Tuesday, 24 March 2015

ADHD Drug Holidays: Should Your Kid Get One?


Experts debate the pros and cons of giving kids a break from ADHD drugs.

WebMD Feature
Reviewed by Smitha Bhandari, MD

Are you considering giving your child weekends off or even a summer-long break from ADHD medications

It may work just fine. Your child may regain his appetite and catch up on his growth (some ADHD drugs may slow a child's height and weight gains).

Then again, a so-called medication vacation may unleash the very behaviors that have been controlled so well by prescription drugs. That could put a strain on the child, you, and other caregivers. And there is some evidence that keeping a child on their ADHD medications will lessen symptoms better than stopping and starting.

Unfortunately, there is no one-size-fits-all answer. It comes down to what works best for you, your child, and your family. Doctors say it's easy to get on and off the stimulants that are typically prescribed for ADHD, which is characterized by hyperactivity, impulsivity, and/or inattention.

"The bottom line, it isn't harmful and it's part of personalization of care -- not to have a standard that fits all, but to have a flexible approach that meets the needs of the individual child and family," says psychiatrist Benedetto Vitiello, MD, who leads the Child and Adolescent Treatment and Preventive Intervention Research Branch at the National Institute of Mental Health in Bethesda, Md.

Here's what you need to know about the pros and cons of drug holidays.

The Nature of ADHD Drugs

According to CDC statistics from 2011 (the most recent available), about 6.1% of U.S. children ages 4-17 take stimulants such as Adderall, Concerta, Ritalin, and Vyvanse to control symptoms of ADHD.

Another half million or so take nonstimulant prescription drugs -- such as Intuniv, Kapvay, and Strattera -- which work on the brain differently. Those should not be stopped, because they take longer to go to work and far longer to leave the body, says Mark Wolraich, MD, a pediatrician in Oklahoma City who helped write the latest ADHD treatment guidelines for the American Academy of Pediatrics.

If a child is taking nonstimulants, Wolraich says, ''You could do it [take a drug break] over the summer time, but not over the weekend.''

Stimulants, on the other hand, are quick acting and leave the bloodstream quickly. In other words, there are no withdrawal symptoms; so, there isn't a weaning period.

"On those meds, it's important to realize the treatments improve behavior and reduce symptoms," Wolraich says. "If you stop taking them, you revert to behaviors you saw before... stimulant medications don't build up in the bloodstream. That's why you can stop and start them.''

source : ADHD Drug Holidays: Should Your Kid Get One?

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