Is It Safe to Stop ADHD Medications on the Weekends?

Attention-deficit/hyperactivity disorder (ADHD) is a common neurodevelopmental condition that can present in different ways and range in severity. Anyone can live with ADHD, although some things may increase the risk, such as family history.

ADHD medication can reduce symptoms of ADHD and improve a person's quality of life and mental health substantially.

Research suggests that it can even reduce the risk of suicide in kids who experience hyperactivity, impulsivity, oppositional defiance, and other behavior-related concerns. Needless to say, medication can be an incredibly valuable part of a person's treatment plan if they live with ADHD.

However, as is the case for most medications, a prescription medication for ADHD may come with common side effects and risks. This is one of the reasons why someone might wonder - is it safe to stop ADHD medications on the weekend?

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Should My Child Stop ADHD Medications on the Weekends?

It is actually relatively common for individuals who take stimulant ADHD medication (i.e., central nervous system (CNS) stimulants) to take a drug holiday. However, it’s not the right choice for everyone.

A drug holiday is when you stop taking a specific medication for a period of time, which may be as brief as a few days or for a longer period of time, with the intention to resume the use of the medication after the fact. For example, some individuals who have children choose discontinuation of their child's ADHD medication over the summer because they are not in school.

There can be both benefits and drawbacks to doing this. Let's talk about what they are so that you can make an informed choice.

Pros

One of the most common possible upsides of taking a medication holiday is that it can provide individuals with a break from the side effects they may experience. Side effects such as a decrease in appetite can be a challenge for those who take ADHD medications or who have a child who takes ADHD medications.

A weekend off can provide individuals with a break from these ADHD medication side effects. It can also provide a person with clarity on the efficacy of the drug; if you take time off of it, you can decipher whether or not it is working as intended.

Some may also take a drug holiday in an effort to mitigate risks such as slowed growth in children for relevant medications where this can be a cause for concern. However, it’s worthwhile to note that children who take CNS stimulants generally reach their full adult height regardless.

Cons

Downsides of stopping medication for the treatment of ADHD on weekends can include:

• A break in routine. Since routine can be very important for people who live with ADHD, a potential downside of taking a weekend off of ADHD medication is that it could veer someone away from their routine. Some children find changes in routine challenging and may find it tough to restart medication once the weekend is over.
• Re-emergence of symptoms. ADHD symptoms don't just impact people at school or work. They also create impairments at home, emotions, tics, or emotional regulation, inattentiveness, and so on. Without medication, symptoms re-emerge. This is something to consider, especially if symptoms are severe, primarily hyperactive/impulsive, or cause distress. It is also why some experts say that they generally only recommend a weekend long-drug holiday if medication is primarily used for weekday activities, like school or schoolwork.

It is important to consult with a medical professional before you stop, start, or change a medication routine in any way. They may be able to help you weigh the benefits and downsides of a drug holiday with you and your family's specific situation in mind.

Skipping an ADHD Drug Dose

Skipping an ADHD medication dose will depend partially on the kind of medication that you take.

Stimulant medication

The first recommended type of prescription drug for those who live with ADHD belongs to a class of medication called central nervous system (or CNS) stimulants. These medications are recommended first because they are highly effective for people who live with ADHD. In fact, 70 to 80% of individuals who take these medications to treat ADHD experience symptom reduction.

The immediate-release versions of these medications often start working within about 30 to 60 minutes after consumption, and the full effect is experienced after that time. They may wear off within about 4-6 hours, which is why some individuals take medications like Adderall, Vyvanse, or Ritalin 1-3 times per day. The extended-release versions of these medications also take effect quickly, and the effects may last up to 12 hours. Find out more about the similarities and differences of Adderall and Adderall XR - the extended version of Adderall.

Due to how quickly these medications take effect, a drug holiday is most certainly viable if it works for you (or you and your child) and the healthcare provider who prescribes your or your child's medication is okay with it.

Non-stimulant medication

Non-stimulant medications, which often take longer to go into effect, may be more difficult to pause or stop, and it is not recommended to take a drug holiday from non-stimulant medication.

Let's use Strattera, the first FDA-approved non-stimulant medication used for ADHD, as an example. It can take 4 to 8 weeks for an individual to get the maximum benefits from Strattera once the correct dose for that particular individual is determined.

If you miss a dose, it's generally recommended that you take it as soon as you remember or as directed by a medical professional.

However, if you choose to get off a medication like Strattera for a period of time and decide to go back on the medication, it will take time to adjust and feel the benefits again.

Managing ADHD Medication Side Effects

Like any other medications, ADHD medications like Aderall, Dexedrine, Ritalin and Vyvanse has pros and cons. The potential side effects of central nervous system stimulant medications include but are not limited to dizziness, nausea, headaches, dry mouth, difficulty sleeping or insomnia, loss of or a decrease in appetite, a decrease in weight, changes in mood or behavior, rapid heartbeat, heart palpitations, and anxiety or feelings of nervousness.

Here are some tips to help manage ADHD medication side effects:

• Take or administer medication as directed. Often, it's recommended that extended-release ADHD medications, such as Adderall XR, are taken in the morning to mitigate side effects like insomnia.
• Implement a supportive daily routine that helps to relieve side effects. For example, if you or your child experiences a loss of appetite, you may plan meals into the day so that you or your child is able to get the nutrition they need.
• Discuss a change in dose with your or your child's doctor. If ongoing side effects are disruptive, make sure to discuss this with your or your child's doctor. A change in dose may be needed.
• For dry mouth, consider lozenges or keep water nearby.

Sometimes, side effects dissipate when your body gets used to the medication that you take. To understand the specific side effects that can occur with the medication you or your child take, consult with your prescribing physician or pharmacist.

Often, when you pick up your medication, you will receive paper documentation that describes the medication you take and explains the possible side effects, warnings, and risks.

Risks associated with ADHD meds are something that you may want to discuss with your or your child's doctor. For example, risks associated with CNS stimulants commonly prescribed for ADHD symptoms may include slowed growth in children, allergic reactions, drug interactions, an increased risk of serotonin syndrome, and cardiovascular events. Standard recommended medical monitoring may help mitigate and prevent medication risks.

Medication for ADHD can be used alongside other forms of support and treatment. Therapy, parent training or parenting techniques, games, and accommodations at work or school, for example, may all be advantageous for those who live with ADHD.

What works for one person may not work for another; if you try a weekend drug holiday and it doesn't work for you, you may choose to resume taking medication or administering medication to your child on weekends.

Takeaway

With the majority of ADHD meds, it's possible for an individual to take a "drug holiday" or a weekend off. There are pros and cons to taking weekends off of medication, and these should be weighed appropriately.

It is essential to keep in mind that different people may react to taking a weekend off from medications in various ways - even if they take the same medication at the same dose. Talk with your child's pediatrician if you are interested in taking a break from ADHD medication on the weekends or feel that you or your child may benefit from doing so.

A pediatrics physician can provide individualized guidance based on the medication that you take and any other factors that may be relevant to your or your child's care, such as the severity of your or your child's symptoms and the specific symptoms that you or your child experience.

This article is for informational purposes and is not a substitute for individual medical or mental health advice. Please consult with your or your child's prescribing doctor before changing, starting, or stopping a medication routine.