Difficulty in Swallowing Pills
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Q:  Difficulty in Swallowing Pills

When I took lamictal I began having trouble swallowing it because of its bitter taste.  If I tasted it I gagged.  I switched to the dispersable tablets and did a little better but still gagged if I tasted them.  I spent most of my time nauseated and was vomiting fairly regularly.  Ultimately we decided I couldn't handle it and that throwing up my other pills several days in a row was not worth taking that med.  I came off it and the nausea went away but I'm still gagging when I have to take my pills.  I've learned that pills make me gag and no matter what I try they do.  It takes a great deal of effort to swallow any pills now despite having tried every idea I could come up with.  The next step is switching some of my meds to liquids but not all are available in that form.  I have to take 12 pills per day.  Do you have any suggestions for breaking the conditioning?  Thanks.

Dear Anon --
Haven't run into this. A good behavioral psychologist might have a standard package for this "re-conditioning". Usually we use "exposure" for desensitizing to a fearful stimulus; but this is different and I don't have experience with it. I'd guess that the trick might be to condition a new association with the pill: see the pill, experience something very pleasurable, e.g. a little piece of candy, say (sugarless if weight is an issue). There's also a new tradition in "hypnosis" that's developing (e.g. the work of David Spiegel at Stanford; here's a
technical example; and an example of the use of hypnosis for treatment of a perhaps-not-very-psychological problem). If you can find a really up to date, science-oriented psychotherapist who also does hypnosis, that would be another possible option. If you find something that works, would you write back? Thanks --

Dr. Phelps

Published September, 2004


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