ADHD Medication Holiday-What are they?

I had asked a question on our Facebook Page the other day, it asked parents their opinions and personal experience regarding having what is called "medication holidays". I received a lot of great opinions, stories, and more from the wonderful members to our page. I will share more on that, but let me first explain what I have learned about these medication holidays....


What are Medication Holidays?

  A medication holiday, also called drug holiday, drug vacation, medication vacation, structured treatment interruption, or strategic treatment interruption, is when a patient stops taking their medication(s) for a period of time. The period of time could be a couple days, weeks, months or years depending on the patient.


When do patients/kids have Medication Holidays?

Usually when a parent chooses to give their child a break in medication is it on the weekends (one or both days), during holiday vacations from school and during the summer months.


Most parents that do a vacation from meds do them on the weekends, some just during the school year and others will do every weekend all year round. Some just do one day and some do both every weekend. Others will have them off theirs medicines on the weekend unless they are going somewhere or doing something that makes the parent feel they should take their medicine.

Usually the parents that do weekends without meds will also let their child without them on holiday vacations from school such as Spring and Christmas/Winter breaks. 
 
Many people also stop medication all summer long. This means that they choose to not have any medications for the entire summer. Others will do it for the majority of the summer



and have the child take their meds for special events and outings.


Can Your Child have Med Vacations with His/Her ADHD Medication?

500,000+ children age 6-12 (in the US) take non-stimulant medication for ADHD such as Strattera, Intuniv, and Kapvay.  Dr. Mark Wolraich, MD, an Oklahoma City pediatrician says, these non stimulants take longer to work and much longer to leave the body and should not be stopped. Wolraich also says about taking a medication break, if a child is taking a non-stimulant medicines, "You could do it over the summer, but not over the weekend".
 
Around 3.5 million children with ADHD take a stimulant medications like Concerta, Ritalin, Adderall etc. These medicines act much more quickly and leave the body much quicker too, so there's no withdraw worries or having to wean off the medicine. 

Dr. Wolraich says,  "On those meds, (stimulants) it's important to realize the treatments improve behavior and reduce symptoms" he continued, "If you stop taking them, you revert to behaviors you saw before, stimulant medications don't build up in the bloodstream. That's why you can stop and start them."

 
Why have a medication holiday?

Through both my research as well as parents' input, I found that there are some really interesting reasons that parents will choose to give their ADHD child these holidays from their medicines. Although there are those very judgmental people out there that say these holidays are ridiculous, after reading different articles and seeing/hearing what parents had to say, I think there are a lot whose reasoning for implementing medication holidays not only make some sense but also show how much the parents want to help the child to live with and manage his/her ADHD in any situation and with or without medicine. Some of these include:

Decrease the Tolerance Effect.... As many of you know, when taking a medication over a

long period of time you gain a tolerance to the medicine. Well, some parents will choose to give their son/daughter one or all of the above holidays frome their meds to try to keep their tolerance low so they won't need to increase as often. 

Regain Effectiveness.... Parents will also do medicine breaks to keep the medication as effective with the child's ADHD symptoms. This kind of goes hand in hand with the reason above.

Help with Weight Gain/Loss Issues... There are many cases with ADHD medications, especially with stimulants, in children can curb their appetite causing weight loss or they can also gain access weight. In these cases, parents will choose to take breaks from the medication to help the child's appetite to help with these types of weight issues. I had a woman comment on our Facebook page and she said that her son will eat like crazy when he hasn't taken his medicine, but when he is on it he barely eats and so the breaks help him be able to eat better and be healthier. 

See if the Medication/Dosage is Still Needed... Doctors and parents will take the child off his/her ADHD medication for a period of time, usually throughout the summer months, to see if the medicine is still needed and if the same dosage should be used or changed. This is something usually done when the child is on a lower dosage or is showing signs of no longer needing medicine. If the child is showing signs of needing a possible increase the doctor will prescribe a higher dosage for a couple weeks and check up to see if it has helped. 
 
Deacrease Short/Long Term Side Effects.... Many parents are fearful of the lone term effects and even the immediate side effects of their child being on these ADHD medications. Therefore, they will take their child off their medicines for weekends/summer months so they can try to decrease these effects on their children. Although there are no real good studies showing any bad effects from long or short term use of these meds, I can surely understand the scare. 
 
These are the main reasons that parents of children with ADHD will give their child Medication Holidays. There are some parents that will do it just because they feel bad their son/daughter has to take medicine everyday and want to give them a break.

 I even had a couple parents that will take their child off medicine for the summer so they can work with them through counseling and therapy to help him/her cope with their ADHD and manage it better without meds. I think that is a great idea, if able to be done of course, because the more your child can manage his/her ADHD impulses, attention and focus on their own, the less medicine they may have to be on and the less academic support they may need the next year, and/or their medicine may work better because they are working with the medicine a little more.


Should Your Child Get Drug Vacations?

Every situation, child and family is different. Therefore, I can't really tell you whether or not it is a good or bad idea to try a medication holiday on your child. My opinion however, is that it all really depends on the child and his/her particular needs, and to always talk to your child's doctor before proceeding with any interruption in your son/daughters medicines. He/she will be able to guide you to the best possible options for your child's individual needs.  

I hope this answers some of your questions on what medication holidays are and why they exist. I will be writing more on this as I find out more. As always, thanks for reading!!

~Stacy


Resources- Dr. Mark Wolraich, WebMD, Child ADHD Info on Facebook, Parents of ADHD children.