Severe Medication Avoidance in 9 year old

[MetsMama]

Hi All - My son is 9 years old and has ADHD and dysgraphia. He enjoys school and really wants to do well, but has many of the classic signs of combined ADHD (other than being disruptive), which keep him from being able to do his best. At home we have similar issues. In short, we feel ADHD medication is the right thing for him, but he has sooo much trouble taking medication.

It has been this way since he was a toddler. He wouldn't even eat ice cream if mixed with meds. He has some taste and texture sensitivities, so I think that's part of it. We worked with a Speech Language Pathologist for a while last year and finally got him to take crushed pills mixed with chocolate sauce and whipped cream. That was not for ADHD meds, though. We've now started him on ADHD meds and while he suffered through it for a while (he gets anxious before taking the meds and sometimes gags while taking them), he has now started to totally refuse.

We have really tried everything: Setting up a reward system. Mixing with chocolate sauce or candy, crushed pills and chewable pills and capsules that can be opened. We can't mix liquids with juice because he doesn't like juice. He does like gatorade, but I'm afraid we'll ruin that for him too if we try mixing it with meds. He has a total mental block. Does anyone have experience with this or know of a professional resource? Is there a magical ADHD medication that has no taste? I'm way past the point of googling ideas and am feeling defeated. Thanks for any feedback.

[Onthemove1971]

What about the patch? Same type of medication but in a patch.

[MetsMama in reply to Onthemove1971]

Thank you for your suggestion! I have thought about this, but his sensory issues extend to this sort of thing as well. Plus, he gets so anxious and sometimes outright refuses to let me remove bandaids. I'm afraid that even if he'll wear the patch, he won't let me take it off later. I read that it sometimes causes skin irritation, but I don't actually know what the removal process is like.

[Onthemove1971 in reply to MetsMama]

Best of luck!In our household health/medication are #1 because that is what helps to make our son successful.

We have made it very clear he will take his medication. If not no internet, no phone/tablet/computer and now no car.

I give him every flavoring/drink/yogurt/protein shake as long as I watch him take his medication am/pm... we found medication in other places when he was young so we watch everyday.

I wish you the best in helping him understand how much of a life changer it is.

We are always here for you!

[Aloysia in reply to MetsMama]

The patch comes off in the shower, so I think if you just put a sponge with some water on it, it would come off. It's not as sticky as my estrogen patches that are meant to stay on for a week and need to survive showers. My daughter has very sensitive skin and has reactions to a huge amount of skin products - when she uses the patch, the area is slightly red for a few hours after removal (but not itchy). I think it's worth a try. You'll find out quickly if it won't work for him due to the sensory issues.

[MetsMama in reply to Aloysia]

Ah, that's helpful to know. Thanks.

[Aspen797]

Too bad about the patch not working, that’s a great idea. In our area there is an OT group that works specifically on texture/taste sensitivity and picky eating. Maybe contact your state’s OT association and see if they can refer? They should also be able to help with sensory sensitivities.

Our son did well with opened dexmethylphenidate sprinkled on applesauce when he was little. No taste. Gradually practiced swallowing mini m&ms. But an OT should be best able to guide. Good luck! That sounds challenging!

[MetsMama in reply to Aspen797]

Thank you, great idea. I’ll look into that.

[Aloysia]

I copied and pasted this from a reply I wrote to someone else a long time ago:>>>

Someone previously on this forum suggested this video for learning how to swallow pills:

hardynutritionals.com/video...

I asked my daughter what reward she would want for watching the video and doing the exercise the first day, then what reward she wanted for practicing every day the first week, and what reward for being able to actually swallow her pill. We came to an agreement.

She started with nerds. Then moved to tic tacs and mini-M&Ms. Then tried regular M&Ms. I ordered empty capsules in the smallest size (size 5) from Amazon. She filled them with nerds or sugar so they would have a little weight. She can finally swallow that size. However, her medication comes in size 3 capsules. I've ordered empty capsules in size 4 and 3. But she hasn't been successful with those yet. So right now I am opening her medication capsule and putting it into two size 5 capsules (which she can swallow). We're not done yet, but this is significantly better than opening the capsules into pudding, etc and trying to get her to swallow it. Also, learning how to swallow pills will really help when I need to give her pain medication or antibiotics since she doesn't like the taste of the liquid or chewables.

A big thank you to everyone on this forum who gave so many suggestions and helped us to get this far!!!

<<<

[Shantismurf]

Your son sounds a lot like mine! 13yo, ADHD and dysgraphia, major sensory struggles and strong-willed as a bull! I consider him a Highly Sensitive Person. Small injuries are huge for him, he has the same freak out about removing bandages, and don't even get me started about shoes!He just started meds for the first time a couple weeks ago, and thankfully he's grown out of his aversion to swallowing pills, though his was never as extreme as your son's. He's gotten so much more accepting and adventurous with food in the last couple years. This will work out eventually!

If I were in the same boat as you I'd keep trying to help him see how much better he feels when he takes it...or maybe he's experiencing some side effects that he's having a hard time communicating and that's why he's averse? Regardless, it sounds like this is something that has to come from him. He has to decide that taking the medicine is better than life without. I'm so sorry, this sounds like a huge struggle and you are working so hard to accommodate him!! You're doing an amazing job!

[MetsMama in reply to Shantismurf]

Thank you, you've given me hope about this getting better. I agree it has to come from him and have been trying to point out specific times when I think he would benefit from having taken the medication. He's starting to agree at times, so we'll see if it eventually helps him bite the bullet.

[Elijah1]

Appears that he has a lot of anxiety. Has that been treated? Reduction in anxiety can make compliance easier.

Secondly, the patch (methylphenidate or amphetamine) can be placed on his back to minimize the urge to remove it. For the other ADHD medications, Vyvanse dissolves in liquid and has no real taste. Some brand name ADHD medications (such as Adzenys, Cotempla, Evekeo) come as oral disintegrating tablets so they dissolve almost instantly in the mouth or in liquid.

[MetsMama]

Thank you, I didn't know about Vyvanse being dissolvable. I'll try looking into that.

[iheartsunsets]

Does he like Oreo cookies? When my daughter started medication she could not swallow pills yet so we put it in a the cream of a mini Oreo cookie and she ate it.