Should my child take an ADHD drug holiday?

Q. Should my daughter go off her ADHD medication — or take a “drug holiday” — during the summer or holiday breaks?

A. For some children, it may be a good idea to take a break from their usual medication for ADHD over the summer. For other kids, taking a “drug holiday” can be a real mistake. Deciding what to do requires parents and prescribers to weigh several factors:

• How kids behave when they aren’t taking their ADHD medication

• Whether they’re experiencing side effects from the medication

• What they’re going to be doing during the summer months, holidays, and other breaks

Years ago, many doctors thought that all kids who were taking ADHD medications needed to go on “drug holidays” from time to time. Back then, there were concerns that the medications might stunt a child’s growth. But we now know that most kids on ADHD medications do not have any serious long-term problems with their growth rate.

However, there are some reasons to reduce the dose or stop the medication over the summer, or even during shorter holidays, like winter break. This might not be a bad idea if your child happens to be very small for her age. The same goes if your child is a bit underweight. It might make sense to reduce the dosage during the summer if the medication has a big effect on her appetite.

Some children taking stimulants for ADHD find their appetite declines on days when they are taking the medication. Usually that lasts only for the first few weeks after starting the medication, but for some it continues much longer. For the holidays, especially, they may enjoy the chance to eat more heartily if they’re not on any medicine.

Another reason some kids take a break is if they don’t need the medication very much when they aren’t dealing with school and homework. Some kids function quite well without it for most other activities like playing sports and hanging out with friends and family.

Also, other kids, particularly teenagers with ADHD, do not like being required to take any medicine every day. They may appreciate being allowed to decide whether or not to take medicine when it’s not essential to do so.

Talk with your child’s doctor. If the doctor agrees to stop the medication for the summer or over a holiday break, he might recommend restarting at a reduced dose about a week before school starts.

Doctors often use this kind of phase-in so kids won’t feel too jittery from suddenly starting at the dose they were used to before. This approach tends to be used after kids have taken a break for more than a week or two.

But there are lots of kids who need ADHD medication for more than just school and homework. Does your daughter need medication to help with things like following directions or getting along with other kids? Then it’s probably a good idea to stick with the medication. It could help her adapt to changes in her usual routines that happen during summer and holiday breaks.

Summertime can be quite unpleasant if there are many days when your child gets caught up in hassles with other kids. Going off medication can also make some kids extremely moody.

Another reason many kids keep taking medication is that it may help curb risky behavior. Things like boredom and low self-esteem can lead some kids with ADHD to endanger themselves or others. This is a constant concern. But it may be especially important in the summer or during breaks from school when kids have more free time.

As you’re thinking about what to do, keep in mind that this doesn’t have to be an all-or-nothing decision. For example, if you’re curious about taking a medication break during summer, consider whether your child will be going to summer school. If so, then it might be a good idea to continue the medication for at least the weeks when she has classes.

Also, summer school is often just a few hours in the morning. Taking a short-acting type of ADHD medication might work well on those days.

Camp is another activity to consider carefully. I’ve heard stories about parents sending their kids off to camp without their ADHD medication — and without telling the camp their kids have ADHD! This can lead to all sorts of trouble.

Taking ADHD medication during camp may help your child participate more fully and successfully in camp life. Most sleepaway camps have a nurse or other staff member whose job is to keep the medication safe. This person will also make sure your child gets it at the right times. For day camp, longer-acting medications can be given at home just as they would be during the school year.

Whether you decide to stick with medication during camp or take a break, it’s a good idea to talk to a camp staff member. Sharing behavior strategies that work for your child at home or in school can help smooth the transition.

Just be sure to talk to your child’s prescriber as you’re debating whether to take a break from ADHD medication. Together you can come up with the best plan for your child to follow over the summer and during the holidays.

Find out what your younger child, or tween or teen, needs to know about ADHD medication. And learn about signs your child’s ADHD medication needs fine-tuning.

Understood is not affiliated with any pharmaceutical company.