How to get teens to take medications?!

[Iamwipedouttoo]

It has been awhile since I have posted.

difficult child was prescribed Vyvanse 30mg months ago, has only taken them spottily. Four weeks ago, at her insistance she didn't need medication so our psychiatrist gave her a three week trial off the medications (that is a whole interesting story in itself - psychiatrist tore up the script in front of difficult child with sent her into a fit, her accusing the psychiatrist of being mean).

difficult child went back to the psychiatrist this week and said she wanted to start taking the vyvanse again because she thinks it was actually helping her.

Unfortnatley, one of her side effects from vyvanse is irritability so the psychiatrist started months ago prescribing something with it but difficult child refuses to take it because she is irritable and that is who she is and it is our problem not hers. medication was lexapro - difficult child said she didnt like it after taking it twice in three days. psychiatrist now prescribed tenex. When she changed the medication difficult child got all argumentative saying that she was irritable and that was just who she was and we needed to get over it and blah, blah, blah...why aren't we on medications, etc...actually ran out of the psychiatrist's office. psychiatrist told me that until we get the irritablility under control it was going to be very hard to work with her.

bottom line, difficult child won't take the medications...she "forgets", isnt home, it doesn't fit in her schedule, etc. We told her she could keep them in her room to take so she won't forget, offered to give her a pill box with dosages for the weekends when she stayed at friends (which is pretty much the norm right now), and would have the pharmacy make up a small bottle I could give to teh school nurse in case she forgot at home. The school won't allow the kids to have tylenol in their possession so allowing her to keep some on her all the time isn't possible.

I am gonig to be very honest here, I am at the point I can't deal with her temper outburts, namecalling, general disregard for anything she's been asked to do, etc.

She needs to try to be on these medications to see if they will, in fact, make a difference. Only then can we try something else, or not. She needs to get the irritability under control because no one in our home wants to be around her anymore because we just don't know what will set her off (therapist says she has some depression, anxiety, too, so that could be irritability too).

therapist also says shes ambivilent about the medications in general. I thought I saw the light at the end of the tunnel when she admitted that the vyvanse was helping her with school. Now she doesn't want to take the Tenex to help with the irritability. Our family doctor, who is very teen friendly, actually tried to talk to her about it and I thought he was getting through about the irritability thing.

Help! What have you all done to get your teens to take their medications?

All I want is for her to give it a try so we can start to work with her. We can't even talk to her without having her get angry or annoyed or accusing us of just starting problems where there aren't any over the tiniest stuff! I am at my wits end.

Is it wrong to refuse to do anything for her until she starts trying the medications? I mean, we've been at this for nearly 4 months with no baseline to even begin from.

She'll be 18 at the beginning of summer so time is running out for us to excercise our parental cajoling on this.

 

[BusynMember]

If she's 17, I'm not sure you can. She'll be 18 soon and you can tell her to move out if she is still disagreeable. But many adults unfortunately choose not to take their medications. Remember, medications don't change everything.

To defend her, although it may be hard for YOU, I've taken many medications that actually made me feel so horrible that I wouldn't take them again. Sometimes that was only after one dose. It scared me. Maybe the Lexapro made her feel weird the very first day.

I am picky about what I take and am glad I finally found medications that work and don't have horrible side effects.

If she is drinking or taking recreational drugs, that would knock out any effectiveness of medication anyway.

 

[DammitJanet]

You can tie in anything she really wants: cell phone, computer, car, money, etc. into taking medications. Find her currency as Dr Phil says and use that as a way to get her to take medications. In fact, if she wasnt taking medications and was so irritable, I dont think I would allow her to have use of my nice toys...especially a car. She can wait until she is 18 and out on her own to buy one.

 

[TerryJ2]

I'm with Janet.
{{{{hugs}}}}

 

[whatamess]

Do you think she'd be willing (with you or on her own) to fill in a mood chart/medication chart, so she can actually track how she's feeling and how the medications affect her?

 

[emotionallybankrupt]

medication compliance was a huge issue here, and we never got it completely under control except during certain stretches of time. For my difficult child, it was a matter of routine. Morning compliance was the best it ever got, and that is because her morning routine was more consistent, even if the time schedule ran a bit later on the weekends. The pill box had to be at a specific place in the kitchen cabinet, and she got her medications along with her morning juice. If anything at all disrupted that consistency, all bets were off. If I tried to be "nice" and take the medications and juice to her in her bedroom--if she were sick, for instance--she'd say ok but wouldn't take them. She'd always be "going to do it in a minute," and it didn't happen.

I'd caution against using any incentive or consequence plan, because my experience was to then find pills here and there in her room, from when she had forgotten but didn't want to tell me. Then you get to worry not only about difficult child, but about smaller children or pets that could find the pills. I always thought it was strange she didn't just flush them to get rid of the evidence, but she didn't.

We simply had the agreement here that I would not scold, reprimand, etc. as long as she was honest about what she had and had not taken. Once we had that deal, things were a lot better.

Because some medications/dosages are dangerous to zig-zag around, another strategy we tried was to get the routine set using something that didn't matter so much--like a multivitamin or calcium supplement. I loaded the pill boxes just like I would for other medications, and we got the consistency going that way before moving ahead to prescriptions.

