September 11, 2026
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Shedding Light on the Risks
& Benefits of Medications
Shedding Light on the Risks
& Benefits of Medications Should You Take A Drug Holiday?
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Drug holidays are often discussed on social media, particularly for ADHD medications and GLP-1s. But while planned breaks make sense for certain drugs, for others they’re unproven, and potentially risky
September 30, 2026
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In recent years, there has been much discussion on social sites like TikTok and Reddit about taking a “drug holiday” from prescribed medications — especially Attention Deficit/Hyperactivity Disorder (ADHD) meds and GLP-1s — in order to ease side effects, avoid potential long-term risks, reduce drug tolerance, or simply allow for a break from how a drug makes you feel.
But taking a break from most medications, especially without medical supervision, is not recommended and can be dangerous. Stopping a medication can bring back symptoms, allow a disease to progress, or trigger withdrawal.
Drug holidays are used with only a limited number of medications, and the evidence supporting them varies considerably depending on the drug and the reason for taking a break.
What Is A Drug Holiday?
A drug holiday is an intentional temporary break from a medication. There are cases where a drug holiday may be clinically approved, often with the goal of reducing side effects or long-term risks while maintaining control of an underlying condition.
Drug holidays have also been proposed as a way to address tolerance to certain medications, potentially restoring some sensitivity to the drug when treatment resumes.
A drug holiday only makes sense if the benefits of pausing outweigh any risks, says Sara Rogers, PharmD, co-founder and President of the American Society of Pharmacovigilance and a member of MedShadow’s Health and Medical Advisory Panel. That means the break should reduce side effects or long-term harms without allowing the underlying condition to worsen significantly, she explains. For medications whose effectiveness diminishes over time due to tolerance, the goal is to restore some of the benefit seen when treatment first began.
The drug classes discussed below are the most commonly discussed, but there are other drugs that may need to be paused due to tolerance, toxicity, or other issues. Any planned break from a medication should be discussed with a healthcare provider, as some drugs should not be stopped abruptly.
Should You Take a Drug Holiday From ADHD Medication?
At 21, Grace, a designer living in New York City, was diagnosed with ADHD, a diagnosis that explained many of her childhood and adolescent struggles. While Grace had managed to get good grades, a college degree, a job — all the markers of a high-functioning person — she was regularly confronted by less visible obstacles. “I struggled a lot with executive dysfunction, like motivation, keeping track of time, and just managing my stress,” she says. “I was constantly going through cycles of hyper-focused activity and severe burnout.”
Her psychiatrist prescribed Vyvanse, an extended-release stimulant, but recommended she take a drug holiday on the weekends. Because she wasn’t diagnosed until adulthood, he believed Grace had developed coping strategies and that her ADHD was relatively mild.
Grace has stuck with that schedule, though she notices a difference on the weekends. “I’m mostly more tired, and sometimes it’s a little bit easier to get emotionally dysregulated, but I wouldn’t say it’s so severe that I feel the need to take [my medication] on the weekends,” she says.
Weekend, holiday, and summer-vacation drug holidays are hotly debated in the ADHD community, especially online. Some see the whole idea as driven more by stigma than science.
“The idea that my brain only needs it to be more productive so that somebody can get the benefit of my labor during the work week, but that I don’t deserve that stability on the weekend so that being with my kids feels easy, is just obnoxious,” says Caitlin Connors, 43, an expat living in Folkestone, England.
She, like many people with ADHD, can’t imagine functioning without medication. “It’s like playing a video game, and you just put extra hard mode back on,” says Connors, who has experienced forced “drug holidays” due to shortages of ADHD drugs.
Can ADHD Drug Holidays Reduce Side Effects?
But others, especially parents of children with ADHD, support the practice. One review of the research found that 25% to 70% of parents whose children take stimulant medication give them drug holidays, most often during school breaks. “If you’re not in a school setting where you need to focus, the idea is you won’t necessarily need that extra support,” says Dr. Rogers.
Parents say they may pause medications for several reasons: to see whether their child still needs it, to provide relief from side effects like suppressed appetite, slowed growth, and sleep problems, or, in some cases, to address concerns about developing tolerance and needing progressively higher doses.
However, research backing drug holidays for kids taking ADHD medications is thin. A 2018 NICE evidence review found only one small study on ADHD drug holidays and rated the evidence it provided as very low quality. While a few additional studies in the review found that parents reported improvements in side effects, like sleep issues, low appetite, and slower growth, other studies found the opposite — drug holidays led to worse ADHD symptoms in both children and adults, with no evidence of improved quality of life.
