Refusing to take medication

Post Reply New Topic

Hi,

I have an 18-year-old son with autism. About six months ago, he began refusing to take his Lexapro. It was fine for a few months, but then we saw the effects of him not taking it...aggression, depression, etc. For the past month, I have been grinding up the pill and trying to hide it in his chocolate milk, but the problem is he refuses to drink the chocolate milk every day. He wants to drink it only every other day and sometimes every third day (OCD-type behavior). He is also VERY limited on his foods so only eats hard, crunchy foods and that prevents us from hiding it in something he eats.

Does anyone have any ideas? He also just recently decided that there is nothing wrong with him, and he does not have autism. We cannot even say the word autism without him getting very angry.

Thank you in advance.

Jeannine

Is it possible that the medication has undesirable side effects? I've had a rather rocky history with medications myself, partly for this reason. I'm not sure how I'd approach your son about it, but it's very well possible his medication may be making him feel worse in some ways.

I actually used to use the same medication in the past, and it never really sat well with me. There was a brief period where I felt better after taking it, but then that feeling went away after about a week and I just started feeling emotionally blunted. It should also be noted that I had a hard time keeping to a regular dosing schedule, and that this has been one of my biggest struggles with medication.

Another thing to keep in mind, grinding up your son's medication may change how his body absorbs and metabolizes it. Pills are designed the way they are for a reason, and if you change that it can alter the effects in undesirable ways.

Are you sure you are treating your son with respect? Do you expect him not to see your writings here? Why don't you try as I do? I write every single message here for my children to read. Why hide things behind your children's back? Heck, print out my message here, and give the instructions to your son.

So he is verbal, and has good understanding in general. If I were you, I'd go get him a digital voice recorder, anywhere from US$50 to US$100.

This is how he would use it. First of all, he needs some outside activities (outside of home) that makes him happy, things that he enjoys. Things that makes him laugh. Things that make him realize that life is fun and worth living. I don't know, walking in the park, going to birthday parties, going to entertainment parks, roller coasters, music concerts, going out and have frozen yogurt, whatever. Second step: when anxiety/depression or any negativity attacks, he needs to record down (himself) the event. Just a few words are sufficient. Third step: he needs to replay the recording at moments when he is doing something else. The best time is when he is happy and laughing. Trust me, the first few times it's painful to be listening and be reminded about those negative moments. However, at the moment of re-listening, that's the moment he can figure out how to re-wire his way of thinking, how to handle/solve the problems. Perhaps things are never as bad as he thought. Perhaps there is a different way of looking at things. He needs to tell himself, yes, life sometimes is stressful, that's a given. But life sometimes is also fun. These painful reminder moments are like eating chili pepper: you eventually get used to them. Fourth step: the next time negativity attacks, he needs to remember the entire thought process that he himself went through when he was calm or happy. He needs to tell himself, yes, life sometimes is stressful, but some other times is fun!

That's all. You build a space-time wormhole tunnel to connect your bad moments to your good moments and vice-versa. And anxiety/depression/negativity is gone. No medication needed. No side effects.

Even my 8-year old daughter knows about this trick already. The other day I asked her, what do you do when you feel angry and all stressed out? She told me: you think on the good moments of life. Voilà. All these tricks are known since thousands of years ago. A digital voice recorder just makes it a lot easier to accomplish. Give it to your son as a birthday present. It can save a life.

I think you should probably try to have a talk with him about why he doesn't want to take the meds. Is it just because he is in denial? Are there also side effects he has issues with?

How long has he been diagnosed and how long has he been aware of the diagnosis?

While I was not diagnosed as a child (or officially, even now) I can say that there is a stage where you don't want to be doing something differently that other people do not have to do, or be disallowed from doing things either just because of someone else thinks you need it. I am probably not clear in what I am saying, so I will give an example.

When I was a kid, my parents had rules for me that were different from other kids for health reasons. They would tell me b/c of this or that disease in the family I could not eat this food or that food. It was socially awkward and weird, and even if it was b/c I personally had a hea;th issue (as opposed to x% higher risk of something way down the line) I would have resented it.

