Drug Holidays from ADHD Medication: Recommendations and Considerations

Benefits and Implementation

The American Academy of Child and Adolescent Psychiatry recommends considering drug holidays from ADHD medications during weekends and school holidays when academic demands are lower, to help manage medication side effects such as suppressed appetite, growth retardation, and sleep problems 1
Drug holidays provide an opportunity to assess whether continued medication is still necessary, and can be used to reduce common side effects like insomnia and improve appetite, with the American Academy of Child and Adolescent Psychiatry suggesting that short breaks can be beneficial 1
The American Academy of Pediatrics suggests that for non-stimulant medications like extended-release guanfacine and clonidine, medication should be tapered rather than abruptly discontinued to avoid rebound hypertension, with a strength of evidence based on clinical guidelines 3

Stimulants work only as long as they are given, with symptoms typically returning rapidly after discontinuation, according to the American Academy of Child and Adolescent Psychiatry 1
Drug holidays should be avoided during important academic periods, school tests, beginning of school year, or significant social activities, as recommended by the American Academy of Child and Adolescent Psychiatry 1
Rebound hypertension can occur with abrupt discontinuation of extended-release guanfacine and extended-release clonidine, requiring these medications to be tapered rather than suddenly stopped, as advised by the American Academy of Pediatrics 2, 3

For preschool-aged children, drug holidays may be particularly important as this population is more sensitive to stimulant side effects, according to the American Academy of Pediatrics 3, 4