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NEW ENGLAND CENTER FOR PSYCHIATRIC TREATMENT AND EDUCATION

SIMON EPSTEIN, M.D.
91 STRAWBERRY HILL AVE. #140
STAMFORD, CT 06902
203-348-8579

Monthly NewsNotes

Monthly NewsNote

June 2003

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SUMMER: TIME FOR A MEDICATION HOLIDAY?

As school ends and vacation begins, the question of the use of medication often arises. Parents frequently tell me that they’re stopping medication because school is out. Unfortunately, that may not be a good idea, and here is why.

First, remember that ADD is a 24/7 condition that is present 12 months a year. So most of the child’s symptoms will persist during the summer.

Next, keep in mind that medication often goes far beyond helping a student with ADD focus in school or complete homework assignments. Medication reduces impulsivity, increases the ability to handle frustration and reduces distractibility. This means that behavior is more consistent, the child is calmer, and peer relationships and family interactions are much better.

The opposite may also be true. Without medication the child is more difficult, increases family tensions, and has more trouble with his/her friends. Since the family is often together more during the summer, these problems could be significant.

Therefore, for most children, it is a good idea to continue the use of medication during the summer months.

There are some situations when the medication can be used in a different manner. Camp is one example. I’ve found that most children who take a long acting medication for school and then a short acting preparation for homework can change that routine. One long acting pill at breakfast is usually all that is needed. Perhaps the extra activity removes the need for a second dose, and in general it is not necessary. But the long acting preparation at breakfast is important and should not be dropped.

There is one time when a parent might consider stopping the use of medication, and that’s when an underweight child loses weight or cannot gain while on the stimulant. Then
summer is a good time to try to “fatten up” the child. Of course, it may not be possible to stop the medication, and then other solutions must be sought for the weight problem.

Finally, there is something else that can be done this summer. That would be a trial with Strattera (see Monthly Note for May). This is a fairly new medication that works for 24 hours and might be useful in certain situations. Strattera takes several weeks to become effective, and summer is a good time for a trial.

In summary, I believe that medication should be used in most cases during the summer to insure that the child and family will function at the highest level with the lowest amount of tension caused by ADD.

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