ADHD Drug Holidays

Dr. Brett HowardADHD

“I don’t take my medication over the weekend.”

“We are taking the Summer off.”

“I’m not in school over Winter break, so I save up my medication for when I really need it.”

ADHD drug holidays (i.e., the purposeful discontinuation of stimulant medication over weekends or school breaks) can take many forms, and the reasons ADHD patients provide for taking holidays can be just as numerous. Some report “not needing” the medication during these holidays while others want to “limit medication side effects.” Often ADHD patients report that they take holidays to restrict the use of their stimulant medication to only those times they feel their ADHD gets in the way of things.

Everywhere I go…there it is

ADHD (when appropriately diagnosed) is a chronic disorder that is pervasive across many or all domains of living. In fact, the DSM-5 diagnostic criteria require:

“Several inattentive or hyperactive-impulsive symptoms are present in two or more settings (e.g., at home, school, or work; with friends or relatives; in other activities).”

Which means that your ADHD is not supposed to turn itself off when the school bell rings, when you leave work for the day, or when you go out of town to visit grandma. Instead, your ADHD symptoms are always with you. They are likely to be just as present when you attend a birthday party over the weekend, go to a Nats game with friends, or visit with your kids after a tough day’s work.

The Social Side of Executive Functions

ADHD is increasingly understood as a group of impairments that affect our system of “executive functions.” Among these functions include your ability to organize, prioritize, focus, shift attention, regulate alertness, sustain effort, manage emotions, utilize our working memory, recall stored information and self-regulate our actions. You require these abilities to successfully navigate the subtleties involved in living in a society…in addition to successfully completing your math homework.

 Millennia before you needed executive functions to read Beowulf,

the human animal evolved them to survive as social beings.

You need your executive functions at their best if you plan to keep that surprise party a secret, be your most charming you on that blind date, and to get up bright and early Saturday morning to attend that yoga class with your friend. If you are somebody who interacts with others every day, then you may benefit from taking your ADHD stimulant medication every day as well.

The Benefits of a Drug Holiday

There are, of course, times when your mental health prescriber may encourage you or your loved one to take periodic breaks from stimulant medication. When a child or adolescent is falling behind on their projected growth chart or when a stimulant seems to contribute to episodes of insomnia are two such occasions.

Your prescriber may also believe that a periodic discontinuation of a stimulant medication is beneficial by possibly enhancing the effectiveness of the medication when the medication is reintroduced, but this practice is debated among prescribers. However, ANY decision to stop taking stimulant medication is best done in close cooperation with your mental health prescriber as there will always be a list of costs and benefits of doing so.

ADHD at Home

ADHD symptoms can get in the way of listening attentively to your partner or in getting the most out of a symphony. Stimulant medications can do wonders in helping you regulate your emotions and get motivated enough to clean out the garage.

Whatever is on your agenda after hours and on weekends, ADHD symptoms can easily get in the way of being at your best and most effective. Drug holidays are often practiced, but the utility gained from periodically going off your medication may pale in comparison to the successfully social you that shows up to the party appropriately medicated.