ADHD Drug Holidays

Expert Q&A

A Wild Child Jumping Around
Do kids need their ADHD medications every day?. Maartje van Caspel

Q. I would like to know the side effects of not giving Adderall to an ADHD child on the weekend, when he gets it 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.

ADHD Drug Holidays

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. And some parents do choose to skip giving ADHD stimulant medications on weekends, holidays, summers, or other breaks from school.

The main problem with this strategy is that their 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. ADHD symptoms can interfere with your child's 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 benefits outweigh the risk.

If he really functions better on his medication, then it is probably a good idea to take it every day and not skip doses.

Side Effects of ADHD Medications

Appetite problems and poor weight gain can be big problems for some children taking stimulants. If his medication 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. On the other hand, 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 Focalin XR, or a non-stimulant medication, like Strattera, might be better alternatives.

Although ADHD drug holidays were once popular, there are now so many different medications and dosages of each medication, that it is much easier to fine tune a child's dose and avoid side effects than it used to be.

That makes it easier to avoid ADHD drug holidays and allow your child to take his medication every day.

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.

Skipping a Dose Of an ADHD Medication

In most cases, if you simply forget to give your child a dose of his ADHD stimulant one day, then you can usually just restart it the next day.

You do want to be careful that you don't give an extended release stimulant, like Adderall XR, Concerta, or Focalin XR, etc., too late in the morning or afternoon, or your child will likely have a lot of trouble going to sleep that night. You also don't want to give an extra dose without talking to your pediatrician.



American Academy of Pediatrics Clinical Practice Guideline. ADHD: Clinical Practice Guideline for the Diagnosis, Evaluation, and Treatment of Attention-Deficit/Hyperactivity Disorder in Children and Adolescents. Pediatrics. 108(4):1033.

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