Can I train myself out of a gag reflex?

November 1, 2023 8:25 AM

After starting one new medication, my gag reflex is in overdrive, especially when it comes to taking that one pill. Is there a way to train myself out of it?

The problem is pretty definitely just psychological because it's a perfectly normal sized pill (the size of an ibuprofen), and the gagging starts basically as soon as I start moving the pill toward my face. I've always been a little sensitive about things touching my tongue or lips but this is ridiculous, and I never had problems with previous daily meds or vitamins. The issue has been exacerbated lately because of huge anxiety/stressors, but I just really would like to be able to take my two morning pills without 5 minutes of retching and red face and tears. Is there anything I can do?
if it matters, the pill is a concerta generic

posted by specialagentwebb to Health & Fitness (23 answers total)

Since this med doesn't have to be taken on an empty stomach, try eating a little right before you take the pill -- take a couple of good-sized bites out of a bagel or an apple or a breakfast sandwich, whatever you're having for breakfast, then a big swig of a drink. It serves as kind of a warm up to make swallowing easier.

Also, when taking the pill, you might try placing it slightly to the side of your tongue instead of the very middle, then relax your tongue and take a big gulp of water.
posted by mochapickle at 8:40 AM on November 1, 2023

I had a real issue with taking pills for this reason for a long time.

A combination of the following helped me a lot:
- Doing something else while swallowing the pill. Watching a quick YouTube video, reading a bit of a magazine article or a book, walking across the room, just looking around and mentally naming what I see. Anything to give my mind something to focus on other than OH MY GOD WHAT ARE WE DOING.
- Swish it around with the water in your mouth before swallowing so you feel it as little as possible.
- Cutting big pills in half and taking half at a time (might need to check if you can do this).
- You could also try the gag reflex "hack" of making a fist with your left hand with your thumb in your palm. Focusing on that can help you ignore the urge to gag.

But honestly the biggest thing that got me over it was just practice and time. The first few times might be a bit difficult, but you'll get the hang of it. Once your brain realises it's all totally fine, it will get easier.
posted by fight or flight at 8:40 AM on November 1, 2023

Don't know if this will work for you but: I had a hard time taking pills when I was younger and it seemed to focus on the pill touching my tongue. I started taking pills by taking a drink of whatever (sometimes something with flavor/texture like orange juice rather than water helped with this) and squooshing the pill into my mouth and swallowing hard. I don't feel the pill so it just goes down like I'm plain old drinking the liquid.
posted by less-of-course at 8:41 AM on November 1, 2023

Ugh...I have this issue sometimes and I can't ever predict when it's going to happen. Once the gagging has started, I have to stop trying to take the pill and give my brain and body a chance to reset. The gagging just gets worse if I keep trying to push through. Having breakfast or doing some other activity for about 20 minutes and then just popping the pill in my mouth and taking a big gulp without a lot of prep time is the way to go. Basically, I try to get the pill swallowed before my brain even has time to think about it.
posted by victoriab at 8:52 AM on November 1, 2023

I take bigger pills with food instead of water. My throat kind of closes up if my mouth feels something solid in a sip of water, but my body is fine with a pill in a bite of food. Could you try that? Do you have some “disposable” pills like ibuprofen where you can practice just putting them in your mouth and then spitting them out, so you get used to the feeling of having the pills on your tongue?
posted by music for skeletons at 9:00 AM on November 1, 2023

I've been taking a small handful of pills every day since I was in my teens and even still, today, with all my experience, there is only one surefire way of successfully swallowing everything: drink water first.

