How To Avoid an ADHD Crash

Medications can be helpful for many kids with attention-deficit/hyperactivity disorder (ADHD). But when they wear off each day, some kids may experience an ADHD “crash,” which can be no fun for them — or you.

Pediatric specialist in developmental behavior Carrie Cuffman, MD, explains what an ADHD crash looks like and how to avoid it.

What is an ADHD crash?

Stimulants like Ritalin® and Adderall® (and their generic counterparts) are the most common types of ADHD medication. These medicines can last four to 16 hours, depending on the type and how quickly your child’s body processes them.

While some kids feel OK when their medication wears off, others struggle with a “crash,” aka a medication rebound. If your child takes their med in the morning, you’ll likely see this crash sometime in the afternoon.

“An ADHD medication rebound is when your child’s ADHD meds wear off too quickly,” explains Dr. Cuffman. “This rapid drop in medication levels can cause ADHD symptoms to be more intense than usual.”

If your child’s having a crash, they might:

• Feel extremely hyper or “wild”
• Get angry or upset over things that wouldn’t usually bother them
• Have emotional outbursts (like crying or yelling) without an obvious reason

You can usually spot an ADHD medication crash by its timing. “Keep track of when your child takes their medication each day,” suggests Dr. Cuffman. “A crash usually occurs 30 to 60 minutes before the medication should be out of their system.”

An ADHD crash can be hard on kids because they often don’t have the same emotional control as adults. “On top of the symptoms from the crash, a child may feel confused or stressed,” she adds.

As the meds leave the body, your child’s behavior and emotions typically return to their normal (non-medicated) levels. “An ADHD medication crash can last about an hour,” Dr. Cuffman says. “But that can feel like a very long hour if the crash is severe.”

Preventing the ADHD afternoon crash

You and your child don’t have to accept a medication rebound as a part of life with ADHD. There are ways to sidestep crashes and find the right balance:

• Booster medication. One of the best ways to avoid a crash is by adding a mini-dose of the medication they already take. “A dose of short-acting ADHD medication can be helpful,” shares Dr. Cuffman. “This small ‘booster’ dose helps counteract the rapid drop-off of medication without interfering with bedtime. Your provider can tell you when to give this to your child.”
• A healthy snack. Nobody likes being hangry, and that may be what your child is feeling during an ADHD crash. “ADHD stimulant medications can suppress appetite, so your child may suddenly get hungry when the medicine leaves their body,” notes Dr. Cuffman. “Have a healthy snack ready for them before the crash occurs. If they start to crash when they get home from school, pack the snack in their bag and have them eat on the way home.”
• Downtime. If possible, give your child some time to chill out as their medication wears off. “Try to avoid activities that are demanding for your child during the hour the crash normally happens,” she advises. “They may need some time to regulate and relax.”
• Medication change. A different stimulant medication with a different delivery system or a dose adjustment may help manage ADHD medication crashes.

Lifestyle tweaks for ADHD

You can also help your kiddo function at their best with a few lifestyle changes. Children with ADHD often feel better if they:

• Adopt a balanced diet. Eating a variety of fruits, veggies, whole grains and protein is especially helpful for kids with ADHD. “Healthy eating habits help your child get the nutrients they need,” says Dr. Cuffman. “They may also help stabilize their blood sugar levels, which can minimize symptoms like restlessness or fatigue.”
• Cut out caffeine. Many ADHD medications are stimulants, and caffeine is a stimulant, too. Put them together, and your child may be getting too much. “Soda, energy drinks, coffee and tea can all provide a dose of caffeine that can make your child feel restless or jittery,” warns Dr. Cuffman. “Choose caffeine-free drinks and check the ingredients to be sure there’s no hidden caffeine inside.”
• Get regular exercise. Exercise naturally improves focus and boosts energy levels, which is a big win for kids with ADHD. “Help your child find a physical activity they enjoy, and aim for five days a week if possible,” she suggests. “Start with small goals, like 10 to 15 minutes per day, and increase from there.”
• Stick to a sleep schedule. Going to bed and waking up at the same time every day can help turn down the volume on ADHD symptoms. “Kids are busy, so it can be hard to get them on a consistent sleep schedule, but it’s worth the effort,” states Dr. Cuffman. “Quality sleep is a key part of managing ADHD.”

Team up with your child’s provider

If your child has ADHD, you don’t have to manage it alone. Your child’s provider can help you with questions and concerns that come up along the way. And if you think your child might be having issues with their medication, speak up.

“Tell your provider how your child is doing and whether the medication is working well for them,” urges Dr. Cuffman. “With so many medications available, we can work together to find one that fits your child’s needs.”