Growth and appetite are among the most common reasons parents may consider a break from stimulant medication, and studies do show that kids taking stimulants may eat less and gain weight and height more slowly. In one randomized trial, drug holidays helped children gain weight faster, although they didn’t improve their rate of height growth. Research on final adult height is more reassuring: Most studies show that continued use of stimulant medication doesn’t affect long-term growth and a person’s final height, or, if it does, the effect is minimal.
Can a Drug Holiday Reverse ADHD Medication Tolerance?
While research doesn’t settle whether drug holidays help with tolerance, anecdotally, some people report they need to increase their stimulant dosage over time, says Dr Rogers. Studies do find tolerance develops in some people, but estimates vary wildly, from about 3% to 66%, depending on the study and how tolerance is defined.
“The drugs are stimulating the release of different neurotransmitters, so if that’s happening constantly, your body can produce some adaptive mechanisms that may make it appear or feel less effective,” says Dr. Rogers. But controlled studies on stimulant tolerance are limited, and there may be other explanations for perceived tolerance, including a change in the severity of a person’s ADHD or shifting demands at home, school, or work.
Given the limited evidence, there are no standardized guidelines on ADHD drug holidays. Instead, most experts recommend reassessing children yearly, and if warranted, parents may want to consider a pause to test whether the medication is still needed.
Why Drug Holidays Are Common With Osteoporosis Medications
Bisphosphonates, the first-line treatment for osteoporosis, are medications for which taking a break is considered standard practice.
Osteoporosis develops when the body’s continuous system of bone building and repair slows down, causing bone to break down faster than it rebuilds and grow increasingly porous, weak, and prone to fracture. Bisphosphonates slow the natural processes that dissolve bone tissue, giving the body’s tissue-rebuilding cells an opportunity to catch up.
“Bisphosphonates have this neat property of sticking to bone for a long time, which allows us to give [medication] breaks,” says Cathleen Colon-Emeric, M.D., chief of the Division of Geriatrics and Palliative Care at Duke University School of Medicine. Firmly lodged in the bone, and with a half-life that can extend beyond 10 years in humans, the drug continues to work long after you stop taking it. For people at lower risk of fracture, taking a break may reduce exposure to rare but serious risks associated with long-term use while some of the drug’s protective effects persist.
One rare but serious risk associated with long-term bisphosphonate use is an atypical fracture of the femur (thigh bone), which can occur with little or no trauma. About 13 out of 10,000 women who’ve taken the drug for more than eight years have a femur fracture. “Discontinuation reduces the risk of femur fractures by about 50% in the first year and by more than 80% within 3 years of stopping,” says Dr. Colon-Emeric.
What About Supplements?
TikTok abounds with advice on “cycling supplements,” the idea that taking intentional breaks from a supplement can boost effectiveness and reduce any potential safety issues. Some worry that supplements can put a strain on their organs or cause toxicity, for example. But the practice owes more to theories and anecdotes than evidence.
“I’m not aware of strong human evidence showing that routine schedules such as “five days on, two days off” prevent tolerance or make them safer,” says Rosia Parrish, ND, a naturopathic physician practicing in Boulder, Colorado.
The possible exception: supplements containing stimulants, such as Panax ginseng, yerba mate, or rhodiola. These may lead to a minor tolerance, so an occasional break may restore sensitivity, while reducing side effects such as insomnia and anxiety.
“Planned breaks may reduce total exposure or help determine whether a supplement remains necessary, especially when long-term safety data are limited,” says Dr. Parrish.
“The recommendation is primarily based on the FLEX and HORIZON trials, which have largely confirmed that drug holidays are safe for many patients,” says Kaley Hayes, PharmD, Ph.D., associate director of pharmacoepidemiology at the Center for Gerontology and Healthcare Research at Brown University. Those trials found that rates of most fracture types did not increase in women who paused bisphosphonates after five or six years, compared with women who kept taking the drugs.
The FLEX trial did find a slight uptick in vertebral (spinal) fractures in those who took a drug holiday. But the difference was small, says Dr. Colon-Emeric. “Unless a person’s risk of vertebral fracture is particularly high, the benefits of a holiday outweigh the small increased vertebral fracture risk,” she says.
A task force of the American Society for Bone and Mineral Research recommends a drug holiday after three to five years of bisphosphonate treatment — three after IV treatment (like Reclast) and five after oral treatment (like Fosamax). “That seems to be the ‘sweet spot’ where you have achieved most of the fracture reduction benefit you can expect with bisphosphonates, and also where the risk of femur fractures starts increasing more rapidly,” says Dr. Colon-Emeric.
