When and How a Child Should Stop Using ADHD Medications

ADHD is a condition that is well recognized by most parents, teachers, and pediatricians. Kids with ADHD symptoms typically have problems paying attention, get easily distracted, and/or are hyperactive and impulsive.

Starting ADHD Medications

It is often clear when a child needs to start ADHD medications, as their ADHD symptoms are causing some form of impairment. Some possible reasons to start include:

• Behavior problems at school and/or at home
• Difficulty making and keeping friends
• Problems in after-school activities and sports
• Trouble in the classroom and falling behind at school

For these children, an ADHD medication—usually a stimulant—is the recommended treatment to target these core ADHD symptoms. Behavior therapy, instead of or in addition to a stimulant, is also sometimes recommended.

Stopping ADHD Medications

It is usually a lot less clear whether your child should be taken off ADHD medication after they have been doing well for some time. Should they take it for the rest of their life? This might seem reasonable to some parents, as many adults are now getting diagnosed with and treated for ADHD.

Or perhaps one of the below factors has caused you to think about stopping the medication:

• Too many ADHD medication side effects, like a decreased appetite, insomnia, or moodiness
• When they don't want to take it anymore, often when they become a teenager
• At the beginning of every school year to see if they actually still need it

By themselves, none of those are really good reasons for a child to stop taking their ADHD medication. For example, if your child is having too many side effects, a lower dose or medication change might be better than just stopping medication altogether.

Signs to Consider

Unfortunately, once a child is on an ADHD medication and doing well, many parents and pediatricians don't want to "rock the boat," and will continue the medication from one year to the next, never really considering if it is still necessary. However, ADHD medication should continue to be monitored, even after the right dose is found initially.

As a part of a periodical assessment, the physician and family should look for signs that indicate the child might be able to stop their ADHD medication. Some possible reasons to stop include:

• Your child has been well controlled and free of ADHD symptoms for at least one year while taking medication.
• You haven't needed to increase the dose of medication, despite the fact that the child has grown and gained weight in the past year or two.
• ADHD symptoms are not noticeable on days that you don't give the child medication or when they forget to take it.

Keep in mind that not every child is going to be able to stop taking their ADHD medication when they get older. ADHD symptoms likely are never outgrown, although hyperactivity symptoms often decrease as a child gets older.

When to Stop ADHD Medication

If you, together with your pediatrician and your child, decide that stopping their ADHD medication might be a good idea, it is important to choose a good time to try it.

Wait for a low-stress time when your child is in a good routine at school—perhaps after a round of tests when school might be a little easier. Even a vacation might not be a good time, since your child won't have the same demands as they would at school, such as reading, going to class, studying, etc.

How to Stop ADHD Medications

It's very important to consider the potential risks of stopping an ADHD medication beforehand and how to do so as safely as possible. For example, the non-stimulant medication clonidine should not be stopped abruptly as it can cause high blood pressure. Consult your doctor so they can oversee the process safely.

Once you do stop their medication, be sure to regularly check and make sure that your child is continuing to do well.

Don't just wait for your child's next report card, though. Instead, give each of your child's teachers an ADHD questionnaire to fill out in about two weeks, such as the Vanderbilt Assessment Follow-Up form. A parent form is also available, and both can be scored by your pediatrician to make sure your child's trial off ADHD medication is really working.

Teens and ADHD Medications

Since the non-medical use of stimulants or abuse of Ritalin and Adderall is an increasing problem in teens and young adults, most parents likely wouldn't think that getting teens to take their prescribed ADHD medications would be a problem.

Unfortunately, compliance with taking their ADHD medication often becomes a problem for teenagers, both for teens who have been taking their medication for years and those who are just starting to take something. In fact, growing feelings of independence among teenagers often make them resistant to taking any medications for chronic conditions.

If a trial off of medication isn't a good option, you might be able to improve your teen's compliance with their medication by:

• Getting your teen involved in the decision on whether or not to continue taking their medication, instead of simply trying to force them to take it
• Making sure your teen understands their medication isn't a cure or crutch and is like taking any other medication for a chronic condition, like using an inhaler for asthma
• Talking to your pediatrician to ensure your teen doesn't have another problem, such as depression, anxiety, oppositional defiant disorder, drug use, etc., that is contributing to their non-compliance
• Adjusting your teen's medication dosage or changing medications if side effects are a problem, even settling for a reduction in ADHD symptoms instead of trying to get rid of them altogether
• Considering allowing your teen to take breaks from their ADHD medication on weekends and other breaks from school
• Getting help at school or after school, such as extra tutoring, when trying a trial off ADHD medications

Extra counseling and behavior therapy are also good options if your teen resists taking their medication and their grades, relationships, and behavior at home begin to suffer.