Ritalin Breaks

[Jaclyn]

Hi Everyone, My names is Jackie and I am new.

I have an 8 year old ADHD son who is on Ritalin. He has been on it since he started school, even though he was diagnosed ADHD prior to school. My doctor feels (as do I) that he should only be on Ritalin for school. I never really asked my doctor why he felt that way since I agreed. Does anyone else have a child on Ritalin but was advised not to give it to them on weekends, holidays, etc. and did they ask the Doctor why?

Thanks a lot.

[rosyred45]

Hi Jackie, welcome to the family.

While I don't medicate my son, I do kn ow that some parents do the breaks for a couple of reasons.
#1. Some medications have a significant effect with weight loss. The weekends are the time to "fatten" em back up.
#2. Another thing I have heard was that some medications effects tend to lose effectiveness when constantly being taken, there fore the dosage would have to be upped.

There are others here that have a lot more knowledge than I do, obviously, so I'll let them take it from here.

But, cruz around and see if there is anything else that interests you, this place has been my saving grace.

Take care

[eaccae]

Jaclyn,

Hi and welcome.

First of - our med history: DS will be 9 next week but he has been on ritalin since he was 5. He started off with 5mg ritalin in the am and at noon which he stayed on for 2.5 years. After 2.5 years we needed to increase the dosage to 10 mg ritalin twice a day. That worked well and then we decided to try a time released ritalin. We started off with 20mg metadate cd once a day. This worked really well but due to insurance reasons we had to switch to 20mg ritalin LA. The ritalin LA released too much for ds in the am (he was too medicated) and not enough in the afternoons (creating a terrible rebound). We were able to switch back the ritalin LA. It wears off by the time school is out which we have dealt with but now that we are in 4th grade with more intense homework and hockey after school we are in the process trying a booster of ritalin when he gets home. We tried 5 mgs but we think we need to do 10 mgs as the 5 isn't doing anything.

Okay - now to the topic of med breaks: We used to do med breaks on weekends, holidays and summer vacations. We did this for two years due to our pediatrician's recommendations. After two years we spoke the pediatrician - we couldn't do it any more. DS is highly energetic, highly inattentive and highly impulsive and we were going through WWIII. The pediatrician (who has two adhd children herself and an adhd doctor husband) decided that it would be best to stop the breaks. She sadi that she had personally changed her mind about giving the breaks because 1) a side effect of stopping a stim is that it can cause increased hyperactivity for a couple of days and 2) most importantly she felt that his adhd didn't stop when he wasn't in school so why should his quality of life stop. DS is very small for his age and skinny - but he was that way premedication, his father was that way until college (he is onlyl 5'8") and at 5'7" I am the tallest in my family - it isn't related to the meds and he eats like a madman from 4:00 until he falls asleep. He does have trouble sleeping - but for us that was also premedication. He didn't sleep even when he was an infant. Neither my sister or I can fall asleep easily. So stopping meds for him will not help with these issues as they existed before. For many people - these issues are directly related to medication and - as Kaiti said - they often need to take med breaks in order to get food in their children.

As for building up a tolerance - I personally don't believe that med breaks play any role in that. I think that is something that varies from individual to individual. DS took med breaks for 2 years and it took 2.5 years to need a higher dose of meds. He has now been without med breaks for 2 years and still doesn't need an increase in med dosage.

You asked some great questions. I don't know if I helped you at all. I have found that med breaks vary from family to family as well. For some who have inattentive as a primary issue - the meds on the weekends aren't as necessary. For us - DS's impulsiveness (my primary issue) was still there and our family life was falling to pieces. Again for us - it has made a HUGE difference in our quality of life!

I hope this helped some.

[HooDunnit]

Hi Jaclyn and welcome to the forums. I think that medication breaks are probably a good idea. Continuous use of a stimulant can lead to the patient becoming tolerant or "immune" to the medication. That might require increasing the dosage over time, and increasing the dosage can lead to the development of side-effects such as anxiety, difficulty sleeping, and so on.

Barry

[Jaclyn]

Thanks guys for replying.

The reason why I don't give my son meds over the holiday/weekend is to give his body a break and to help him learn to cope. I just think that if I keep giving him his meds all the time, when does it stop. There comes a time when he has to learn how to control his urges, fits, etc. If there are no breaks, when does he learn to cope with his ADHD.
I have heard of people being on it in their 20s, is that because parents never gave them a break from it. I have heard all the pros and cons about breaks, but no one has ever brought this one up. I just wondered if people felt the same way.

[finnmom]

Hi and welcome


My ds9 is currently on Concerta 18mg and Ritalin 5 mg, on schoolday´s ONLY. It work´s great for us, as a matter afact, it´s the common policy with these med´s here in Finland, only to give those on schoolday´s (if just possible to handle the situation without them otherwice). For us it´s no hard one; I can handle my ds perfectly well when I keep monitoring him and stay one step ahead of him, I cant do that in school, so med´s help me on that!

[jdmom]

I don't give Jarrett his meds on weekends/school breaks. My reason being that Jarrett is VERY hyperactive, but it is something that I have learned to love. I love his boundless energy. Jarrett is not very impulsive and doesn't tend to do scary things. He's actually a bit of a chicken. I think that comes from his anxiety. If he was impulsive and tended to do dangerous things unmedicated, he would definitely stay medicated on weekends/holidays. He takes his meds to help him focus on his school work. Plus, he's not the best eater in the world when he's on meds. I like him "catching up" on the weekends, and over the summer he gained, and has managed to keep, 7 pounds.