I don't think it's going to work if you don't have a way to monitor the pill box and its contents, though. If the box is coming and going to different houses and/or staying in her room or purse, you're going to have a hard time knowing what's happening, and it's also going to be hard for her to establish that consistent routine.

How many doses a day does she need? Is there any time of day at all when you could count on her being at home consistently, just long enough to take the medication? Anything you can get in an extended release form is helpful.

 

[aninom]

Do you think she'd be willing (with you or on her own) to fill in a mood chart/medication chart, so she can actually track how she's feeling and how the medications affect her?

I think that's a great idea. If her refusing to take the medications is connected to them making her uncomfortable, EVEN IF this actually isn't the case, maybe working with her on figuring that discomfort out will make the point that the medications aren't some sort of arbitrary punishment or instrument of control you are wielding over her, that it's in fact your mutual concern, that you care for how the medications will pan out.

Getting her to actually fill that chart in, I imagine is another story - but at least you will have made your this-is-our-mutual-concern position clear by suggesting it.

I am gonig to be very honest here, I am at the point I can't deal with her temper outburts, namecalling, general disregard for anything she's been asked to do, etc.

Remember that this is about HER, not you, that whatever she does and whatever name she calls you, she probably doesn't understand the full impact of her actions upon you. She only feels this kind of liberty in acting out because at some level, she still knows you do love her, and she trusts you to see the entirety of her bad side.

All my best, best wishes go out to you. Hopefully it won't be like this forever.

 

[flutterby]

I have nothing to offer because I've had this battle with my daughter for at least 4 years and haven't found anything to be successful with her.

You have my sympathy. I completely feel your pain.

(((hugs)))

 

[horserider]

You are truly not alone in this dilema. Our nearly 17 yr old (in 1 month) has not been medication compliant since April. He also was on Vyvanse (and Abilify). Has your difficult child been on medications for long? With our son he just got tired of so many years on so many different medications and the side effects. Has your difficult child expressed why she wants to be off medications now? It seems since both our difficult child's are so close in age it could be hey are seeking that "independence" from parents.

Our difficult child is currently in a theraputic program in the jjc which I believe is a result from his instability from being off his medications, and the violent outbursts that landed him there. It was just a matter of time. Ironically, although he has struggled for 4 months to "earn weeks", etc he still refused to go on his medications.

I came to the decision with our difficult child that I will no longer force the issue with medications. Part of the detachment I have learned here. He will make his decisions, if his life spirals without medications when he is released, he will pay the concequences. Ironically the last 3 wks he has made hugh strides in the program, the intensive therapy and structure helps, along with wanting passes home. Sometimes with all the hormones and teen years issues I think they have a hard time realizing how much their medications help them.

Good luck to you and hang in there

 

[Iamwipedouttoo]

Thank you all for your suggestions. I really appreciate them.

I am so at my wits end with the medications thing because I want her to at least give them an honest try to see if they will help her, that is it.

I really feel that I have expressed over and over that she should at least give them a try and if they make her feel bad we can ask the doctor to find something else for her but that she had to start somewhere - the doctor can begin to make changes to medications if she doesn't have a starting point. All reasonable requests in my opinion. The problem is she doesn't have a "problem", we have the problem.

The mood chart is an excellent idea IF I can get her to fill it out. I don't want her to continue if they are making her feel bad from side effects.

She said that the Lexapro made her feel like crying all the time (she only took it maybe two-three days - maybe). The psychiatrist encouraged her to give them at least two weeks, but she refused.

I think I'm going to just do my best to encourage her to give the medications a try. I honestly have no way of enforcing the medications other than to tell her that she can forget to be driving with me unless she gives them a fair shake.

 

[DammitJanet]

Your thinking on giving them the old college try is reasonable. That is what I did with my son.

When my son was under 18 he had to take medications...no two ways about it. He lived here and he had to take his medications. I did tell him he had the right to not feel bad on medications because I took medications and I knew that some just plain made me feel bad on them. What we worked out was that if they didnt have any immediate horrible side effects such as nausea, vomiting, or something like that, he would stay on them for a month to six weeks to give them a try. If they seemed to be working OK, he would continue if he felt they were working. If he didnt like them, he had the option to try something else. Some things were too sedating for his liking. OK...we would try something different. He had the right not to be a zombie. I dont want to live like a zombie.

Because I did this, and he trusted me that I would listen to him, he went through several medication trials. He isnt on medications now and doesnt want to be on them. I dont blame him but I do think eventually he will probably end up back on them.

 

[emotionallybankrupt]

If your teen will just work with you on the medications, you and the doctor can possibly help with reducing or eliminating the side-effects.

Several years ago, I tried Lexapro and had such awful side effects that I thought I couldn't take it. Same story with several other SSRI's. The solution turned out to be so simple. The doctor had me split the lexapro in FOURTHS and take 1/4 tab for 8 days, 1/2 for 8 days, 3/4 for 8 days, and then up to target dosage. NO side effects at all. I couldn't believe that nobody (including me) had ever considered that maybe my system just could not tolerate so much so fast. I've forgotten the mg. amounts, but I know that the first attempt was considered the typical way to do it. My body doesn't like "typical."

Might be worth asking. In the past, I've disqualified quite a few medications due to side-effects, when the solution might have been just as simple.

Good luck.