As summer arrives and school routines shift, many parents of children with ADHD begin to wonder whether they should take a break from medication. These “medication holidays,” often scheduled over weekends or long school breaks, are usually motivated by concerns about side effects, especially the widespread belief that stimulants negatively impact appetite and growth.

But what does the latest research actually say? And what are the real consequences of pausing ADHD medication during the summer months?

The Growth Myth Finally Debunked

One of the most persistent myths surrounding stimulant medications is that they cause a long-term reduction in growth. While it’s true that some children experience a temporary dip in height or weight gain early in treatment, long-term studies have now shown that these changes are minor and do not persist over time. In fact, children who continue medication typically catch up to their peers by adolescence.

A landmark study that followed hundreds of children over a decade found that while there was some early growth delay, it averaged less than 3 cm over ten years and ultimately, there was no meaningful difference in final height between medicated and unmedicated children. This evidence strongly counters the old idea that taking a break from medication is necessary for a child to grow “normally.”

What’s important to understand is that this slight reduction in height gain, particularly in the early years, needs to be weighed against the well-documented benefits of treatment, including improved daily functioning, better emotional regulation, and a significantly reduced risk of injury. For children with impulsive or risk-taking behavior, medication can be a protective factor. And for many families, the gains in safety, self-control, and quality of life far outweigh the modest and typically temporary impact on growth.

That said, growth should always be monitored as part of a responsible treatment plan. Your child’s healthcare provider can track height and weight regularly and adjust dosage or treatment strategy if needed. But remember, a medication holiday shouldn’t be your first response to a growth plateau, especially if the medication is otherwise helping your child thrive.

Why Families Still Consider Medication Breaks

Despite the reassuring data, many families still feel pressure to stop medication during school breaks. Some hope that taking a pause might restore a child’s appetite, improve sleep, or simply give them a rest from daily dosing. But according to Dr. Max Wiznitzer, pediatric neurologist and ADHD specialist, stopping medication, even for a short time, can have unintended consequences.

Going off medication for short periods to allow for weight gain or respite says Dr. Wiznitzer, “doesn’t help the child develop a tolerance for the medication.”

In other words, taking breaks may actually prevent the child’s body from adjusting to the medication in a healthy, sustainable way. Many of the side effects that occur in the first few weeks, like reduced appetite or trouble sleeping, naturally fade over time as the body adapts. But that adaptation requires consistency.

“If you stop on the weekends, you basically start over on Monday,” Dr. Wiznitzer explains.

A person’s body adjusts to the medication over the course of the first few months and side effects can lessen or disappear after that time. However, if medication is taken during the week and stopped on the weekends, possible side effects are less likely to go away as the body is not able to develop the necessary tolerance.

The Real Impact of Medication Holidays

Beyond the physical side effects, stopping medication can also disrupt the emotional and behavioral progress many children make during the school year. In families I work with, it’s common to see a resurgence of irritability, emotional dysregulation, and impulsivity within days of stopping. Parents often describe feeling like they’re “walking on eggshells” again after weeks or months of calmer, more regulated behavior.

In a recent study, children who paused ADHD medication during the summer showed a loss of gains in emotional control and planning skills, skills that are often hard-won and critical to daily functioning. While appetite and sleep may improve slightly off medication, the trade-off is often a reemergence of conflict and frustration at home.

When Medication Breaks Can Be Risky

While medication holidays may seem harmless, they are not recommended for all children, especially those with the hyperactive/impulsive or combined presentations of ADHD. These children tend to have more intense symptoms, including impulsivity, risk-taking behavior, and difficulty with emotional regulation. For them, stopping medication can have immediate and serious consequences.

Children with more severe ADHD symptoms often experience a return of challenges once medication is stopped. For those who struggle with impulsivity, this can increase the risk of unsafe or risky behaviors. Without the support of medication, it becomes harder for them to pause, think, and make safe decisions in the moment, something that can be especially concerning during unstructured times like summer.

This isn't just theoretical. Research has consistently shown that children with untreated or undertreated ADHD are at significantly higher risk for accidents and injury. Studies have found :

Children with ADHD are nearly two times more likely to visit the emergency room due to injuries than their neurotypical peers.
Those with impulsive symptoms are at particularly high risk for accidental poisonings, bicycle accidents, falls, and burns.
A large Swedish registry study found that ADHD medication reduced the risk of serious injuries by up to 31% in children and 58% in adults.
Another long-term study reported that children and teens with untreated ADHD had a higher risk of premature death, often linked to impulsive accidents like traffic injuries.