I think it just depends on the severity of your child's condition and how it affects your family.

[camismom]

My dd has taken Ritalin pretty much since first grade (give an take a few times where she has tried other meds). We too only give it on school days. I have to say when she was younger I gave it every day but that was because she was just sooooooo hyper and impulsive I worried for her safety. As she has gotten older she has gained a little more control of herself and I too feel that taking it every day makes her rely on it and doesn't help her to see the behavior herself and learn to control it. I also feel it will only make her build up an immunity and make us keep increasing the dose. The way I look at it... if you can handle your child off the meds, then it's your choice.

[Linda]

:)Paul started meds when he was in 1st grade(6). We only gave it to him for school only....He is 16 now and med free.

I think it all depends on your child...some kids have to take it daily but it is a personal decision depending on all the factors...especially the level of hyperactivity.

[eaccae]

Please don't take this the wrong way as I respect everyone's opinion on this board, whether I agree or not. But I feel I most post as I do not believe that med breaks are that cut and dry . . .

I have accepted the fact that DS may have to be on meds for his whole life. It would be great if he didn't - but his father should be on medication and isn't - and I actually am making an appointment because if I DON'T get on meds soon I will probably fall apart. I have dealt with my inattentive add for 36 years but the more things that are pulling at me the harder it is for me to cope and I have reached the point where if meds is going to increase my quality of life then I am all for it. My father takes lithium every day. Half my family takes insulin every day. So taking a medication everyday - if it has to be - it has to be.

For DS- like I said - DS is highly impulsive and THAT is the main reason that med breaks don't work for us. It is something that hopefully will improve with age (research shows that the brain goes through some changes during the teen years and often times medication dosages can be dropped down and some cases eliminated) - but it isn't something that he will be able to just learn to cope with - especially at this age. And personally - if there is something out there that helps him the way the meds are helping him - then I guess I personally feel - why SHOULD he have to try and learn how to cope with it and make life a living ****.

We are lucky - his side effects are minimal, we have only had to increase the dosage once in 4 years (even without med breaks - it isn't creating a tolerance buildup) and when on the medication he is happy, self confident, able to focus, able to enjoy all aspects of life and still maintains a "normal" amount of energy with absolutely no personality change. He has told me on several occasions that he doesn't feel any different physically when on the meds, but he feels in control when on the meds.

With all the studies out there - especially the scans showing the difference between the white matter for adhd kids/adults when on meds vs. off meds and adhd vs. nonadhd - and knowing that it IS indeed a biological/chemical disorder . . . I don't have the guilt that I did 4 years ago when we started this. I don't have the guilt that I had for deciding to medicate. And I don't have the guilt that I had 2 years ago when deciding with the pediatrition to stop the med breaks.

As a parent recently said to me . . . they spent a lot of years learning to accept that this was a true disorder that wasn't going to go away. I think that is one of the hardest things that we as parents have to learn to accept!

That said - I personally believe that if it isn't affecting the quality of life of your child - then med breaks aren't a bad idea. But just as different meds work differently for each individual . . . med breaks have to be customized per each individual. I just want to make sure that, if down the road, anyone here needs to reevaluate - they don't feel guilty about having to make a change. As I said - we went 2 whole years not medicating on the weekends, holidays, school breaks or summer vacation . . . for us the right decision was stop the med breaks. For some . . . they start off with no med breaks and find that it works best for them to have med breaks.

My point, I guess, (sorry for this long ramble) is that it is a decision that is not as cut and dry as the reasons posted above.

(Oh yes - and I want to be clear that when I mean cope I mean cope - DS must still be responsible for his behavior, on or off meds - we do have a behavior/parenting plan in place and it has made huge differences ).

[finnmom]

Eaccae, you´re totally right!

This all depend´s on child him/herself, some do better with med´s everyday, some can cope with "only-schooldays-plan". I think that with med´s it´s always a personal choice, something work´s for one and not for the other! And you´re right about behaving with or without med´s too... med´s are not the answer, there has to be all the other thing´s taken care too.

I´am sorry you felt like you had to defend your action´s, it sure wasnt my intention´s at all We all do the best for our own kid´s!!!

[eaccae]

Thanks, Marja. I think that personally I have gone through so much guilt over the years because I have chosen the med route and I would justify in my mind that it was okay because I gave med breaks. When we came to that crossroad where we decided that we has to forgo the med breaks (a very hard decision) and I saw the result . . . I finally let go of all of my guilt and justifications. I guess I just wanted to be a voice out there so that if someone else was coming to that crossroad - that guilt didn't get in the way of doing what was best.

[AnneM]

I totally agree with the others who have said that this DEPENDS ON THE CHILD ... Some children NEED their meds every day .. others really only need them for the "school" environment .... it varies hugely ... I also understand that different doctors can feel differently about this BUT at the end of the day IMHO it is down to the individual child and NOT how a particular doctor feels about breaks or no breaks.

My own son has been on Concerta since he was 13 ... (and is now 16) and is getting to a point where he really appears to no longer need them ... however he has always had breaks at weekends etc. because the only environment he has ever really needed his meds was the classroom environment at school. However, a friend of ours finds that her son really cannot cope at weekends without meds so HE takes them every day and has had to since he was 6 (and he is now 15)

SOOO ... imho it is all part of the trial and error of medication and the variants between different children and their needs...

GOOD LUCK! I am sure you will find the "right" way for your own child but you may have to "experiment" a little first ....