If there is a history of him being told you cannot do x or y, or you must do z because of autism (even if valid and true) it would be natural for him to rebel against it. Even if it is just this one thing, if it is unpleasant, or makes him feel weird to be doing it, it would make sense on a certain level to denounce the autism to make it go away. I am not saying that you are not correct that he needs his meds. What I am saying is an exercise in theory of mind from the other perspective in why he may not be compliant.

I think making him take the meds by grinding it in his food is not the way to fix this. His own rights to personal autonomy aside, it is not even practical due to how he eats. The better thing would be to go the longer way around and convince him. If his behavior off meds is intolerable, I would be honest about that.

If it is dangerous for him to be living with you without the meds, that is perfectly reasonable to bring up, and information he needs to have. if there is a mental-age issue or something else going on, it may be a tricky thing, but if he has the ability and legal rights to make his own decisions, this is the best thing. Even if he is not, you are going to want him to get to that place, anyway, eventually.

Jason, that sounds neat. I want to try that immediately with my son (9, AS).

Jeannine, I do think talking with your son more is where you need to take this, not trying to hide the meds better.

I do also think there is a time for medication, so while I like Jason's idea and plan to try it myself and with my family...I think anti-depressants and anti-anxiety meds do sometimes save lives.

What worries me about your writing is hearing only how you experience this. How it affects *you* when he takes medication. But, believe me, I have also had those thoughts myself. My point is NOT to demonize you. It was easier for me when my son took Prozac and my husband and I got into a mighty fight when my son wanted to stop (I thought he should be able to stop, if he wants, as long as he didn't go back and forth and back and forth). Which, by the way might be worse than not taking it at all. Lexapro doesn't work on an as needed basis (I've taken it before).

But, first talk with your son. Even if he is non-verbal. Talk with him. Communicate and find out what *he* wants. I think this is important with younger children, but your son is actually a man...so it's even that much more important to let him have choices that affect his life so deeply.

Of course I tried to talk to my son. That was the first thing I did. I asked him if the pill made him feel different and he said no. He has been on it since he has been six, so if there were side effects, I'm pretty sure this would have happened long ago.

As far as this affecting 'me' I have always put my son first and me second. This has absolutely nothing to do with me. When he came off the medication, he became very depressed within months and mentioned ending his life SEVERAL times. This is when I knew he HAD to be put back on the medication. He felt worthless and said he hated himself. And again, I did talk to him and asked him to go back on and he refused. That is when I began 'hiding' it. Sorry, but I feel hiding it is better than what the alternative (God forbid) may be and on a side note, his doctors, therapists, teachers, agree.

As far a tape recorder, he has been through 18 YEARS of schooling, and myself and the district have tried everything under the sun to help him regarding dealing with depression and anxiety. I am not a newbie here. He is 18. He was diagnosed at three, but we have had therapists coming in my home and working with him since he was 18 months old.

I understand if people do not have an idea or suggestion for my problem (which was if anyone else this problem and if anybody had any ideas), but really you all should not bash what you have no clue about. Sorry if I sound defensive, but some of these responses were inappropriate. And please understand, screen_name, that I am not intending this towards you. This is the last post, and I hit reply.

Do you think it's possible someone told him that being on medication is a bad thing? People on the spectrum can be easily influenced.

The OP is REALLY not going to want to hear this.

But as an 18 year old, your son is an adult. Do you have legal right of attorney and rights over his medical care? If you don't you are committing a crime, punishable by prison time. I know that sounds weird to someone who's been his mother his whole life, but now he's an adult. You don't have legal rights like this anymore. By putting those pills in his chocolate milk, you are acting criminally. That you are his mother doesn't change this. In fact, from a certain point of view it makes it creepier.

Secondly, Lexepro has significant withdrawal and start-up side-effects. This means that by going on it, and then going off it, and then going on it again without medical supervision could cause significant damage. People do sometimes have seizures when this happens. Its VERY rare, but he could die.

