Drug Holidays From ADHD Medication: International Experience Over the Past Four Decades

J Atten Disord. 2015 Jul;19(7):551-68. doi: 10.1177/1087054714548035. Epub 2014 Sep 24.

Abstract

Objective: ADHD is managed by stimulants that are effective but can cause growth retardation. Prescribers should ideally monitor children and trial a "drug holiday" to enable catch-up growth. Our aim was to map the experience of drug holidays from ADHD medication in children and adolescents.

Method: A comprehensive search of the literature identified 22 studies published during the period 1972 to 2013.

Results: Drug holidays are prevalent in 25% to 70% of families and are more likely to be exercised during school holidays. They test whether medication is still needed and are also considered for managing medication side effects and drug tolerance. The impact of drug holidays was reported in terms of side effects and ADHD symptoms. There was evidence of a positive impact on child growth with longer breaks from medication, and shorter breaks could reduce insomnia and improve appetite.

Conclusion: Drug holidays from ADHD medication could be a useful tool with multiple purposes: assessment, management, prevention, and negotiation.

Keywords: ADHD; adolescents; children; drug holiday; medication.

MeSH terms

  • Adolescent
  • Attention Deficit Disorder with Hyperactivity / diagnosis
  • Attention Deficit Disorder with Hyperactivity / drug therapy*
  • Central Nervous System Stimulants / administration & dosage*
  • Central Nervous System Stimulants / adverse effects
  • Central Nervous System Stimulants / therapeutic use*
  • Child
  • Drug Administration Schedule
  • Holidays
  • Humans
  • Medication Adherence / statistics & numerical data
  • Methylphenidate / administration & dosage*
  • Methylphenidate / adverse effects
  • Methylphenidate / therapeutic use*
  • Schools
  • Sleep Initiation and Maintenance Disorders / chemically induced
  • Sleep Initiation and Maintenance Disorders / drug therapy
  • Time Factors

Substances

  • Central Nervous System Stimulants
  • Methylphenidate