PSYCHIATRIC MEDICATIONS AND MEDICATION-FREE PERIODS
Kids who take psychiatric medications, such as a stimulant or an anti-depressant, should go with their parents, before camp starts, to consult with the psychiatrist who prescribed the medication. Families
should also consult with the child’s psychotherapist if that person is not the same one who prescribed the medication. These pre-camp consults are important for several reasons.
First, you’ll want to make sure that your child has more than enough medication to last the entire camp stay. Camps in remote locations may have difficulty refilling prescriptions if they run out half-way through the camp session.
Second, you’ll want to design a medication schedule that fits the camp’s daily schedule. At school, medication may be easy to administer every few hours, but at camp, the normal dosing times may fall in the middle of an activity period. Show your child’s psychiatrist the camp’s daily schedule and discuss a realistic dosing schedule. Before and after meals are convenient times for campers to visit the health center. Other times, switching to a long-acting form of stimulant medication is the most convenient solution.
Third, kids must know how to recognize and manage any side-effects of their medication. Common side effects like dry mouth, sleep problems, and loss of appetite may worry your child unless he recognizes the symptoms as side-effects of his helpful medication. On opening day, it’s also a good idea to give your child’s cabin leader a short note explaining possible medication side-effects. If cabin leaders are misinformed, they may mistake the origin of your child’s symptoms. For example, thbey may think his dry mouth means he is dehydrated, or that his loss of appetite is from homesickness. This misunderstanding may lead the cabin leader to address a problem that doesn’t exist.
Fourth, you’ll want to discuss the possibility of a medication-free period (sometimes called a “drug holbiday”). Medication-free periods are set times when doctors and parents plan for kids not to take a certain psychiatric medication. Sometimes medication-free periods work well, but that’s not always true. The decision to have a medication-free period during overnight camp needs to be made thoughtfully. Parents and kids should discuss the pros and cons with the treating therapist and with the psychiatrist who prescribed the medication. Here are some of the pros and cons to discuss:
Pro: Overnight camp is intended to be a relaxing, recreational, and supportive environment. At most camps, there are no academic pressures. If your child’s psychiatrist was already considering a trial off the medication, camp might not be a bad time to try.
Con: Your child is on his medication for a reason. The hope is that she is currently benefiting from the positive effects of that medication. Taking the medication away removes one of her ways of coping. The camp experience can be made unnecessarily difficult when kids have to deal with everything new at camp plus the experience of stopping some helpful psychiatric medication. The reasons why your child is currently taking a psychiatric medication probably won’t disappear at overnight camp, so probably the medication shouldn’t either.
Con: Some psychiatric medications are long-acting. For example, it can take a week or more for some anti-depressants to get out of your child’s system. This fact, combined with the change in environment, makes it hard to look back, after a two-week session at camp, and decide whether the cmedication-free period was successful or not.
Pro: One of the most popular reasons that doctors and parents plan medication-free periods is to give kids a break from undesirable medication side-effects. This is commonly the case with stimulant medications that are prescribed for Attention Deficit Hyperactivity Disorder (ADHD). These medications include Ritalin (methylphenidate), Dexedrine (dextroamphetamine), Cylert (pemoline), and Adderall (mixed amphetamines). Some psychiatrists recommend occasional medication-free periods because these medications may temporarily decrease kids’ appetites and growth rates. Some stimulant medications may also temporarily cause drowsiness or depressive symptoms. If your child is experiencing uncomfortable side effects from the medication she takes each day, then it can be relieving to take a break.
Con: Many kids with ADHD who were well-behaved while on medication come to camp during a medication-free period and face huge challenges. These kids did well at school while taking their cstimulant medications. They were able to listen and follow directions. They were able to make and keep friends. And they were confident in their abilities. However, things change for these kids when they stop taking their medication and come to camp. Compared to school, camp has just as many times when they have to listen, follow directions, and keep their bodies calm. Off medication, these kids struggle to follow simple directions. Camp also has many new potential friends, but impulsive, hyperacctive behavior makes these kids difficult playmates. For these social and emotional reasons, many child psychiatrists and psychologists are adamantly against medication-free periods at camp. Stopping an otherwise helpful medication at camp can turn what is supposed to be a fun, relaxing time into a miserable, stressful time.
The Expert Opinion: Russell A. Barkley, Ph.D., a clinical psychologist and world-renowned expert on ADHD, says this regarding medication-free periods:
The conclusion: We agree with Dr. Barkley that the best time to try a medication-free period is a month or so after a child has settled in to a new place and a new routine. For most campers, that means staying on stimulant medications as prescribed because camp lasts less than a month. However, for some kids at 8-week camps, it may be worthwhile trying a medication-free period during the second month of camp. If you do opt for a medication-free period, please tell the camp nurse or doctor so they understand your child’s medical history and can monitor his progress for you.
The bottom line is that stimulant medications help most kids with ADHD adjust to change. Therefore, medication-free periods are best attempted after these kids have had a month or so to get used to a new environment. That generally excludes camp as a testing ground.