Thirdly, none of the anti-depressants treat autism. Your son might have depression, too. But many people on the spectrum react very poorly to SSRI inhibitors. I am just on of these people. Prozac created terrible side-effects with me, to the point where I was really starting to go crazy, pulling out my hair and hearing things. When I told my doctor this, he INCREASED my dose. That's right, he saw a young person with disabilities and thought that prozac could do nothing but good, and my parents, bless their hearts, told the man that it was doing good things for me... to this day, i have no idea why. Apparently, to them, I looked better. They didn't know I was hearing things and they apparently didn't link my jumpiness and my pulling my hair out with anything other than needing more medication. Trials of lots of other SSRI inhibitors created a slew of different, but really awful, side effects.

(I take St. John's Wort now. It has a mild anti-depressant action and none of the side effects with me. St. John's Wort does interact with other medications, so don't mix and match without professional help. I also benefited from stimulant medication. I'm one of those people it slows down. But then even that started to give me migraines.)

Remember that autism is, in part, a communication disorder. We don't identify our feelings well and we don't always have the ability to express what is wrong with us. Your son might be having terrible side effects and you might not even know it. Or, he may simply feel that this is a way for him to assert his adulthood and gain control over his own body. Well, good for him! That's exactly what an 18 year old should be doing.

I didn't intend to bash you and I'm sorry you and your son are having trouble.

I won't help you hide the medicine better because I don't believe it is a good idea.

I still wish you the best though.

You are a terrible human being ... What kind of person grinds up pills and puts them in someone's food or drink? That's what they do in date rape scenarios and when they wanna drug someone out. Definitely an unsavory thing to do to your 18 year old ... who technically has the choice whether or not THEY want to take it. You ever come to think that not for nothing MAYBE the stuff has terrible side effects??? Many of anti-depressants actually make you suicidal as a side effect. Remember, big Pharma is not your friend.

I really don't think that is warranted here.

I know my husband can relate to how she is feeling. He's wanted me on antidepressants many times when I haven't wanted to be. He didn't hide it in my food though.

But
1) her son *just* became a man and she's his mom. It's not uncommon for parents to try to get their children to take their medicine in any way they know how. Cut her some slack. (I agree that children of any age should be allowed some level of input, but with that belief aside...it's still new that her son is grown. Old habits are hard to change.)
2) People are more likely to change if you can find a way to empathize with them and attempt to see it from their perspective. She's already shown that the level of pushback she's received is too much for her. I'm afraid your post will do very little to change her mind and may instead drive her away. ...when we possibly *could* help her find solutions to her problem.

This is true unless the individual in question has a court order for custodial care.

I don't think that she's reading anymore. I'm guessing that she wasn't psychologically prepared for people to point out how wrong her actions are. My guess is she's probably a pretty average parent. Parenting is really hard. And everyone f-s up sometimes. Its weird that we treat the job of parenting like its the only one in the world that shouldn't include a learning curve. Its got to be a real hard transition for a parent when their kid turns 18, especially if that parent has been micromanaging their kid the whole time. Both of them probably need lessons in how to either be an adult, or live with the fact that your kid is an adult.

All very true.

And parenting is insanely hard! And you are so right, we treat it as if there was nothing you could possibly know ahead of time to help.

I studied intensely before my first child was born and I still, as you say f up all the time...

*slams head against desk*

I think we drove away the OP. I wish the best for her and her son, and I think figuring out the reason why he's quit taking his medication is part of it. Now, even though he's been on the medication for years, I wouldn't leave out the possibility of side effects. It's possible there's something he doesn't like about the medication, that he just hasn't spoken up about. I'm not saying he should be grilled about it, and in fact doing so may make things worse, but if he's decided to quit taking it after years of use, there's likely a reason behind it.

Now OP, your son's an adult, and just a theory I have is that he may be experiencing "male-specific" issues with the medication, if you catch my drift. Issues like this are common with SSRI medications, and it's a complaint some men have with taking them.

Another theory, to reiterate an idea I expressed earlier in the thread, is that it's possible someone (or something, like a joke in a TV program) told your son that being on medications is a "bad" thing and to quit taking them. Unfortunately, people on the spectrum tend to be suggestible to bad ideas like this.

Whatever the case may be, I hope things work out well for you and your son.

Yea, I hate to be the "troll" but I'd be pretty darn pissed if I found out that my parents were sneaking meds into my food. Like I said, only unsavory characters do that kinda thing. Date rape people and those who are legit trying to kill someone by poison will put stuff in their food.