Can my child stop his medication during the summer? 

I am frequently asked this question by patients taking stimulant medication to help their child's attention.  The origin of their asking usually stems from two thoughts: 1) the medication is for school, and 2) it could give a break from side effects.  I base my treatment recommendations on research, but my conclusions can differ from one individual to the next.

Research has shown that children with ADHD who take stimulant medication daily perform better.  Remember that the medication not only helps with self-control, but it also supports initiation, organization, and social engagement.  One very large research study blinded parents, teachers, and patients, which means that the observers and the patient did not know if the child was taking the medication or which dose he was taking.  Each week the medication was secretly changed and the parents, teachers, and students rated behavior.  The results were overwhelmingly positive that all observers notice a difference on and off the medication and this finding is consistent whether or not a student is in school.  So, while the benefits may be subtle outside the classroom, they certainly exist.

Some parents want to give their child a break from side effects.  Early studies suggested that stimulant medication usage results in a loss in height potential by about ½ to 1 inch.  However, a more recent, very large study that followed kids over a 10-year period disputed that finding and reported no loss in height.  On the other hand, other potential side-effects, like appetite suppression and irritability exist, and those need to be taken into consideration.

There are also things about these medications we do not know, and the information is not necessarily what you might think.  We have a tremendous number of studies on the use of medication, but very little information on the effects of prolonged breaks.  Given that the brain thrives on rhythm and regularity (e.g. sleep, nutrition, exercise), it is possible that breaks from the medication could actually be a negative.  So, while it is tempting to jump to the conclusion that less is better, it may not actually be the case.

Ultimately, the decision comes down to whether the pros outweigh the cons.  In general, I support the regular use of medication for children that need it, but I take every decision individually and seriously. Be sure to mention this possibility at your child's next appointment if you are considering making any changes to their medication plan -- and enjoy a terrific summer! ~ Dr. Korb

If you have not already had a photo added to your child's records at the CDM within the last year, please forward a recent digital photograph of your child to Rosalie at [email protected] -- we are updating all of our files and hope to include more current images of our clients to assist our clinicians. Thank you!