Kids who take psychiatric medications, such as a stimulant or an anti-depressant, should go with their parents, before camp starts, to consult with the psychiatrist who prescribed the medication. Families
First, you’ll want to make sure that your child has more than enough medication to last the entire camp stay. Camps in remote locations may have difficulty refilling prescriptions if they run out half-way through the camp session.
Second, you’ll want to design a medication schedule that fits the camp’s daily schedule. At school, medication may be easy to administer every few hours, but at camp, the normal dosing times may fall in the middle of an activity period. Show your child’s psychiatrist the camp’s daily schedule and discuss a realistic dosing schedule. Before and after meals are convenient times for campers to visit the health center. Other times, switching to a long-acting form of stimulant medication is the most convenient solution.
Third, kids must know how to recognize and manage any side-effects of their medication. Common side effects like dry mouth, sleep problems, and loss of appetite may worry your child unless he recognizes the symptoms as side-effects of his helpful medication. On opening day, it’s also a good idea to give your child’s cabin leader a short note explaining possible medication side-effects. If cabin leaders are misinformed, they may mistake the origin of your child’s symptoms. For example, thbey may think his dry mouth means he is dehydrated, or that his loss of appetite is from homesickness. This misunderstanding may lead the cabin leader to address a problem that doesn’t exist.
Fourth, you’ll want to discuss the possibility of a medication-free period (sometimes called a “drug holbiday”). Medication-free periods are set times when doctors and parents plan for kids not to take a certain psychiatric medication. Sometimes medication-free periods work well, but that’s not always true. The decision to have a medication-free period during overnight camp needs to be made thoughtfully. Parents and kids should discuss the pros and cons with the treating therapist and with the psychiatrist who prescribed the medication. Here are some of the pros and cons to discuss:
Pro: Overnight camp is intended to be a relaxing, recreational, and supportive environment. At most camps, there are no academic pressures. If your child’s psychiatrist was already considering a trial off the medication, camp might not be a bad time to try.
Con: Your child is on his medication for a reason. The hope is that she is currently benefiting from the positive effects of that medication. Taking the medication away removes one of her ways of coping. The camp experience can be made unnecessarily difficult when kids have to deal with everything new at camp plus the experience of stopping some helpful psychiatric medication. The reasons why your child is currently taking a psychiatric medication probably won’t disappear at overnight camp, so probably the medication shouldn’t either.
Con: Some psychiatric medications are long-acting. For example, it can take a week or more for some anti-depressants to get out of your child’s system. This fact, combined with the change in environment, makes it hard to look back, after a two-week session at camp, and decide whether the cmedication-free period was successful or not.
Pro: One of the most popular reasons that doctors and parents plan medication-free periods is to give kids a break from undesirable medication side-effects. This is commonly the case with stimulant medications that are prescribed for Attention Deficit Hyperactivity Disorder (ADHD). These medications include Ritalin (methylphenidate), Dexedrine (dextroamphetamine), Cylert (pemoline), and Adderall (mixed amphetamines). Some psychiatrists recommend occasional medication-free periods because these medications may temporarily decrease kids’ appetites and growth rates. Some stimulant medications may also temporarily cause drowsiness or depressive symptoms. If your child is experiencing uncomfortable side effects from the medication she takes each day, then it can be relieving to take a break.
Con: Many kids with ADHD who were well-behaved while on medication come to camp during a medication-free period and face huge challenges. These kids did well at school while taking their cstimulant medications. They were able to listen and follow directions. They were able to make and keep friends. And they were confident in their abilities. However, things change for these kids when they stop taking their medication and come to camp. Compared to school, camp has just as many times when they have to listen, follow directions, and keep their bodies calm. Off medication, these kids struggle to follow simple directions. Camp also has many new potential friends, but impulsive, hyperacctive behavior makes these kids difficult playmates. For these social and emotional reasons, many child psychiatrists and psychologists are adamantly against medication-free periods at camp. Stopping an otherwise helpful medication at camp can turn what is supposed to be a fun, relaxing time into a miserable, stressful time.
The Expert Opinion: Russell A. Barkley, Ph.D., a clinical psychologist and world-renowned expert on ADHD, says this regarding medication-free periods:
Treatment can be stopped annually for a week or two, usually a month or so after the beginning of the new academic year to give the child time to get used to the new school year and the teacher to get to know the child before stopping the medicine. When a doctor waits to see if a child who has been off medication for the summer has trouble in school without it, the child is put in the position of developing a bad reputation with the teacher and classmates—an image he or she must then overcome after going back on the stimulants. We believe it’s better to get the school year off to a good start with the medication and then stop the medication briefly during October. If there is a cbrief decline in school performance, the child can be kept on medication during that school year.
The conclusion: We agree with Dr. Barkley that the best time to try a medication-free period is a month or so after a child has settled in to a new place and a new routine. For most campers, that means staying on stimulant medications as prescribed because camp lasts less than a month. However, for some kids at 8-week camps, it may be worthwhile trying a medication-free period during the second month of camp. If you do opt for a medication-free period, please tell the camp nurse or doctor so they understand your child’s medical history and can monitor his progress for you.
The bottom line is that stimulant medications help most kids with ADHD adjust to change. Therefore, medication-free periods are best attempted after these kids have had a month or so to get used to a new environment. That generally excludes camp as a testing ground.
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