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Attention Deficit Hyperactivity Disorder

Convincing Someone to Take Medication

02/17/1998

Question:

My son is 16 and has ADD. What is the best way to convince him to take his medication (Ritalin SR)? He pretends to take it, but secretly disposes of it.

Thanks

Answer:

Medication issues are very common among teens. They don't want to be seen as different from their friends, so they commonly will not take prescription medicines. In order to convince your son to take his medicine daily, you will need to find out what the issues are for him. Does he feel that the medicine is not effective? Does he have side effects from the medicine? Does he have trouble swallowing the medicine or does it taste bad? Does he have a regularly scheduled time for taking his medicine or does he just take it when he remembers? Does he feel loss of control because it isn't HIS choice to take the medicine? Is he seeking a specific reaction from you by not taking his medicine? Are there any other secondary gains on his part when he doesn't take his medicine? These are just a few of the possible issues that your son may have regarding medication use. You may already know the answers to these questions. If not, it would be helpful to understand the specific reason(s) for not taking medicine. If your son does not believe that the medicine is effective, is this a valid assumption on his part? If so, he may wish to discuss this with his physician so that the dose may be changed or a different medicine may be tried. This also applies to any side effects or other difficulties with taking medicine. Some medicines come in liquid or chewable forms that may be easier for him to take. If your son feels that he is being heard and is allowed some choices, he will be more apt to want to take his medicine. He may also want to negotiate with you and his physician about when and how he takes his medicine. He may not wish to take the medicine on weekends or may want to take "drug holidays." This refers to being off medicines for a trial period to see if he can maintain control over his ADD symptoms. If he can, then it isn't necessary for him to stay on the medicine. You might want to negotiate some specific target behaviors to be monitored while off medicine. Since this is agreed upon mutually, this can give him the sense of control that he needs. If he isn't taking his medicine because he desires specific reactions from you, this sometimes can be a more difficult situation to address. When someone tries to elicit negative reactions from others, it is commonly because they feel they have no control in the situation. They may also feel lonely or lacking in love and attention from others. If their self-esteem is low, this can lead to inappropriate ways of dealing with stressful situations. If you believe that any of these may apply to your son, some short-term counseling to address these issues may be quite helpful. Being loving and supportive of your child is very important. He is lucky that you care about him and are concerned about his medical treatment.

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Response by:

Margaret C Sweeney, MD
Formerly, Associate Professor of Clinical Family Medicine
College of Medicine
University of Cincinnati