Drug Holidays During ADHD Treatment

With school ending and summer vacation starting, many parents of children with ADHD wonder whether or not it makes sense to do a “drug holiday” until school resumes in the Fall.  The Child Mind Institute recently provided some commentary on this issue for both parents and clinicians. 

The bottom line answer, as it is for many things in our field, is “it depends.” For many children, ADHD symptoms extend far beyond the classroom, especially those with more hyperactive-impulsive symptoms.  Starting a new camp, taking a family vacation, or even spending more time hanging around with siblings may all be impacted by having ADHD behavior flare up without treatment.   Consequently, it makes sense to many experts that the “default” position is to continue treatment during the summer. 

On the other hand, there are certain conditions for which a summer break from ADHD medications, especially stimulants, may be very reasonable.  Those instances could include the following.

  1. Children whose appetite and potentially growth have been negatively impacted by medications
  2. Children who have behavioral side effects of medication such as increased irritability or fatigue (although if these are significant it may make sense to consider a medication change overall)
  3. Children with predominantly inattentive symptoms who are really being treated to keep up at school (as long as they can do some things like continue reading during the summer)

Presently, we do not have evidence that drug holidays help maintain the potency of the medications when they are reinstated.  Nevertheless, this decision is often a good place for a clinician to follow the lead of the parent and the child.  If there is a strong desire to try it and no clear contraindication to doing so, then it often is the right move.

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