Drug holidays from ADHD meds?
March 17, 2013 4:27 PM   Subscribe

Do you take weekends off or longer "holidays" from your ADHD meds? Why or why not?

I have ADHD, inattentive/impulsive type, and am now taking 54 mg of Concerta daily after starting on instant release methylphenidate about 6 weeks ago. (Snowflake detail: I'm female, middle-aged, and was diagnosed in adulthood.) The doctor says I should take it every day and not skip days, the same way I'd take meds for blood pressure or another physical condition that needs to be treated. I skip a day now and again, but never a workday. Some days I plan to skip but wind up feeling so unmotivated and unfocused that I finally go ahead and take the medication just so I can get anything at all done. Like the doctor said, I probably need it every day, but I'm also wary of building a tolerance. Yeah, I know the plural of "anecdote" is not "data," but I'd be very interested to hear your experiences with taking or not taking time off from meds, especially if you take a form of methylphenidate like Ritalin or Concerta. I'm also just wondering if my own experiences are in the normal range (or at least in the "I've heard of that" range). One more thing: I read this but it didn't address directly what I wanted to know. Thanks in advance!
posted by sister nunchaku of love and mercy to Health & Fitness (13 answers total) 4 users marked this as a favorite
Nope. Because I tend to wake up one morning six months down the road and realize I have gained twenty pounds and stopped paying bills.

I really wish I was being flippant.
posted by DirtyOldTown at 4:30 PM on March 17, 2013 [6 favorites]

Nah, I like to be on it whenever I'm awake. Without it, I just mill about instead of relaxing and enjoying my book or whatever. Even goofing off takes a surprising amount of focus in order to enjoy it.

Similarly, I'm very myopic and when I'm awake I always have on my glasses or contacts. Because why would I want to blunder around not being able to see, even for a minute?
posted by tel3path at 4:32 PM on March 17, 2013 [1 favorite]

Oh and. Skipping a day won't actually do you any physical harm. If you want to skip a day, skip it. I just don't like to, myself.

Also, don't worry about building up a tolerance. That's a nonissue for most people.

Plus, you take a holiday from your meds every day, while you're asleep!
posted by tel3path at 4:35 PM on March 17, 2013

I used to skip weekends, but really there was no useful reason. You won't build up a tolerance--if you need a higher dosage, you'll know it. I take Adderall SR, and after 7 years at one dose, went up a little bit last year. And as you move into peri menopause, trust me--the brain fog that some MDs say doesn't exist--the Adderall greatly helps.
posted by Ideefixe at 4:42 PM on March 17, 2013

I do, on weekends and when traveling. I do it because I'm on amphetamine-based ADD drugs and I don't want to build up a tolerance, as higher doses give me tummy troubles. Also, I don't like the feeling I get that everything is crashing down to a halt that comes when my meds run out (used to be after 10-12 hours, but with worse insurance I'm now on meds that run out at 6-8 hours). It's nice to avoid that by taking the day off.
posted by croutonsupafreak at 5:42 PM on March 17, 2013

I skip one day a week, only because my doctor tells me to.
posted by 4ster at 5:42 PM on March 17, 2013

People will develop tolerance to the "fun" effects of stimulants, but the therapeutic effects don't have that problem.
posted by gjc at 6:36 PM on March 17, 2013 [1 favorite]

I skip weekends because I tend to sleep in and generally laze around the house until after noon or so and I forget to take my pill. As a result I'm noticeably less productive on weekends, but that's quite all right for my lifestyle. If I have a reason to wake up before 10 am or if there are people depending on me, I will make an effort to take the meds with my morning coffee.
posted by halogen at 7:35 PM on March 17, 2013

I take methylphenidate, as well as Lamictal.

I take weekend 'drug holidays' from the methylphenidate only, under my doctor's ever watchful eye. Lamictal is something I take all seven days.

I do so because I've planned my life to where the weekends are basically relaxing/decompressing time from my job, and to also not build up a tolerance. I'm extremely sensitive to medicatin anyways that the I'd rather take the weekend off I stead of upping my dose. Last time we tried that, the methylphenidate gave me panic attacks instead, and I had to drop out of school.
posted by spinifex23 at 8:31 PM on March 17, 2013

No, I don't. I've been on 54mg of concerta for a few years and haven't built up a tolerance. My doctor has told me it is okay to skip a day occasionally if I wanted to.

I ran out of pills actually and have spent the weekend off my meds, I'm remembering exactly why I take my meds every damn day. Life is frustrating and I haven't gotten anything done today.
posted by inertia at 8:44 PM on March 17, 2013 [1 favorite]

Basically everything tel3path said.
posted by inertia at 8:46 PM on March 17, 2013

Response by poster: Thanks for all the responses. I realize the answer is pretty much "your mileage may vary," but it's still super helpful to me to learn about how others use the meds effectively and therapeutically. The other thing I'm wondering is if I'm experiencing some rebound--sometimes when I take a day off, or after the Concerta wears off, I feel EXTRA scattered and indecisive and unable to get a start on the to-do list, maybe even worse than before I was medicated. But that's probably another question! Again, thanks to all to answered. I'll keep checking back if anyone else wants to add their experience.
posted by sister nunchaku of love and mercy at 7:11 AM on March 18, 2013

My teenaged sons skip their stimulant ADD meds whenever they don't have to do schoolwork. They find the side effects worth putting up with only when they have work to do that they can't attend to without the medication. They have enough schoolwork to do that there are not very many days, aside from vacation, that they can skip it altogether, but they have a short-acting alternative medication for days when they have only a little schoolwork to do.
posted by artistic verisimilitude at 8:41 AM on March 18, 2013

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