These findings are sobering and underscore the importance of continued treatment for children whose symptoms don’t “take a break” just because school is out.

For these families, consistency in treatment isn’t about control, and it certainly isn’t about medicating for convenience. It’s about safety. Medication can be a vital tool for reducing dangerous impulsivity, supporting emotional regulation, and helping a child stay grounded, focused, and secure in their environment. Letting go of guilt around medication use is important, especially when that treatment is helping your child navigate the world more safely and successfully.

When a Medication Holiday Might Make Sense

While consistent treatment is essential for many children with ADHD, especially those with more severe symptoms, there are specific situations where a carefully planned and closely monitored medication holiday might be appropriate.

One common reason families explore a break is to reassess whether medication is still needed at the current dose. As children grow, gain maturity, and build new coping skills through therapy, coaching, or structure at home and school, their support needs can shift. A trial period without medication, under medical supervision, can provide valuable insight into how they function in daily life without it and then the dosing can be adjusted.

Another consideration is a change in context. During summer holidays, vacations, or time spent at home, some children experience fewer environmental demands. If symptoms are relatively mild and the child’s safety isn’t at risk, a brief pause might help parents observe how their child navigates a less structured environment without medication. It’s important, however, to be realistic about what the break is meant to evaluate, not just school performance, but overall behavior, mood, and relationships, especially in the context of friends and family.

A medication holiday can also be helpful when preparing for a treatment transition. For example, if a teen is moving from stimulant medication to a non-stimulant option, or nearing the age where they’ll manage their treatment independently, doctors may recommend a short break to establish a clearer baseline before making changes.

Finally, some older children or teens may initiate the conversation themselves. It’s not uncommon for kids to wonder what life feels like without medication. When this curiosity is supported by a thoughtful plan, including clear expectations, behavior tracking, and ongoing communication, it can be a valuable opportunity for self-discovery. Rather than viewing this as resistance, parents and providers can reframe it as a step toward autonomy and self-awareness.

In all these cases, the key is collaboration, structure, and follow-up. A medication holiday should never be impulsive, automatic or based solely on fear or guilt. When done thoughtfully, it can offer families new insight into their child’s needs, strengths, and evolving brain.

A word of caution, a true medication holiday should always be a collaborative decision made with your child’s healthcare provider, and it must be closely monitored. It’s also important to ask your prescribing physician about the reasoning behind their recommendation and the research evidence supporting their advice.

In my practice, I often see that well-meaning pediatricians or GPs may not be fully up to date on the latest ADHD research, particularly when it comes to medication. This isn’t due to negligence; rather, it reflects the reality that general practitioners simply can’t be specialists in every area of medicine. ADHD is a complex, evolving field, and staying current requires dedicated focus, something that many busy physicians understandably don’t have the capacity to do on top of their broader responsibilities.

So… Should You Consider Taking a Summer Break?

Ultimately, the decision to pause medication during the summer is deeply personal, but it should be informed by evidence, not myths or guilt. If your child is doing well on medication, tolerating side effects, and benefiting emotionally and socially, there is no compelling reason to stop just because school is out. ADHD doesn’t take the summer off and neither should support and treatment.

If you’re feeling unsure, here are some good next steps:

Schedule a check-in with your child’s prescriber before making any changes.
Keep a behavior log during any planned medication holidays or breaks.
Communicate openly with your child about how they’re feeling both on and off medication.
Consider non-medication supports, like structure, movement, outdoor time, and coaching to complement treatment

Many families wrestle with the decision to take a medication break each summer and it’s completely understandable. There’s no one-size-fits-all answer, and making the “right” choice can feel overwhelming. But with good guidance, honest observation, and a plan rooted in your child’s unique needs, you can make a decision that supports their development, body, brain, and heart.

Whether or not you decide to take a medication break, summer is a valuable window to observe your child more closely without the pressures of school. Tracking their behavior, mood, appetite, sleep, and daily functioning can give you powerful insights into how they're doing and what they need. These real-world observations are incredibly helpful not just for you, but also for your healthcare provider when making treatment decisions.

And remember: if symptoms begin to disrupt your child’s well-being or the harmony of your home, it’s okay to pivot and resume medication sooner than planned. Flexibility is not failure it’s responsive, thoughtful parenting.

Download my Printable Summer Medication Tracker & Reflection Journal below.

Want to make this easier? I've created a printable Summer Medication Tracker & Reflection Journal to help you through this process. It includes:

✔️ Daily medication checklists

✔️ Mood, appetite, and behavior logs

✔️ Weekly summary pages

✔️ Space for reflections and notes for your provider

Should My Child Take a Medication Holiday This Summer?