Stopping ADHD medications

Like many adults with ADHD, Justine Ruotolo took a stimulant (in her case, Adderall XR) for her symptoms. Then about 11 years ago, he started meditating. Soon after taking the pill, she started shaking. Ruotolo’s doctor reduced the dose, but 6 months later it happened again. He decided to stop the medication and hasn’t looked back since.

Ruotolo largely credits meditation with calming and focusing his brain enough that he no longer warranted a drug push. She read a lot about her condition and received training from an ADHD coach.

There are many reasons why someone with ADHD may stop taking medication or not start at all. Some people hate the side effects. Others find it difficult to pay for the medicine. Or, like Ruotolo, they find that non-drug strategies work quite well for them.

There are no official treatment guidelines for adults with ADHD in the United States. But “the best practice is to treat true ADHD with a stimulant unless there are contraindications,” says Craig Surman, MD, a neuropsychiatrist and researcher at Harvard Medical School. Co-authored by Surman FASTMINDS: How to Cope with ADHD (or Think You May). However, he notes that not everyone has severe problems with ADHD.

“Some people have symptoms of ADHD rather than a full diagnosis,” he explains. Even those who check all the boxes for ADHD may find that their symptoms improve in certain situations. For example, a graphic designer has no problem focusing in a company where the boss is breathing down his neck. But if you’re going to be a graphic freelancer, it might not be so easy to stay on task when you’re managing your own schedule. “People with ADHD live by deadlines,” says Surman.

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If you’re comfortable with medication, it’s hard to tell if you still need it. Surman often advises high-functioning people who have been taking stimulants for some time to take an occasional “drug holiday.” That is, stop the drugs for a short time to see if they still need them. It’s probably a good idea to check with your doctor if you want to try this.

Regardless of whether you take medication or not, non-pharmacological approaches are important in treating ADHD. “They are not mutually exclusive,” says Surman.

Ruotolo knows this from personal experience and from working with other people with ADHD. Shortly after his diagnosis, he became an ADHD coach. After that, she obtained a master’s degree in clinical psychology and became a marriage and family therapist (LFMT) in addition to being a coach. Some of her clients thrive with a combination of drug and non-drug strategies. Others find that they do well without medication and rely solely on non-drug approaches such as exercise, meditation, and counseling.

Going without medication is not enough of a symptom for everyone with ADHD. But some non-drug strategies, either in addition to or instead of medicine, include:


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“Understanding ADHD is key,” says Surman. Recommends a visit to learn about the causes and symptoms of the condition. “You have to understand which challenges are ADHD and which are something else,” says Surman, who is on the board of CHADD (Children and Adults with ADHD). It also suggests exploring the resources it provides ADD (Attention Deficit Disorder Association). Support groups are another good way to learn about the condition from your peers, she adds.

Cognitive Behavioral Therapy (CBT)

CBT is a highly focused and results-oriented form of talk therapy. It helps with anxiety and depression, two conditions that often coexist with ADHD. Even if ADHD is your only concern, there is a good chance that CBT will help.

CBT can help adults with ADHD change their thinking patterns and develop skills that make living with ADHD easier. “It focuses on behaviors that help people take ownership of their condition and stay organized,” says Surman. However, organizational strategies are only part of it. CBT also helps to retrain the way you think. You will learn to recognize your automatic negative thoughts that tend to occur in challenging situations. You will learn to react more positively and efficiently in the future.

(Note: If you have another mental health condition that isn’t already under control, Surman recommends seeking treatment first. Depression, anxiety, substance abuse, and autism spectrum disorders often overlap with ADHD.)

ADHD coaching

Unlike CBT, coaching focuses solely on your actions and organizational strategies (rather than how you feel about those things). “Some people say, ‘I need someone to think things through with me to decide what to do first.’ This is where coaching can be very helpful,” says Surman.

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As a trainer, Ruotolo considers the needs of clients. “We talk about specific organizational strategies, like how to clean your desk and house and how to live an organized life,” says Ruotolo, the book’s author. ADD Land: Gift of ADD.


At the core of Ruotolo’s practice is mindfulness – focusing on living in the present moment rather than dwelling on the past or worrying about the future. “Our brains are like that, thoughts just keep going and going,” he says. “With alert awareness, you just notice a thought and observe it, but you are not attracted to it.” Over time, this practice changes the connections in the brain, so you respond differently to the world around you, adds Ruotolo.

Lifestyle changes

Everyone should stay physically active, eat healthy and sleep well. But these basic self-care measures are vital for anyone struggling with ADHD. Lack of sleep can interfere with cognitive function, says Surman. Proper exercise and proper nutrition are good for the brain. While such simple modifications alone are unlikely to be enough to treat ADHD entirely, they are an important part of any self-care regimen.