ADHD patient teaching

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For parent/patient teaching of ADHD medications in general, should the kids take a medication holiday? Or continue treatment without interruption?

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I would consult with whoever is actually prescribing the medication to the child re: what her/his preference is on that question.

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Specializes in Pedi.

Take a medication holiday when?

Whether or not the child takes the medication every day or on school days only is a question for the provider.

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This is a potential SATA question for an exam I am taking on Tuesday... Some of the answers include (take in the AM, give with food, take on holidays) I'm doing the LPN to RN bridge with EC. I personally worked for a child psych doc and we would say YES give them a drug holiday, but I'm not finding what the correct test question answer is....I hope this makes sense...

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Specializes in Pedi.

"Take on holidays" means something different than "take a medication holiday"...

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Specializes in Complex pedi to LTC/SA & now a manager.

Take as prescribed. If the Rx states take daily in AM. The education would be take around the same time each morning. Perhaps when brushing teeth so it becomes routine and less likely to forget. It's out of the scope of an RN to advise a patient to take medication holidays as that would be a prescribing provider protocol

I can see take on holidays on a benzo Rx for family induced stress ;)

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Specializes in Pedi.
I can see take on holidays on a benzo Rx for family induced stress ;)

I need some Xanax to get me through the holidays...

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Specializes in Complex pedi to LTC/SA & now a manager.
I need some Xanax to get me through the holidays...

I don't know if I'm going to make it through this week as the drama started last week. Maybe a double time double shift will do just fine if it weren't for my offspring

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Specializes in Short Term/Skilled.

The only one who can suggest a medication holiday is the provider. (as an aside, it is routine for kids to come off their meds from time to time to see how they're doing) Yes, with food, yes in the AM, Yes on holidays, weekends etc.

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Specializes in critical care.

This would vary based on child, severity of symptoms, ability of parents to provide safe environment and supervision off meds, etc. It would be up to the MD's discretion to decide. If you've been given instructions by the provider to take holidays, then that's part of your patient teaching.

Keep in mind, if they are on a med like kapvay or any SSRIs, going off cold turkey for a med holiday can be dangerous. This is another reason why MD preference needs to guide you on this, and it will be individual to the child.

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Specializes in Pediatrics, Mother-Baby and SCN.
This is a potential SATA question for an exam I am taking on Tuesday... Some of the answers include (take in the AM, give with food, take on holidays) I'm doing the LPN to RN bridge with EC. I personally worked for a child psych doc and we would say YES give them a drug holiday, but I'm not finding what the correct test question answer is....I hope this makes sense...

Well clearly in this context the most obvious answer that it is NOT is take on holidays. Some families will take a break from the meds on a day off from school, etc. but that is not what this is saying (ie. a drug holiday like you are interpreting it.) Usually the goal is to have the child functional and able to focus for school and regular daily tasks, so not just on holidays.. The most correct answer would likely be take in the AM, however many ADHD meds can cause digestive upset, etc so give with food may also apply.

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Specializes in Behavioral Health.
Well clearly in this context the most obvious answer that it is NOT is take on holidays. Some families will take a break from the meds on a day off from school, etc. but that is not what this is saying (ie. a drug holiday like you are interpreting it.) Usually the goal is to have the child functional and able to focus for school and regular daily tasks, so not just on holidays.. The most correct answer would likely be take in the AM, however many ADHD meds can cause digestive upset, etc so give with food may also apply.

While popular, the data supporting drug holidays is pretty contradictory, with a couple exceptions. As ixchel mentioned some medications (Kapvay, Strattera, Intuniv, etc - long acting medications that affect BP) make drug holidays off limits, some people have symptoms too severe to stop taking meds, and for everyone else the data on whether there's any benefit is mixed. The two exceptions are kids who have trouble sleeping due to their medication and those who have slowed growth.

Stimulants (Ritalin, Concerta, Vyvanse, Adderall, etc) are usually dosed in the AM to be taken after breakfast, but short-acting ones would also be dosed throughout the day. On the other hand, the alpha2 agonists (clonidine, guanfacine) commonly cause sedation, especially when they're first used, so they're frequently taken at night. They also don't typically cause anorexia, GI distress, or N/V so there is no recommendation that they be taken with food.

Basically, this question seems to only apply to extended release stimulants. :)

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