The recommended drug holiday duration for bisphosphonates is 2-3 years, though the recommendation may be shorter if you’re taking risedronate (Actonel), which has less staying power in the bone.
What Happens When You Take a Break From a GLP-1?
There is strong curiosity about drug holidays among people who take GLP-1s, medications for Type 2 diabetes and weight loss that mimic a natural hormone in the body and help to regulate blood sugar levels and appetite. People are micro-dosing, weaning themselves off, and taking drug holidays, either to lower side effects, stick to a maintenance schedule, or to keep down their costs. Some pause over the holidays so they can indulge in the festivities without a suppressed appetite.
“If someone feels nauseated, it’s fine to give a drug holiday for a couple of weeks and resume medication,” says Gitanjali Srivastava, M.D., medical director of obesity medicine at Vanderbilt University. But it also depends on how someone is doing, if they’re in active treatment or in maintenance mode. “If you’re still losing weight, a drug holiday could cause some setbacks,” she says.
Pausing them for too long, however, may reverse much of your gains. When some people stop taking GLP-1s, research shows they tend to regain weight and lose metabolic benefits, such as reduced blood glucose, cholesterol, and blood pressure.
Restarting after a pause can come with its own complications. People typically start on a low dose to minimize side effects, like nausea and diarrhea, and then slowly work up to an effective dose, explains Dr. Rogers. “If they were to stop taking the GLP and then start it again, that might reinitiate the severe gastrointestinal symptoms when they restart,” she says. Or if you pause for too long, you may have to restart at the lower dose.
If you’re taking a GLP-1 and have type 2 diabetes, stopping can send blood sugar levels back up, says Dr. Srivastava.
Drug Holidays vs. Deprescribing: What’s the Difference?
A method of stopping medication that is often confused with drug holidays is deprescribing, which describes stopping a medication altogether or reducing the dose long term. Deprescribing is recommended when a drug is no longer effective or needed, or when the side effects or long-term risks outweigh the benefits. The conditions that warrant deprescribing are often found in the treatment of older adults.
“As we get older, our bodies can’t metabolize or eliminate the medications like they used to when we were younger,” says Stefanie Ferreri, PharmD, a professor at the University of North Carolina Eshelman School of Pharmacy in Chapel Hill and a member of MedShadow’s Health and Medical Advisory Panel. That can make drugs more potent, or cause effects to linger longer than intended. Deprescribing can also ease the burden on the liver and kidneys if someone is taking multiple medications, otherwise known as polypharmacy.
Growing concern about polypharmacy is one reason the Centers for Medicare & Medicaid Services (CMS) is prioritizing deprescribing. In May 2026, CMS published new guidance for healthcare providers on billing for deprescribing as part of standard medical care, recognizing its importance and emphasizing that it is an element of patient care that requires time and labor.
Discussion around deprescribing in older adults often focuses on titrating down or off medications that affect the brain. “When medications work in your brain or cross the blood-brain barrier, and your body can’t eliminate them or metabolize them as quickly, you get more side effects, and that causes more cognitive impairment,” says Dr. Ferreri. These side effects may also include confusion, drowsiness, dizziness, or balance issues.
According to Dr. Ferreri, medications commonly flagged for deprescribing include:
- First-generation antihistamines (like Benadryl)
- Pain medications (opioids)
- Sleeping pills
- Muscle relaxants
- Benzodiazepines (anxiety medications)
- Tricyclic Antidepressants
But deprescribing isn’t only for older adults. “Sometimes patients have just been taking a medication forever, but don’t question why [they’re still on it],” says Dr. Ferreri. One example she gives is proton pump inhibitors (PPIs), which are commonly used to treat gastroesophageal reflux disease (GERD) and heartburn. While PPIs are often intended for a limited course of treatment, some people continue taking them for years without reassessing whether they still need them. Long-term use has also been associated with a number of adverse effects.
“As a pharmacist,” adds Dr. Ferreri, “I always encourage people to question why they’re taking a medication and how long they need to be taking it.”
Whether you’re considering a weekend off an ADHD medication, pausing a GLP-1 because of side effects, or wondering whether you still need a medication you’ve taken for years, it’s important to remember that a drug holiday isn’t simply time off from treatment: it should have a specific purpose and a plan, developed with your healthcare provider, for when — or whether — treatment should resume.
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