Need some medicine-taking suggestions! :(

[OrganizedChaos]

I am feeling at the end of my rope with this! A little backstory: He was on Ritalin to start but getting him to take pills was a no-go. So they switched him to Vyvanse, 20mg, once a day. This did okay for him at school but by the time he came home he was out of control until bedtime. Pediatrician upped it to 30mg and told us we could split the powder in half. This wasn't a great solution but it was okay and my son had no idea he was taking it cuz I'd mix it with a bit of milk. The psychiatric doctor put him on Adderall-XR 5mg, 2-3 times per day. The problem is that Adderrall has a bunch of little tiny beads in the capsule. My son won't take pills so we have to mix the medicine. He actually did okay on this medicine, only slight better than Vyvanse, but the problem is the beads cause a tactile (I'm assuming) sensitivity with him and he will not ingest them. Not in drink or yogurt or even in candy (we've been getting creative!). Got my new script and every pharmacy in my area has it on back-order. So, they psychiatric doctor decided we'd do Vyvanse at 30mg, once a day. I've had some old Vyvanse 30mg that we've been using since the Adderall shortage. It's still not the right medication and they won't give me anything else to try because it's either pill for or he's too young (he's 4). So, back to Vyvanse. Only now, since he knows we were trying to trick him with the Adderall, he refuses ANYTHING we could mix it in. Milk - dumps it. No candy. No yogurt. So we have to mix it with milk, put it into a medicine syringe and pin him down and give it to him. I HATE doing this. It seems so barbaric and just not right.

However, if he doesn't have the medicine, he's violent and absolutely out of control. And I don't mean he's up and running around. That doesn't bother me a bit. Our house is kid-proofed, he can run around like a little monkey as long as he's not doing anything dangerous (which he usually doesn't do. He's not fearless.). He bites, hits, spits, throws toys at people, destroys EVERYTHING - he's just so completely out of control without it. I don't know what to do.

Am I the only one with these issues? Please please give me some suggestions to try to get him to take the medication! Even though it's not the right medication (it really isn't but nobody wants to give him anything else, it seems, because he's so little.), at least this medicine does help a little. When it's in his system he's not violent. Still usually destructive and very active but not violent. He has some sensory issues and is an EXTREMELY picky eater. He generally lives on chips, yogurt, crackers, milk and peanut butter (I give him PediaSure to supplement). And if he sees any sort of powder (Vyvanse is a white powder) on anything he will refuse it.

I'm getting ready to go to my first Autism support group. I'm hoping they can offer some suggestions as well but I know you guys are a wealth of information!

Mostly, I just want to know that it gets better. The psychiatric doctor says they can't do anything for him until he's older but we've been dealing with this for 2.5 years - how much longer can we keep going like this? Of course we'll keep going but man, some days I just feel so defeated.

 

[HaoZi]

What about condiments, applesauce, or pudding? I'd think you could mix it in with peanut butter, too, especially if he likes the chunky kind.

 

[OrganizedChaos]

He doesn't eat condiments. Applesauce is hit and miss. Oddly, he's not a pudding eater (he prefers yogurt). And he only eats the sooth peanut butter. Getting him to eat anything is difficult, even without medicine being in it.

 

[HaoZi]

Umm... if it's safe to heat the medication, what about scrambled eggs? Or mixed into his pediasure? Are you putting this on top, or mixing it in thoroughly? Will he eat oatmeal? Oh wait... how fine a powder is it? Could you put confectioner's sugar on something and it would blend in? That stuff is great on pancakes, french toast... How well does it mix? Would juice hide it?

 

[buddy]

What about a patch? There are patches for many medications including ritalin. difficult child wears two for clonidine. We change them weekly. Ritalin would be daily I am sure. but you can sneek in when he is asleep and stick it on so it is activating before he wakes...maybe. The clonidine patch.... it allows us to have less agression in the mornings and I get him to cooperate with taking his other medications easily. I am truly blessed in this one area, difficult child will take all the pills in one handful. no water! I dont get it but he does it.

 

[Ktllc]

I have not been in the same situation, but I've had to give daily medication to my oldest when he was very young (life threatening issue if left untreated). Of course, it only came in a big pill. The pill was blue and we had a whole story about the pill being a spiderman pill. Where it would go, etc... I finally found out that giving him the pill by drinking through a straw was the best way. Almost magical. I would make him drink plenty first, then put it in his mouth and really rush him to keep drinking. It worked quite well but we really had to prep him. He was 3 at the time.
If a pill is not realistic, you might stll want to try the straw: open the pill, put it in a drink and let him drink with the straw. It help prevent the gaging effect. With the suction, one doesn't feel the texture as much.
An other thing, since he knows already that you give him medications, try to explain why they are important and helpful. He is young, but not too young for an explanation. Something like "it will help not get angry. This way you can enjoy such and such activity. That would be nice not to fight today, wouldn't it?"
Good luck! And if it boils down to the syringe... don't feel guilty. You know what is best for him. Better being upset for a few minutes about the medications than being raging all day.

