Why do teenagers go off ADHD medication?

There are a couple of reasons why kids who are around 13, 14, or 15 often decide they want to stop taking medication. First, this is a time when they’re developing autonomy, and it’s typical for kids this age to start challenging their parents. Secondly, ADHD does change over time. If you look at long-course studies, you see that 65% of kids will experience a remission of some of their symptoms by the age of 25. So for some of these kids, their ADHD is actually not as bad as it was when they were younger, and they may not need as much medication as they did, or not need the medicine at all.

The other thing, too, is the body changes. It’s easy to see when a kid comes into my office who’s four inches taller than he was when I saw him last. The liver changes, too. When the liver changes, it metabolizes the medicine differently, which is why I’ll hear kids who have been comfortable with the medication in the past start to say, “I don’t like how I feel on the medicine. I’m not myself, or my personality is different.” It may mean they’re metabolizing it too effectively now, so they may not need as much as they did.

What I’ll do with the parents and the child in the office, or the young adult in the office, is say, “All right, let’s take a break and do an experiment, see how you feel.” I’m going to put the control in the teenager’s lap. He may come back and say, “I can’t do school without it. This past month was horrible. I’ll go back on medicine.” Or maybe he’ll go back onto something that’s not as strong or not as much. Or maybe he doesn’t need it.

This way we avoid a struggle over who’s in control. And I always think periodically taking time to stop the medicine and see whether we need it or not is good practice.