I was a teenager during the 1980s and cannot say the word “holiday” without Madonna’s song playing briefly in my head. For most holidays the perky music seems okay, but for discussion of a “drug holiday” it feels a bit off. Sort of like, “Yay! You have a chronic illness! Cel-e-brate!” Despite the strange juxtaposition, Holiday played on while I researched the pros and cons of taking a break from my medications.
I am not considering a holiday from my Avonex. Rather, it is the myriad pills that have me annoyed. So many pills. I have a few chronic diseases to contend with. For the MS symptoms alone I take three types of medication daily, as well as four supplements, for a grand total of 13 capsules and tablets a day.
Harvard Medical School’s publication Should You Take a Drug Holiday? emphasizes that you should never do this without guidance from your healthcare provider. Some medications are dangerous to stop abruptly. There are other consequences and considerations that your doctor can talk through with you, such as how long you can stay off the medication and whether to taper or quit abruptly. Your healthcare provider will make sure you stay safe on your “holiday.”
Reasons to consider a drug holiday
Find out if a drug is actually working. It can be difficult to know if a medication is really helping, until you stop taking it. This was true for me and nortriptyline. Nothing like the sensation of dozens of needles stabbing me in the arm and leg, combined with an increase in grumpiness (i.e., irrational urge to elbow people out of my way if they were too bubbly). Conversely, you may find that your symptoms are no different without the medication. Maybe you don’t need it, or maybe you need an alternative.
Reduce tolerance. For many MS symptom medications, such as Neurontin (gabapentin) or baclofen, the body acclimates and develops a tolerance. This is the ultimate good and bad of my pharmaceutical world. I appreciate the tolerance factor, as it means I can now take medications to control nerve pain during the day and not fall asleep on my keyboard. However, the dose must be increased periodically in order for efficacy to keep pace with the tolerance factor. Taking a break from these types of medications may allow you to reset and go back to a lower dose, thus being kind to your liver and kidneys that must process all these meds.
Sort out side effects. Most medications have side effects. When you take several it can be difficult to determine which one is causing which side effect. Is it the baclofen or nortriptyline that makes me snore? Do I space out sometimes because of the gabapentin, or because I need more coffee? Do I need more coffee because of the baclofen? A drug holiday may help you sort this out and ask your doctor about alternatives if needed. As mentioned earlier, the simple reduction of your tolerance may be enough to get a handle on side effects.
Be less burdened on an actual holiday. Taking multiple medications several times a day can be a drag. Maybe you have a real vacation coming up and you’d rather use that space in your luggage for another pair of shoes. Or you just don’t know how you’ll carry your pills in your swimsuit.
Whatever the occasion, if there is a time when you think the cons outweigh the pros of your pharmacy regime, ask your doctor or pharmacist if it’s okay to skip them. Like Madonna said, it may be “just one day out of life, but it can be…be so nice.”
I plan to stick with the usual meds for my upcoming vacation, but will see my doctor when I get back to discuss how to safely try a drug holiday. My hope is for an increase in energy, focus and concentration if I can reduce my tolerance, and thus dosage, of medications.
I wish you luck if you decide to take a holiday. Take some time to cel-e-brate!
Note: Multiple Sclerosis News Today is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of Multiple Sclerosis News Today, or its parent company, BioNews Services, and are intended to spark discussion about issues pertaining to multiple sclerosis.