 

[HaoZi]

Mine would rather take a pill than any other version, her method is to take a big swallow of liquid, toss the pill to the back of her mouth, then swallow. She hates the taste of the pills themselves, but says liquid is worse and she doesn't want injections.

 

[keista]

Yeah, I have some experience in this. From 2 to 7, DD2 was medicine-PHOBIC, and this included toothpaste. Unfortunately, I had little success with her until we got to a situation where she HAD TO take medicine at 7. She worked with a therapist for 2 months, and I came up with a monstrously inappropriate reward (marshmallow peeps to get her in the dentist chair and take the prescribed antibiotics - yes, you read that right)

Yes, to the patch! If you can get his medications in patch form, do that! If not, take a deep breath and a leap of faith.

A 4 y/o Aspie is difficult enough to deal with, now add medicine aversion. So, how are his communication skills? Can you see some logic getting through to him as was suggested? Do you think you can negotiate a deal with him? I don't care what it might take. At this point, you really shouldn't either. I'm guessing that the peace that you would gain would be worth, say, a bowl of ice cream if he takes the medications (in an acceptable form or acceptably "hidden" to him) The ice cream is just a suggestion. Find whatever it is that will really get his compliance. Cotton candy? pizza for breakfast? trading cards? whatever. The trick is, whatever you and he negotiate, he NEVER gets at any other time except when he complies with medications. And, if you do manage to reach this negotiation, don't expect it to work right away. He may still back out of the deal a day or two, and when he finally decides to comply, you still may have to spend a lot of time comforting and urging him to comply and that it will be OK.

Oh, my heart goes out to you. I totally agree that pinning him down and forcing it on him is not a good idea. I tried that method exactly twice. Once at about age 3 with cold medicine. You know the fast melt sheets? They dissolve almost instantly after hitting the tongue. Well, I got it in her, but she managed to spit out 3/4 of it even after I kept her mouth closed for 20 seconds. ?????

by the way I know you said it was a texture thing with the beaded medicine, but does he ever eat sprinkles? Or maybe not anymore because of this? Anyway, mixing with sprinkles was my very first thought - hiding the texture within a texture. Just thinking out loud.

 

[InsaneCdn]

All I can offer is UGHs and {{Hugs}}.

 

[OrganizedChaos]

Wow, I thought I'd be back last night after my Autism support group and I was just wiped afterward! Turns out I'm coming down sick.

Thanks, everyone, for the suggestions! That confectioners sugar is a great idea because Vyvanse looks JUST like it! Now it's just getting him to try the confectioners sugar because he knows the V is powder lol. But, hey, it's all the more reason to make some French toast!

I also did some searching on the patch (Daytrana) and it looks very promising! The psychiatric doctor is out of town until tomorrow so when I called this morning they couldn't tell me if he'd prescribe it. I'm hoping to try it! Yes, I read about a lot of people putting the patch on their child before waking them up - I think we'd try it that way. If he sees us put it on I think he'd tend to obsess over it because he does that with stuff. But if he doesn't see it happen... Certainly worth a try!

Trying it with a straw might also be a good idea. He's so smart and he's now suspicious! LOL! Poor little guy.

Because he's hearing impaired and doesn't have much language, I can't get it through to him about the medicine helping him.

Thanks again! Lots of great ideas and I will try them all until I can make it work!

 

[DammitJanet]

I was going to suggest teaching him to swallow a pill with a tic tac or mini M&M but being hearing impaired may be a bit hard though I would try. The mini m&m's taste good so he wont be too irritated with you. My kids had to take ritalin from 4 years old and they could take it without water at the drop of a hat. They do make a cup just for this and you can find it in the drugstore. Ask the pharmacist.

 

[HaoZi]

Let him go shopping with you for the confectioner's sugar and other things you need for french toast, like a special little field trip. Then he knows where it came from and won't suspect the package. I've found those Parmesan shakers like you see in restaurants are great for it if you happen to have one.

 

[nvts]

The way we got my kids to take medications was make it fun...we did "THE ALIEN SLIME SWALLOW" in your case yogurt would do it - they liked pudding. Then we'd make up a stupid story and everytime we said "Alien Slime Swallow" he'd take a mouthful of pudding. The hear-impaired would make that one tough! The patch sounds like your best option!

Beth

 

[Liahona]

I taught difficult child 1 to swallow pills using the gel caps and pixie stick method described in this link.

Pills

 

[buddy]

I also did some searching on the patch (Daytrana) and it looks very promising! The psychiatric doctor is out of town until tomorrow so when I called this morning they couldn't tell me if he'd prescribe it. I'm hoping to try it! Yes, I read about a lot of people putting the patch on their child before waking them up - I think we'd try it that way. If he sees us put it on I think he'd tend to obsess over it because he does that with stuff. But if he doesn't see it happen... Certainly worth a try!

