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Caught in the eye of the storm: a qualitative study of views and experiences of planned drug holidays from methylphenidate in child and adolescent ADHD treatment

Caught in the eye of the storm: a qualitative study of views and experiences of planned drug holidays from methylphenidate in child and adolescent ADHD treatment
Caught in the eye of the storm: a qualitative study of views and experiences of planned drug holidays from methylphenidate in child and adolescent ADHD treatment
Background: Attention deficit hyperactivity disorder (ADHD) can be treated with stimulant medication such as methylphenidate. Although effective, methylphenidate can cause serious side-effects, including suppressed appetite, growth retardation and sleep problems. A drug holiday is a deliberate interruption of pharmacotherapy for a defined period of time and for a specific clinical purpose, for example for appeasing side-effects. While some international guidelines recommend introducing drug holidays in ADHD treatment, this is not practised routinely. Our aim was to examine the views and experiences of planned drug holidays from methylphenidate with adults who have responsibility for treatment decisions in children and adolescents with ADHD.

Method: In-depth interviews were carried out. Child and Adolescent Mental Health Services practitioners (n = 8), General practitioners (n = 8), teachers (n = 5) and mothers of children with ADHD (n = 4) were interviewed in a UK setting. Interview transcripts were analysed using grounded theory.

Results: Methylphenidate eases the experience of the child amid problems at home and at school and once started is mostly continued long term. Some families do practise short-term drug holidays at weekends and longer term ones during school holidays. The decision to introduce drug holidays is influenced by the child's academic progress, the parents' ability to cope with the child, as well as medication beliefs. Trialling a drug holiday is thought to allow older children to self-assess their ability to manage without medication when they show signs of wanting to discontinue treatment prematurely.

Conclusions: Planned drug holidays could address premature treatment cessation by enabling adolescents to assess repercussions under medical supervision.
1475-357X
1-9
Ibrahim, Kinda
54f027ad-0599-4dd4-bdbf-b9307841a294
Vogt, Carsten
fc7ebfc2-0b76-43c7-9b9b-79f4afce28bc
Parastou, Donyai
1dcc4d41-10cd-4ec8-a6c3-4abea39d4f44
Ibrahim, Kinda
54f027ad-0599-4dd4-bdbf-b9307841a294
Vogt, Carsten
fc7ebfc2-0b76-43c7-9b9b-79f4afce28bc
Parastou, Donyai
1dcc4d41-10cd-4ec8-a6c3-4abea39d4f44

Ibrahim, Kinda, Vogt, Carsten and Parastou, Donyai (2016) Caught in the eye of the storm: a qualitative study of views and experiences of planned drug holidays from methylphenidate in child and adolescent ADHD treatment. Child and Adolescent Mental Health, 1-9. (doi:10.1111/camh.12156).

Record type: Article

Abstract

Background: Attention deficit hyperactivity disorder (ADHD) can be treated with stimulant medication such as methylphenidate. Although effective, methylphenidate can cause serious side-effects, including suppressed appetite, growth retardation and sleep problems. A drug holiday is a deliberate interruption of pharmacotherapy for a defined period of time and for a specific clinical purpose, for example for appeasing side-effects. While some international guidelines recommend introducing drug holidays in ADHD treatment, this is not practised routinely. Our aim was to examine the views and experiences of planned drug holidays from methylphenidate with adults who have responsibility for treatment decisions in children and adolescents with ADHD.

Method: In-depth interviews were carried out. Child and Adolescent Mental Health Services practitioners (n = 8), General practitioners (n = 8), teachers (n = 5) and mothers of children with ADHD (n = 4) were interviewed in a UK setting. Interview transcripts were analysed using grounded theory.

Results: Methylphenidate eases the experience of the child amid problems at home and at school and once started is mostly continued long term. Some families do practise short-term drug holidays at weekends and longer term ones during school holidays. The decision to introduce drug holidays is influenced by the child's academic progress, the parents' ability to cope with the child, as well as medication beliefs. Trialling a drug holiday is thought to allow older children to self-assess their ability to manage without medication when they show signs of wanting to discontinue treatment prematurely.

Conclusions: Planned drug holidays could address premature treatment cessation by enabling adolescents to assess repercussions under medical supervision.

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More information

Accepted/In Press date: 5 January 2016
e-pub ahead of print date: 18 March 2016
Organisations: Faculty of Medicine

Identifiers

Local EPrints ID: 390278
URI: http://eprints.soton.ac.uk/id/eprint/390278
ISSN: 1475-357X
PURE UUID: c10d4323-e636-4af6-834c-c61b4892580d
ORCID for Kinda Ibrahim: ORCID iD orcid.org/0000-0001-5709-3867

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Date deposited: 07 Apr 2016 09:51
Last modified: 07 Oct 2020 06:22

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Contributors

Author: Kinda Ibrahim ORCID iD
Author: Carsten Vogt
Author: Donyai Parastou

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