A new trend on TikTok is gaining traction, with some parents choosing to take their children off ADHD medication for significant portions of the summer. This movement highlights the complex issues surrounding the use of medication for ADHD, a condition that affects both children and adults. While some see this as an opportunity for a break from the routine of medication, experts warn against making such decisions based solely on social media trends.
Anish Ranjan Dube, MD, chair of the Council on Children, Adolescents and Their Families at the American Psychiatric Association, cautions against following TikTok advice without medical consultation. He emphasizes that decisions to pause or alter medication regimens should be individualized and made under professional guidance.
“Recommendations by individual users or content based on the personal experiences of such users may have social value in that others may relate to them, but nevertheless are not appropriate for everyone due to individual differences in biology, the severity of the pathology, and circumstances,” – Anish Ranjan Dube.
The idea of taking a "medication holiday" is not new but has gained visibility thanks to social media. Some parents believe that a break from medication can benefit their children during non-school periods. However, this decision is far from straightforward and requires careful consideration of various factors.
According to Goodman, a specialist in ADHD treatment, people often misunderstand how ADHD medications work. Many believe that stopping medication will immediately clear it from the system. While stimulant medications do leave the body within a day, non-stimulants like atomoxetine or viloxazine may take weeks to show reduced effects after discontinuation.
“If you use stimulant medication and then you stop, the effect of the medication is essentially going to evaporate.” – Goodman.
Goodman also warns about the potential development of tolerance to ADHD medications. Micro-tolerance can result in a stronger effect after skipping a dose, while macro or physiologic tolerance requires increased dosages over time to achieve the same benefits. This can become problematic, especially if not carefully monitored.
“So you started on 10 mg and then had to go to 20 and five years later you’re at a 116; that’s physiologic tolerance, where you have to increase the dose in order to achieve the same benefit. That’s a problem,” – Goodman.
Parents may consider medication breaks for several reasons. Some children use ADHD medications primarily for inattention during school days. Moreover, stimulants can impact growth in terms of weight and height—factors that could concern parents during developmental years. Additionally, some parents observe that stimulants may dampen emotional responses and social engagement in their children.
“Before you change the dose you have to figure out if the side effects are from the ADHD medication or are a function of additional medication that was added that are now having an interaction with your ADHD medication,” – Goodman.
Adults with ADHD typically find a stable dosage that works for them and maintain it long-term. However, concerns about side effects or efficacy changes may prompt discussions about dosage adjustments. Goodman stresses the importance of open communication with healthcare providers when considering any changes to medication regimens.
“Patients will often not have conversations because they don’t want to upset the doctor or because they think the doctor wouldn’t agree,” – Goodman.
“But good clinicians want to hear this information so they can help the patient think through what the best course of action is.” – Goodman.
The diversity of stimulant preparations available offers many options for finding a suitable treatment plan without unwanted side effects.
“There are over 30 different stimulant preparations on the market,” – Goodman.
“It’s very likely you can find something that you can take that does what it’s supposed to do, that lasts as long as you’d like it to last, and doesn’t cause problems.” – Goodman.
However, Goodman advises caution when seeking prescribers who might easily accommodate questionable requests for medication changes without thorough evaluation.
“Now that doesn’t mean you want a prescriber who is going to bend over backward and accommodate what you want,” – Goodman.
“We’re here to provide what we believe you need before we give you what you want.” – Goodman.
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