Can You Take an ADHD Medication Holiday?

Everyone needs a break occasionally. That’s why summer vacations, school breaks and paid time off exist. But for people with attention-deficit/hyperactivity disorder (ADHD), those breaks may also be an excellent opportunity to take time off from their medication.

ADHD medication holidays aren’t for everyone, and there are pros and cons to taking a break from your medicine, says pediatric behavioral health specialist Michael Manos, PhD. Each person reacts differently to medication and medication breaks. Taking a medication break is a serious decision you should make with your healthcare provider.

Dr. Manos shares information to consider if you’re thinking about taking a vacation from ADHD meds.

What is a prescription drug holiday?

A medication holiday is called a “structured treatment interruption.” It means taking a planned break from medication treatment.

“The ‘structured’ part is important,” Dr. Manos notes. “Drug holidays should happen under the supervision and direction of a provider. A missed dose or lapse between prescriptions doesn’t qualify as a medication vacation.”

There are several reasons a provider may recommend that you or your child take a break from ADHD medication, such as:

• Medication side effects interfere with growth, development or quality of life.
• The medication dosage is less effective than it once was.
• You no longer feel you need the medication.

ADHD drug holiday benefits

Providers may be more likely to recommend a medication vacation for children than adults. That’s because children have scheduled breaks from school, so they have extended periods where they may not need the effects the medicine provides.

Another reason is evidence that ADHD medications may cause growth problems in children. These effects tend to be most noticeable in the first two years after starting medication. But kids catch up over time.

A medication holiday may help counteract these growth issues. Studies show that taking longer breaks from ADHD medications can positively impact children’s growth.

Some adults may also benefit from an ADHD medication break. A break from ADHD medication may allow you or your child to:

Relieve uncomfortable side effects

A medication break can provide some relief from the most common side effects associated with ADHD medications:

• Difficulty sleeping: Common stimulant medications may cause trouble falling and staying asleep.
• Weight loss: This typically results from decreased appetite, which affects up to 80% of people who take ADHD medications.
• Irritability: This can be caused by fluctuations in dopamine, norepinephrine and serotonin.

Research in children shows that taking supervised and planned medication breaks can immediately improve a child’s appetite and ability to sleep.

“When children experience these side effects, it can impact their growth and development,” Dr. Manos reiterates. “Taking time to relieve these issues can be critical for a child. But the ultimate goal is to find treatment for that child’s ADHD that doesn’t cause these side effects.”

Improve drug effectiveness

If ADHD medication is no longer working as it should, you may require a dose adjustment (this can be either an increase or decrease of dosage). Another option is a drug holiday. Taking a break from the medication under your provider’s supervision can help you maintain sensitivity to the drug, so it’s more effective when you begin taking it again.

Evaluate how well ADHD medication is working

An ADHD medication holiday offers some people an opportunity to assess the effectiveness of their prescription. Adults and older children who have symptoms might consider talking to a provider about a structured treatment interruption if you:

• Feel symptoms are well managed and have been for a while.
• Developed coping skills or environmental supports to help manage ADHD symptoms.

“As you get older and demands increase, the need to focus your attention also grows. You have more responsibilities and tasks,” Dr. Manos shares. “Taking a longer medication break can show you whether you can consistently manage your time and meet those demands without the help of a drug.”

Downsides of an ADHD medication vacation

Going off your ADHD medication for a supervised and extended period is not a bad thing, reinforces Dr. Manos. ADHD medications aren’t addictive, and you shouldn’t experience withdrawal symptoms.

But there are some factors to consider, including:

ADHD symptoms may resurface

No matter which type of ADHD you or your child have, the symptoms are likely to return quickly. Symptoms may not be as noticeable in kids when they aren’t in school, but ADHD isn’t a problem that only affects school.

“People with ADHD have trouble completing tasks that require directed attention,” Dr. Manos clarifies. “Those tasks happen at home, too. Good examples are finishing household chores or packing for vacation.”

A “holiday” from ADHD medication may be especially concerning for teens whose ADHD causes impulsivity. Without medication, those teens may be more likely to participate in riskier behavior or have social difficulties.

Relief from side effects is temporary

If you or your child are taking an ADHD medication vacation because of problematic side effects, the drug break isn’t a permanent solution.

“A drug holiday isn’t an effective way to manage side effects,” Dr. Manos says. “If medication has bad side effects, you need to work with your healthcare provider, who can recommend permanent ways to eliminate those side effects.”

How long should an ADHD medication break last?

ADHD medications act fast and clear out of your system quickly without an extended ramp-up or withdrawal period. So, you may be tempted to skip meds on weekends or days that require less focus.

But brief drug holidays, such as weekend breaks, may not be in your best interest. Going off medication on weekends can increase the presence of side effects or change the effectiveness of the drug. And if you or your child just started ADHD medication, consistency is important. It can take time to adjust to the medicine. Not taking the drug consistently every day of the week can interrupt that adjustment process.

“The American Academy of Pediatrics doesn’t recommend weekend-long drug holidays,” Dr. Manos states. “But for longer breaks, such as winter holidays, spring break or summertime, it’s OK to suspend treatment under your doctor’s supervision.”