Should people take “medication holidays” off the medication?
There is no way to justify having a child discontinue taking medication for a sustained period of time over the summer or on weekends before he has demonstrated that he has developed strategies to work around his attention weaknesses without the aide of medication.
The same holds true for adolescents and adults with ADD, but the consequences of a medication free weekend can be even more frightening and tragic. I have more than a dozen adolescents who have gotten pregnant or got someone pregnant and, in each circumstance it occurred when they chose not to take the medication on weekends because their friends said they were more fun off. I also have several patients who were killed behind the wheel of the car or killed others when they drove off medication over the weekend.
ADD is a life-long problem that does not take holidays. The price a person pays for being impulsive, being distractible, monitoring poorly, and being unable to sustain focus while “on vacation” is certainly not worth being medication free. Such independence is a fallacy for the off-medication child who is now faced with Mr. Smith angrily knocking on the door holding the baseball that went through his window, Mom screaming at the top of her lungs for the eighth time of the day, the neighborhood children refusing to play with him, boredom at 10:00 on Saturday morning, or a fractured ankle after jumping out of the tree in the backyard.
Discontinuing the medication for any reason before a person is able to successfully meet the expectations set for him in all life spheres is like removing a person’s reading glasses and expecting him to read, or discontinuing a diabetic’s insulin and telling him to make his own insulin and – when he is unsuccessful – demanding that he “try harder!” Unlike the person who requires glasses and the diabetic who needs insulin injections, the ADD individual may, at some point, not require the use of his aid – medication. However, premature discontinuation of the medication is a set-up for serious failure.
Secondly, when the medications are taken only at selective times, a subtle but important paradigm shift is being made. Under these conditions, the medications that should be used for continuous symptom relief of a problem that is there all the time become drugs that are selectively used to enhance performance. I feel this is the wrong message to be giving an ADD individual who, by the nature of his problem, is at a greater risk for substance abuse.
For a more detailed, clinical discussion of the use of medication to treat ADD, visit ADDBasics.org to download Dr. Liden’s free ebook, ADD/ADHD Basics 301: Rationale for Clinically Necessary Off-Label Use of Stimulant Medications in the Treatment of Attention Deficit Disorder / Attention Deficit Hyperactivity Disorder (ADD/ADHD)
Our current blog series is excerpted from Dr. Liden’s best-selling book, Pay Attention!: Answers to Common Questions About the Diagnosis and Treatment of Attention Deficit Disorder.