What happens if you go off ADHD medication?
When Dana Rayburn learned she had ADHD in her 40s, her doctor prescribed Adderall. He took the medication well for a few years, but then insurance stopped covering it. Instead of trying to pay $200 a month for the drug, he decided to try to quit.
In other adults with ADHD, side effects such as loss of appetite or insomnia prompt them to stop taking medication. Some say drugs make them less fun and more spontaneous. Others dislike the stigma that often comes with medication or simply enjoy the idea of treating their condition more naturally without drugs.
Whatever your motivation, before trying to stop taking the drug, it’s wise to talk to your doctor first and find out what to expect.
Anytime you want to change your medication regimen, it’s best to see your doctor. If your provider agrees to stop, you should discuss whether it’s safe to go cold turkey or if you should cut back.
The answer depends on the medications you’re taking, says L. Eugene Arnold, MD, a resident expert at CHADD (Children and Adults with Attention-Deficit/Hyperactivity Disorder). You don’t need to taper off stimulant medications like Adderall and Ritalin, he explains, and you shouldn’t experience withdrawal effects.
Non-stimulant drugs, on the other hand, usually require tapering. “Atomoxetine (Strattera) has a long half-life, so it thins you out a bit,” says Arnold. But if you’ve been taking an alpha2 antagonist like clonidine or guanfacine—many people with ADHD take a stimulant in the morning and another drug in the evening—you’ll need to go slowly to avoid a potentially dangerous spike. your blood pressure – he warns.
Whether you feel physically different depends on your drug, dose, and body chemistry, Arnold says. He says that some patients who stop taking stimulants report feeling a little more tired during the day. This means they sleep more soundly at night. Some people suddenly feel terribly hungry.
Energy and focus shifts usually level out after a day or two. But it may take a few weeks for your appetite to return to normal. Of course, “If you have had an excessive appetite before [starting ADHD drugs that were suppressing it]it will be final,” says Arnold.
Unless you’re misdiagnosed, you’re on ADHD medication for a reason. Will he be able to stay on task and complete projects without the help of these drugs?
Fortunately for Rayburn, non-pharmacological approaches—including organizational strategies, fish oil supplements (which some studies suggest may help with ADHD) and staying hydrated—have worked. He has not needed ADHD medication for 16 years. But Rayburn, who teaches other adults with ADHD, is hardly anti-medication. In fact, he says, most adults with ADHD do best with medication, at least at some point in their lives.
Rayburn advises anyone considering coming off medication to first think about why they took the medication in the first place and what may have changed since then. Have you adopted special organizational strategies, significantly altered your lifestyle habits (such as exercise and diet), or made other changes likely to help the task?
“When you go off medication, you have to be very aware, you have to notice when your brain isn’t working, and you have to be able to adapt,” says Rayburn. He says that some people can catch themselves losing focus, but do well to recommit to strategies that have helped them stay in the past. Others find they need extra help now from a coach or a therapist who specializes in cognitive behavioral therapy for ADHD, Arnold says. Some people find that taking a fish oil supplement helps. “It’s a subtle effect, but it kind of takes the edge off,” he says.
Of course, some adults with ADHD who stop taking medication find that they need to go back to function well—and that’s okay, too. “It’s a good idea to bring in another observer—a spouse, roommate, or coach—who can provide objective feedback on what’s going on,” says Arnold. And if you do return to medication, don’t think you’re giving up the non-drug therapies you’ve been using.
“Medication for ADHD is not a cure; it’s a tool, says Arnold. “It makes things possible, but not necessarily easy. You still have to work on it.”