Medication rebound – it’s real for kids with ADHD. So, what should a parent do when the ADHD medication wears off?

Diane:
So a lot of parents struggle with what they call “medication rebound,” – and I think that is what happens when their kids are on a medication, and at some point during the day, it wears off.

Elaine:
Usually, when they get home from school, when they're back on your turf.

Diane:
Right. So the school people get them all when on their medication, and I get them at home when they're off. And so whether it's emotional intensity or inability to kind of follow through and finish their homework, the parents are really struggling with that after-school time.

Elaine:
It's stressful. I used to it the witching hour, right? And so, part of the strategy for managing that is actually to set realistic expectations for yourself. To understand that it's kind of normal, that there could be a dip at the end of the day. And so to not expect the same kind of compliance or the same kind of self-regulation that you might earlier in the day, to really adjust your expectations. I had a therapist once who used to say, "These kids, we adjust three to five years below their age, and then after 5:00, you drop another two years, right?

Diane:
Well, I think the other piece of it is, so once you've got a clear set of expectations, you also have to do some brain management, right? So whether it's making sure that they get some food and snacks-

Elaine:
Snacks after the day, yeah.

Diane:
-or if they get some rest and some downtime.

Elaine:
Or some exercise, some running around time at the end of the day.

Diane:
Yeah, exactly, to get their brain recharged before you have an expectation that they're going to be able to do their homework or help with dinner or whatever else.

Elaine:
Right. So the other thing I would add is if it's a real problem, or you feel like, "My kid's just not who I think she should be when she's on meds, or if my child is really having a bad medication rebound," talk to your doctor about it. Because it may not be the right med, or this med may not be the right mix for this child. Or there may need to be something else that they can do. Because when kids are feeling out of sorts and off the walls, it doesn't feel good for them either. So you really want to help manage it, and sometimes that's about going back to the doctor and tweaking what you've already got.

Bottom Line:
Medication rebound is a legit challenge for some kids with ADHD. When the ADHD medication wears off, you can either anticipate that and manage the behaviors, or you might want to talk with your child’s prescriber if it feels like the medication is not the best fit.