Drug holiday

A drug holiday (sometimes also called a drug vacation, medication vacation, structured treatment interruption or strategic treatment interruption) is when a patient stops taking a medication(s) for a period of time; anywhere from a few days to many months or even years if they feel it is in their best interests.

Planned drug holidays are used in numerous fields of medicine. They are perhaps best known in HIV therapy, after a study showed that stopping medication may stimulate the immune system to attack the virus.^[1]

As a treatment for HIV

HIV selectively targets activated helper T-cells. Thus, over time, this means that HIV will tend to selectively destroy those helper T-cells most capable of fighting the HIV infection off, effectively desensitizing the immune system to the infection. The purpose of a structured treatment interruption is to create a short interval in which the virus becomes common enough to stimulate reproduction of T-cells capable of fighting the virus.

A 2006 HIV literature review noted that "two studies suggested that so-called drug holidays were of no benefit and might actually harm patients, while a third study suggested that the idea might still have value and should be revisited."^[2]

Other uses

Another reason for drug holidays is to permit a drug to regain effectiveness after a period of continuous use, and to reduce the tolerance effect that may require increased dosages.

In addition to drug holidays that are intended for therapeutic effect, they are sometimes used to reduce drug side effects so that patients may enjoy a more normal life for a period of time such as a weekend or holiday, or engage in a particular activity. For example, it is common for patients using SSRI anti-depressant therapies to take a drug holiday to reduce or avoid side effects associated with sexual dysfunction.^[3]

In the treatment of mental illness, a drug holiday may be part of a progression toward treatment cessation. The idea of a holiday is an acknowledgement that longer term psychoactive drug formulations may represent risks not apparent in early phases of use. The holiday is also a tool to assess a drug's benefits against unwanted side effects, assuming that both will end after an extended vacation (some psychoactive drugs have extended side effects long after cessation, however).^{[citation needed]}

See also

• Rebound effect
• Tachyphylaxis
• Downregulation and upregulation

References

1. ^ Feig, Christy (2000-01-21). "AIDS virus stays in check during drug holiday, research shows". CNN. http://archives.cnn.com/2000/HEALTH/AIDS/01/21/aids.drug/index.html. Retrieved 2006-08-31. 
2. ^ Smith, Michael (2006-12-27). "The Year in HIV/AIDS". MedPage Today. http://www.medpagetoday.com/InfectiousDisease/HIVAIDS/msnbc/4767. Retrieved 2006-12-29. 
3. ^ Rothschild, A.J. (October 1995). "Selective serotonin reuptake inhibitor-induced sexual dysfunction: efficacy of a drug holiday". American Journal of Psychiatry 152 (10): 1514–6. PMID 7573593.