Yasmine, a pediatric psychiatric NP, weighs in on a common question parents ask about ADHD medication.
Well, we made it. Summer is FINALLY here, and my goodness, it was a challenging year for most. School is no longer in session (traditional curriculum, of course), and due to this, my workload often decreases because, to the surprise of no one, school is a significant stressor for most kids and teens. Most of the summer is dedicated to camps, play dates, vacations, and unstructured free time. Because there are no longer academic demands in place, this is the time of year when parents whose kiddos have ADHD diagnoses often ask me if it is okay to stop administering ADHD medications during breaks. It’s a common question I answer in the clinic, so I wanted to provide my perspective to you all.
Before I discuss this in greater detail, this is the best time for my disclaimers. First, parents with kids who have ADHD typically know this, but I want to be as clear as possible. When talking about “taking a break” from ADHD medications, this is reserved ONLY for stimulants like Adderall, Ritalin, Concerta, Vyvanse, etc. We use other types of medications to treat ADHD, and those other medications should be administered consistently without breaks. Breaks can be taken from stimulants because they only remain in the system for several hours; other medications work differently and will disrupt treatment if not taken consistently. If there is any question regarding what medication your child takes, always talk with the prescribing provider. Secondly, some providers have firm opinions about taking breaks from medications, which is also known as a “drug holiday.” Drug holidays have always had some level of controversy in the medical community, so your provider may disagree with how I counsel patients in this particular area. So, it’s just something to keep in mind.
That said, here’s my perspective on drug holidays. Parents inquire about these breaks for a variety of reasons. Usually, it’s because the stimulants decrease their child’s appetite, so taking a break from the medication can allow for an increase in appetite and subsequent weight gain. Others want to reduce the medication burden for their child, so it’s one less thing to take. Whatever the reason, my perspective remains the same. If someone is taking a stimulant because they primarily struggle with academic focus, then taking a break from the medication when school is out makes sense. This is usually reserved for my middle and high school students, who struggle with inattention but often are no longer hyperactive or impulsive. If the medication is being administered because the child can be highly hyperactive or impulsive without it, then the medication should be consistently given without taking breaks. This is important for two reasons. One, safety is always the priority. If the medication allows for better decision-making in this way, it should be given every day to reduce risk-taking behaviors. Two, hyperactivity and impulsivity can impact social functioning. So, even though school is no longer in session, our kids still interact socially through other activities. And we want them to be able to navigate those interactions as best as possible to cultivate positive self-concept and esteem.
A consideration that is often overlooked relates to parents of teenagers who are learning to drive. While on the surface, the medication may have been recommended to help with academic focus, inattention is indiscriminate. So, if you have a teenager who is driving or learning to drive, consistent administration of medication is imperative to maintain safety on the roads and decrease distractibility.
So, that’s it. Hopefully, this provides some direction to discuss with your child’s provider if you consider this for the summer and other breaks. I hope everyone has an amazing summer!
