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A Year-Round Kid
ADHD Medication Holidays
By Carma Haley Shoemaker
Many studies support the importance of keeping a child with attention deficit hyperactivity disorder (ADHD) on medication year round as the best way to manage their symptoms. However, there are many questions as to what kind of medicine is best (once a day vs. two to three times daily) and the benefits and drawbacks of each.
There may be some instances when a medication or "med" holiday would be appropriate. However, a qualified physician, not the parent alone, should only decide these instances. "If the child experiences significant side effects from the medication then a holiday may be needed," says Brian S. Smithley, MEd, a licensed psychologist at Sewickley Valley Hospital's Staunton Clinic in Pittsburgh, Pa. "For instance, when appetite suppression or sleep difficulties occur, a medication holiday may be used to provide an opportunity for the child to recover from the side effects. In addition, medicine holidays may be used to re-determine the current need for medication. But because the medication is a prescribed substance, medication holidays need to occur under the direction of the prescribing physician."
When medication holidays are necessary, parents need to be extremely diligent in utilizing behavioral interventions that can provide a structure and daily routing to minimize the severity of ADHD symptoms. Therapy and counseling can help the child and their parent(s) to develop an effective structure and daily routine.
As far as determining when a child would or should take a vacation from daily ADHD medications, it depends upon the purpose of the holiday. "Med holidays are done for different reasons," says Smithley. "For the significant side effects – or ones that affect a day-to-day event or need, such as appetite, sleeping, etc. – a medication holiday generally occurs on weekends. Summertime medication vacations can be useful in determining if the child has a continued need for the medication. A return of the child's ADHD symptoms would suggest their continued need for the medication and signal the need to restart the medication promptly."