With the Catapres/clonidine patches, they say they stick on (remember they last a week so different need to stay on) even in water, (NOT). They have these disks to put over to protect them and make them stick more....they just caused skin break down. I tried everything, those IV water proof things etc. and nothing worked. I fianlly got the store brand (they are in every drug store under their own name, but they all look the same, I'm sure MADE at the same place) of a bandaid that always has the words.... extra strong/waterproof etc. It has a clear tape around the owie pad in the middle with strings running in a grid pattern across it for strength. You can tell in the picture on it. I get them at walgreens and have also gotten them at cvs. they last a whole week. In addition, I keep hydrocortizone cream to put on right after we take them off because they an itch (again after one day I doubt you will have those issues as much if you use it. When he went thru a phase where he would be bugged by them and threaten to pull them off, I put them on his middle back, near his shoulder blade where it was not easy to pull them off.

He doesn't give them a second thought now, it is well worth the training phase for us.

 

[DammitJanet]

Buddy, do you get the covers from the place that makes your patches? I am betting its J&J right? Same folks who make Duragesic. I had the problem of those patches (the covers) causing horrible reactions on my skin. That is why I had to come off the Duragesic patches years ago. The patch worked wonderful for me but the patches dont stay one well without the covers.

Someone told me several years later that you can spray Benedryl spray onto your skin...the clear kind that looks sort of like a gel...onto your skin and let it dry for about half an hour before you apply the patch and the cover and it will help stop that reaction. Just thought I would pass that along.

 

[SRL]

I want to caution anyone reading this thread to be sure and check with your pharmacist to see if a medication can be safely and effectively split, opened, or crushed.

Also, check at the pharmaceutical company of a specific medication to find out what forms the medication is produced in. Twice I've come up with versions (liquid and a powder form) of various medications my children were taking that their doctors weren't aware of. (Opening a packet and sprinkling Singuilair into pudding was a whole lot easier than dealing with the tablet in a very young child!). Also other forms may come in different flavors (ie mint, thinking of one medication that was in liquid form with the elderly population in mind). These forms might be more palatable or easily flavored by a pharmacist.

Some more ideas for mixing in medications:
Cool Whip
Milkshakes
Pudding
Ice Cream with strong flavors (ie mint chocolate chip)
Oreo Cookies (seriously, sprinkled on the center)

If you've been in a battle with a young child over medication, I'd also suggest tossing whatever your current strategies are and go for a "restart". Don't even bring the medication up--just serve it in a strong flavored snack to see if you can calm the issue down instead of exacerbating it.

 

[InsaneCdn]

Way back once upon a time... I don't remember how many years ago... a pharmacist came up with a way to make custom-flavored liquid medicines. Even figured out which medicines worked with which flavors (some things do NOT go together!)... These were strong medications that most kids hate to take. He found that by being able to give the kid a choice, the kid was often a more willing participant... and he guaranteed to the parent that if this flavor didn't work out, bring it back and he'd replace with another... to get the best fit for the kid.

No idea where that was, or if they still do it. But it might be worth bringing up the whole "hard to take" issue with the pharmacist.

 

[buddy]

Buddy, do you get the covers from the place that makes your patches? I am betting its J&J right? Same folks who make Duragesic. I had the problem of those patches (the covers) causing horrible reactions on my skin. That is why I had to come off the Duragesic patches years ago. The patch worked wonderful for me but the patches dont stay one well without the covers.

OH yeah Janet, we did do the benadryl thing too. The gel helped too but of course you have to let it dry first. Still, it did seem to make the patches not stay on as well (we swim daily in summer). So now, I rip them off quickly and have the cortisone cream ready to go...we have 2% cream to help with other itchy things in our home for him so we use that. Dr. said it is fine to do, only once a week anyway. The "heavy duty/water proof" bandaids...not j&j kind, the clear ones with little strings thru them.... those are the bandaids that work for us....thru swimming and thru showers. The stick for a whole week most of the time. I have learned to order the patches as soon as insurance will let us refill so that each month it backs up a week and eventually I have an "extra" dose if he pulls them off.

I feel for anyone who uses those disks, the patches can be irritating enough. those disks are awful and I have to wonder who in heck tested those and said they were ok. they are meant not to be put on right away, it says they should be put on IF the patches themselves come off a little, but I haven't heard of anyone who has the patches stay on (at least for kids) without something to cover them. maybe people dont shower??? or maybe for teh daily kind, but for a whole 4-7 days???

We were also given the generic form of the Catapres/Clonidine patches (just came out this past year) and they are HUGE and did not stick at all. I had to use three huge bandaids to cover them so we had tons of breakdown of skin plus that adds to his behaviors when he is bothered by any little thing...so insurance approved name brand only.

 

[SRL]

Way back once upon a time... I don't remember how many years ago... a pharmacist came up with a way to make custom-flavored liquid medicines. Even figured out which medicines worked with which flavors (some things do NOT go together!)... These were strong medications that most kids hate to take. He found that by being able to give the kid a choice, the kid was often a more willing participant... and he guaranteed to the parent that if this flavor didn't work out, bring it back and he'd replace with another... to get the best fit for the kid.

No idea where that was, or if they still do it. But it might be worth bringing up the whole "hard to take" issue with the pharmacist.

It's commonly available at pharmacies today, so parents should just ask.