]

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?
   • How long will it take to get the medication and dosage right?
   • How do we know the medication is working?
   • When is it time to switch medications?
   • How can we safely treat ADHD alongside its comorbid conditions?
   • What should I do if my child stops taking their medication?
   • How can we solve medication rebound problems?
6. How can I find an ADHD specialist near me?