Drug holiday utilisation in ADHD-diagnosed children and adolescents in South Africa

Abstract

Objective: Attention deficit hyperactivity disorder (ADHD) is a prevalent disorder affecting people in all age groups. Pharmacological treatment with psychostimulants, specifically methylphenidate, is first line management. The ideal dosing regimen of methylphenidate is debatable with daily use being considered harmful by many. However, it is unknown if sporadic drug withdrawal is beneficial to management. The primary aim was to investigate drug holiday utilisation incidence.
Method: The study comprised a drug utilisation review (DUR) and questionnaire-based survey. The DUR was conducted using a corporate retail pharmacy group database. Methylphenidate prescriptions were evaluated to determine possible drug holiday use through different analyses of dispensing patterns. The survey included several questions relating to drug holiday use.
Results: Drug holiday use was identified in both study populations. Weekends and school holidays were identified as common periods for drug holiday observation. Of the participants that provided reasons for drug holiday utilisation, half indicated that methylphenidate was only necessary for school activities. DUR results indicated that drug holidays appeared to be more commonly observed during March and December.
Conclusions: Reasons for drug holiday utilisation were variable. This study recommends that these drug free periods are only observed if shown to be beneficial to the patient.

Journal of Child and Adolescent Mental Health 2014, 26(2): 95–107