Sometimes I wonder if I actually need my ADHD medication. After all, I made it 36 years without it, so how much could it really be helping? What would happen if I stop taking ADHD meds for a while? Could I be old enough now that my symptoms are essentially gone?
Do the Meds Help?
And then I accidentally miss a day, or a weekend, and I remember why I take my meds. But more on that in a minute.
I hear parents of tweens & teens with ADHD asking this question a lot. Somewhere between middle and high school, their rapidly changing young adults-to-be want to make a valiant push to try life with ADHD — without meds.
Their reasons are usually something like:
- I don’t want to feel/be different (my friends don’t take meds)
- I don’t want to have to take medication (my friends don’t take meds)
- I really think I’ll be fine without it (my friends don’t think I need to take meds)
The message is clear: “Mom/Dad, I want to stop taking ADHD meds!” If you want to support your child in this process, I strongly encourage you to plan for a med-free trial that includes these 3 steps.
3 Steps BEFORE Starting a Med-Free Trial
As with any good scientific experiment, it is absolutely essential to establish clear parameters that will evaluate the effectiveness of a med-free trial.
- Consult the Doctor: Work with your child’s physician to learn HOW to safely titrate off of medication. Some ADHD medications, like Intuniv, cannot be suddenly stopped without severe side effects. Do not take your child off medication without the doctor’s approval and support.
- Decide on the Timing & Duration of the Trial: Agree in advance when it might be a good time to start the trial (the week before exams might not be such a swift idea) and how long the trial will last (usually 3-6 weeks, but can be longer/shorter.)
- Agree on What Success or Failure Looks Like: You and your child must agree in advance on what you are hoping to learn from the trial. For example, one family might look at whether a teen continues to turn in assignments (4 or more missed assignments indicating it is time to return to meds). Another family might focus on keeping the GPA above a 3.0. Still another might be looking at family dynamics and completion of household chores. Be as clear and simple as possible, and identify no more than 3 measures of success.
Life after a Med-Free Trial
So, what happens next? In my experience working with families, teens usually go back on their medication (voluntarily!) before a trial period is over. Why? Because ADHD is a chronic condition, and they recognize that the medication is helping them learn to manage it. Some people may no longer need medication when they get older, but many still do.
I’ve also noticed that many kids who stop taking medication in high school may choose to go back on medication when they get to college. The challenges of their ADHD become more difficult when they have to manage it away from home, and without their familiar systems and structures.
Adults Can Try Med-Free Trials, Too
Adults are no exception. A couple of weeks ago I decided to stop taking my stimulant medication to see what would happen. I had my plan in place: I checked with my doctor and got her approval first, and I gave myself a 2-4 week time frame. In hindsight, I did not discuss success or failure parameters with my husband because I thought the end result would be pretty obvious. Lesson learned – the hard way.
Over the next five days it quickly became evident that my medication is critical to my self-management. Here’s what happened:
- I spent $850 at Target during a one-hour shopping session. And, I left my Target card at home, so I didn’t even get my discount. Goodbye impulse control.
- I put the cereal box in the fridge and the milk in the cabinet three times in 5 days. On medication, that usually only happens once a month. J
- I picked up the family prescriptions from the pharmacy, and put them down somewhere. Unfortunately, 2 of those prescriptions were ADHD medications for my children, which are not easy to replace. I still have no idea where they are.
- I completely lost it with my husband and got snippy with my boss. Embarrassingly so. Yelling, texting hateful things…it wasn’t at all pretty. Hellooooo emotional dysregulation.
- I bought 2 different plane tickets for the same conference because I forgot that I’d already booked my flights! Ugh. So long, working memory.
- And most importantly, (and ironically one of the main reasons that I started taking medication in the first place), I completely forgot that my 12-year-old had early release from school one day. There is nothing quite so gut-wrenching & horrible as getting a call from the school office reminding you to come pick your child up an hour after he was dismissed.
So, me without meds = epic fail. Or more accurately, me without meds equals an inability to manage the many challenges of my ADHD. Faulty impulse control, poor emotional regulation, diminished executive functioning and little or no working memory. Not fun.
That said, there are plenty of people who are able to successfully discontinue medication and manage their ADHD with behavioral therapy, exercise, diet, mindfulness and a whole host of fabulous options.
But it’s important to remember that people who stay on their medication do so because it works for them. The American Academy of Family Physicians estimates that 2/3 of kids with ADHD will continue to struggle with ADHD symptoms as adults. Women, in particular, may see a marked increase in their ADHD symptoms as they approach menopause.
So if would like to stop taking ADHD meds, you might want to do a little research. Give the medication-free trial a shot. If you keep the 3 steps in mind, it will be a success regardless of the results!