Should Kids Come Off ADHD Meds For The Summer?

Fourteen-year-old Peyton has attention deficit hyperactivity disorder (ADHD), and he has been taking Adderall during the school year since the age of eight to treat symptoms such as inattentiveness and impulsivity. During the summers, on his doctor’s suggestion, he stops his meds. Peyton’s mom, Cynthia Hollingsworth, says he might just take them occasionally if he’s doing something that takes extra focus, such as a fishing trip with his grandpa or a summer reading project. “I believe it is very important to give your body a break from these meds when you can,” she says. “When Peyton doesn’t take his meds, he is more hyperactive, of course—but I don’t mind, it’s his summer break.”

Many parents like Cynthia, whose kids take stimulant drugs for ADHD, wonder if they should be giving them a “medication vacation”—or a structured treatment interruption, as doctors call it—during school holidays. There are pros and cons to weigh before making that call.

What you need to know

• Taking a medication vacation isn't a given. A summer break from ADHD medication is not automatically a good idea just because school is out.
• For many kids, staying on medication may still help, especially if ADHD affects safety, behaviour, social skills, emotional regulation or day-to-day routines outside the classroom.
• A supervised break may be worth discussing for some children who take stimulant medications and are dealing with side effects such as appetite suppression.
• Non-stimulant medications are different, so parents should not stop or restart them casually.
• Any medication change should be made with your child’s doctor or nurse practitioner.

Which medications can kids take a vacation from?

Non-stimulant ADHD medications are a separate conversation, says Karen MacMillan, who is an educational psychologist, the parent of a teen with ADHD and the executive co-director of Foothills Academy, a Calgary school for children with learning challenges. Parents should not stop or restart them casually, because the safest approach depends on the specific drug and the child. While stimulant meds often start working in less than an hour, it can take weeks to feel the full therapeutic effect of non-stimulant meds, so you can’t just stop and start them.

And even for stimulant meds, some medical professionals are wary about the physical side effects of taking a break. Current Canadian guidance suggests this decision should be individualized, not treated as an automatic summer routine. The Canadian Paediatric Society notes that some children, especially those who still need symptom control beyond school hours, may benefit from continuing longer-acting stimulant medication on weekends and holidays. Broader Canadian guidance from CADDRA and its review of intentional discontinuation of psychostimulants in youth also supports making these decisions case by case, with a clinician’s guidance, rather than treating summer as an automatic reason to stop medication. Kids may re-experience initial side effects that had previously worn off, such as headaches, irritability or trouble falling asleep.

“After speaking at length with my son’s paediatrician and his psychiatrist about it, we were told that it would be easier on his system to continue with the medication, rather than sending him into withdrawal,” says Caitlin McCormack, mother of five-year-old Declan, who takes Vyvanse.

For many families, though, the more immediate concern is not a one-size-fits-all withdrawal effect, but the return of ADHD symptoms, loss of stability, or the reappearance of side effects when medication is restarted. MacMillan says some families may discuss lowering a dose rather than stopping medication outright during vacations, but any change should be made with the prescribing clinician.

Why take a medication vacation?

When a break may be worth asking about

• Your child takes a stimulant, not a non-stimulant
• Appetite suppression, weight concerns or other side effects are a real issue
• Summer demands are lower, and you can closely observe how your child does
• Your child is old enough to notice and describe how the medication affects them
• Your clinician agrees it makes sense to try a structured, monitored break

MacMillan says parents sometimes want to give their kid a medication vacation because they're worried about common side effects of stimulant meds, such as height and weight suppression. “Studies do show that height tends to correct itself over time, but weight gain may be more of an issue if a child’s appetite is being impacted in the long term,” she says.

Some kids don’t want to take their meds when school’s out, because they notice personality changes when they’re medicated, and complain that they don’t feel like themselves. Wanda Carleton, whose son Lucas* began taking the ADHD medication Concerta at age eight, would keep him meds-free on holidays and weekends. “He reported feeling like he was too quiet and couldn’t talk normally with his friends,” she explains. The whole family was supportive of these breaks. “There were times, when he was not medicated, that his hyperactivity was disruptive to the family, but we dealt with it.”

Why keep your kids on medication, even during holidays?

