ADHD Medication: Dangers of a Medication Vacation

Stopping your child’s medication for the summer may not be in their best interest.

For years, pediatricians told parents to give ADHD medication when they had to — on school days during school hours. But times change. We now know that school problems are only the tip of the iceberg for kids with ADHD. They have problems with paying attention, time management, forgetting/never hearing instructions and organization at home and with peers. These issues relate to executive function—the brain running the ‘home office’ of the kid’s life. Poor executive function is why it takes kids with ADHD an hour to shower. Does this scenario sound familiar to you?

“Get in the shower…..get in the shower….Why haven’t you gotten in the shower? 

I’m not going to tell you again to get in the shower.

“GET IN THE SHOWER!!”

Water turns on. 5 minutes later…not in the shower.

 “GET IN THE SHOWER, you’re wasting hot water!”

Shower curtain noise, sounds of water splashing on kid’s head come from the bathroom. 

“FINALLY”, the parent thinks aloud.

“Don’t forget to wash your hair!”   No reply.

Twenty minutes later –“What are you doing in there?  Finish up!”

Ten minutes later—“GET OUT OF THE SHOWER!”

Child is dripping or half dried off when the parent walks in the bathroom.

The wet dog smell hits the parent’s nose. 

“You didn’t wash your hair.”  “Yes, I did.” “NO YOU DIDN’T. Your mother doesn’t buy shampoo that smells like that!”

After argument and yelling kid gets back in shower. Washes hair in 2 seconds and comes out smelling slightly less like a wet dog.

Parent is defeated, helps complete the dry off to the point that PJs can be put on.

Whew! Now all we have to do is read, pack up for school in the morning and deal with getting to bed! 

Good night…

There is significant emerging evidence that folks with ADHD build and improve their executive function with regular medication use. The old saying that ‘pills don’t build skills’ may be right but it may be wrong. Medication delivers improved sustained attention and improved self-control of hyperactivity and impulsive behavior. Kids in environments that foster executive function –stable homes and quality classrooms, for example—build these skills over twelve to twenty-four months. The Focus-MD experience is that the kids who are taking medication daily – including weekends and holidays – seem to benefit most. It is common for a parent to tell me at a follow-up visit, “he has matured,” or “she has just grown up so much.”  They don’t tell me that the kid’s executive function improved but that is what they are saying when they give examples like, “Shower time is not a struggle any more — HE EVEN PICKED UP HIS TOWEL!”

If you are reading this and thinking that it makes sense but you are reluctant to continue medication in the summer it is likely due to one or both of two reasons: Your child’s personality is adversely affected by the medication, or you have appetite/growth concerns. If your child has these issues during the school year, talk to his/her doctor to resolve them. Nine months a year is too long to have these side effects and dose optimization problems. Getting the dose just right can almost always allow your child to grow into a happy, engaged and normally attentive child. Sometimes dose reduction during the summer is a great idea. Stopping medication is not. Talk to your child’s doctor before stopping medication the day after school gets out.

Dr. Wiley is board certified in Pediatrics. He practiced general pediatrics at Dothan Pediatric Clinic in Dothan, AL for almost 20 years before moving to Mobile in 2008 and founding Focus MD.

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