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ADHD Drug Holidays

Expert Q&A


Updated January 26, 2008

Q. I would like to know the side effects of not giving adderall to an ADHD child on the weekend, when he gets in every day during the week. I was under the impression this is a medicine you would want to keep in your system 24/7. If I am correct, I would like to have a medical expert tell me so I can tell the father to make sure the medicine is given on the weekends.

He is an 11 yr old boy and takes a 10mg pill once daily during the week. I am told by the father that he does not get the pill so he can eat better on the weekend, since he does not eat when he is on the pill. I personally think not taking the medicine is hurting him more then the eating is doing him good. Cassandra, St. Louis, MO

A. You actually wouldn't want Adderall or any stimulant medication in your system '24/7' or you would have a very hard time sleeping. So it is good that they are out of your system after 10 to 12 hours. While that does make early mornings and late evenings difficult for many children with ADHD, there is no way around it right now, short of trying a non-stimulant medication like Strattera.

Since Adderall doesn't have to build up in your system from day to day, it is possible to give it on an as needed basis, so some parents do choose to not give it on weekends, holidays, or breaks from school. The main problem with this strategy is that your child's ADHD symptoms won't be under control during those times. While that may not be a big problem if your child simply has some attentional problems that interfere with his school work, if he is also very impulsive and hyperactive, not taking his medicine may be a big problem. Remember that ADHD isn't usually just a school problem, and it can interfere with his behavior, relationships with family members, and how he does socially. That makes 'drug holidays' not as popular as they used to be.

Just as you likely did when your first started him on Adderall, when thinking about a 'drug holiday' on the weekend, make sure that the benefit outweighs the risk. If he really functions better on his medication, then it is probably a good idea to take it every day.

Appetite problems and poor weight gain can be big problems for children taking stimulants. If Adderall is working very well for him otherwise, not taking it on weekends can be a good idea so that he does eat better at those times. Some children do have more side effects on Monday's after being off their stimulant for the weekend, as they get 'used' to it again, so be on the watch for that.

If you really think that he would benefit from taking his medicine on the weekend, but side effects are making that impractical, then you might talk to your Pediatrician about adjusting his dose or trying something else. A different stimulant, like Concerta or Ritalin LA, or Strattera, a non-stimulant medication, might be good alternatives.

So that you and his father are on the same page on this, it might help if you both go to your child's next visit with your Pediatrician so that you can both discuss your concerns and find the best medicine for your child. If you are right, this type of visit can also help to convince dad to move to your side.

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