When staying on medication may be the safer call

• ADHD affects safety, including impulsivity, elopement, aggression or risk-taking
• Your child struggles with peer interactions, emotional regulation or following directions outside school
• They still need support for camp, daycare, sports, travel or family routines
• Previous breaks led to serious disruption, distress or conflict
• The medication helps your child feel more settled, confident or in control

Other kids actually feel better about themselves when they’re on their meds. “I won't take my nine-year-old, *Nikki, off her Biphentin [during], because it does seem to affect her mood when I do,” says her mom, Chantal Saville. “Nikki is frustrated more easily, which makes her snappish, and she can tell the difference when she's off them, which isn't necessarily a good feeling for her.”

In fact, while it was once a popular approach, the medication vacation is increasingly being called into question by medical professionals and parents alike, because it can undermine a kid’s sense of stability. “Declan has almost no control over himself when he does not have his medication. It's horrible to watch his fear when he can't stop doing or saying something that he knows he shouldn't,” says Caitlin. “He yells and screams at everything, runs away (thinking he’s invincible), and spins and rolls around a lot,” she says. “It’s unbelievable, the shift, when he’s medicated.”

McCormack also keeps Declan on meds year-round as a protective measure, because he would sometimes attack others physically when not medicated: “If he were to stop his medication, it would put his own safety as well as the rest of the family’s safety at risk.”

Some kids are not only taking meds to focus academically, points out Macmillan. “Kids with combined types of ADHD (inattentive and hyperactive-impulsive) can interrupt people, forget things, or behave in ways that really get them into trouble at home and in the community.” And even if school’s out, kids may still need to follow direction and get along with peers in daycare or at camp. “We wouldn’t take a kid’s glasses away for summer,” says MacMillan, “so why feel we have to take away meds that help them to function?”

When your kids should get a say

Older kids, in the middle school and high school years, are likely to have strong opinions on the question of medicating through summer. Parenting book author and mother of four (now grown-up) kids with ADHD, Ann Douglas, believes that as kids get older, it’s good to let them be part of the decision-making process.

“Our paediatrician didn’t raise the idea of taking a medication break until the kids were preteens,” says Douglas. “At that point, she offered it as an option to them—specifically, as an opportunity to take a trial run of being off their medication, so that they could see how well they were able to manage their ADHD without it.” Since Douglas’s kids had treatment plans that included medications and coping strategies, there was some merit in seeing how they’d fare unmedicated. Douglas’s kids only took their paediatrician up on this offer around the time they were getting ready to head off to high school. And Douglas says, “That break did ultimately lead to them going off their medication permanently.”

MacMillan points out that if a kid is starting to question whether their meds are helping, with their paediatrician’s green light it can be interesting to do a week-long break, during the summer, as an experiment. That way, the child and other family members can identify what—if anything—is different. “It’s good to engage a child in this way, so they understand the value of their meds during the school year,” she says. That said, evaluate whether your ADHD child is prone to risk-taking, possible at any age, but particularly prevalent among tweens and teens. They may need extra monitoring if they stop their meds, to ensure they’re weighing the consequences of their actions and decisions. Or it may just not be worth taking any chances.

If your family is planning to travel during the vacations, this can be challenging for a kid with ADHD, so be careful not to throw too many changes into the mix at one time. “Kids who have ADHD really benefit from routines, and they find it difficult to adjust to change, including medication changes,” says Douglas. Can your kid handle going off meds while busting out of the home routine all at once? Libby (last name withheld), the mother of a 14-year-old with ADHD, says, “I don't dare have a kid who hasn't been on meds potentially act out going through airport security. And two weeks in a car with my child off meds—the child who I love more than my own life—is my idea of hell!”

Questions to ask before changing ADHD meds for the summer

If you’re thinking about changing your child’s medication routine for the summer, these are good questions to bring to your doctor or nurse practitioner.

1. Is my child taking a stimulant or a non-stimulant, and does that change how a break should be handled?
2. What benefits does the medication provide outside school, including behaviour, safety, social skills and emotional regulation?
3. Which side effects are we trying to solve, and are there other ways to manage them?
4. If we try a break, what signs should tell us the plan is not working?
5. Do we need to taper, monitor or book a follow-up before making any change?

There is no one-size-fits-all answer to ADHD medication in the summer. For some kids, a carefully supervised break from a stimulant may make sense. For others, especially children whose ADHD affects safety, relationships or day-to-day functioning, staying on medication may be the more stable choice. The best decision is the one you make with your child’s clinician, based on how your child functions, what side effects they are having and what summer actually looks like for your family.

*Names have been changed