I take a decent sip of water
Hold it in my mouth
Tilt my head back and open my mouth
Chuck the pill(s) in
Swallow immediately

My mouth never feels or registers that there's a pill in it so it doesn't do any dumb reactions. 10/10 been effective since I discovered this at 9 years old.

p.s. I am still to this day mad at the nurse who said taking a pill was just like eating a hamburger. What? Unhelpful. Also how do you eat hamburgers, you absolute weirdo.
posted by phunniemee at 9:05 AM on November 1, 2023

I have one pill this happens with, and what I do is I pretend it's just a chunk of brownie. (Substitute anything with substantial density that you like and have eaten many times.) I psyche myself up to just toss it in my mouth and imagine it's a piece of brownie, and drink water right away. I move quickly and it works almost every time.
posted by happy_cat at 9:29 AM on November 1, 2023

I can only take pills if I drop them right down my throat. If it touches my tongue, I will never swallow it. It's not great having to take them this way, but it works for me.
posted by poppunkcat at 9:41 AM on November 1, 2023

This may not work for everyone, but it works for me -- reach in with a clean index finger, and approach the back of your mouth. You'll probably gag. Stop. Wait a few seconds, then try again. Do this a couple more times, then stop for a fair while (at least an hour). Do it all over again. It may take a couple of days, it depends on the person (and their persistance, tbh). You should definitely make sure you don't provoke a full-blown vomit response, the idea is just to trigger your nervous system, not piss it off!

...it doesn't take long before I am able to poke my tonsils without provoking a gag reflex. I have to do this in order to tolerate back-of-mouth dental procedures, and the effect wears off after a couple weeks so I'm fairly sure it's a trained lack-of-response. I also do it if I know I'm going to be asked to swallow a humongous pill.

I have once done something similar using a low-power waterpik type device, but note that most of those devices are much too powerful for this! If you try using a waterpik, make sure it's extremely low-strength.
posted by aramaic at 9:59 AM on November 1, 2023

I take my pill by half-chewing a gummy vitamin I really like, and then kinda sneaking the pill into my mouth right before I swallow. Something about the gummy disguises the pill better than a liquid.
posted by potrzebie at 10:14 AM on November 1, 2023

Oh gosh, I feel you so hard. Taking pills has been an issue for me, forever. What works for me is taking pills with a bubbly water. It helps disguise the feeling of the pill in your throat; all I feel is bubbles and it goes down easy. Sending love!
posted by sucre at 10:30 AM on November 1, 2023

Sit up straight, or stand. Take a sip or more of water to lubricate your throat and use the swallowing muscles. Then the pill. To get beyond the gagging, go get a pill out 10 or more times a day, hold it, take a sip or 2 of of water, put the pill down for next time. That's desensitization. Also, your brain loves rewards. Take a pill, get a star on the calendar. Take a 3 3x in a row, get a sticker on the calendar. Get 3 stickers, get a small tangible treat.
posted by theora55 at 11:31 AM on November 1, 2023

This is less a gag reflex hack than a pill-taking one. When the kid had to start taking a daily pill, and couldn't face trying to actually swallow it just with water, we wrapped it in a little capsule of vanilla ice cream. That helped it slide right down.

He then moved on to swallowing with milk and did something similar to what less-of-course mentioned. He took a big sip of milk to get his mouth all wet and then did pill-milk quickly.
posted by machine at 11:37 AM on November 1, 2023

I've always put pills in my mouth under my tongue. Take a sip, then head back for sinkies / head down for floaties.
posted by emelenjr at 11:37 AM on November 1, 2023

I find that it’s easier to swallow a pill in a spoonful of apple sauce or ice cream than it is with water. Maybe worth a try?
posted by maleficent at 12:15 PM on November 1, 2023

I went through a period of terrible choking on pills. Eventually what worked best was taking it with a thicker-than-water liquid that I like, which in my case is kefir. Sip of kefir to make my mouth and throat chill out, pill immediately followed with big swig of kefir, didn't even notice it going down. (Also, new policy of "partner says nothing and makes no sudden moves when I'm taking meds, and I announce it before I do.")

And I don't need to use the kefir anymore.
posted by wintersweet at 12:17 PM on November 1, 2023

Water, then pill, then more water.

Yogurt also works if the pill can come with food.
posted by nat at 1:39 PM on November 1, 2023

I can’t take my pills with water. I switched to juice and it’s night and day. I have to have a coffee and then take my pills with OJ or bottled juice of some kind (today was Cherry) - no gagging, no crying and no throwing them back up in the sink.

If juice itself won’t interfere with your pill regimen- give it a try.
posted by rdnnyc at 2:51 PM on November 1, 2023

This will sidestep the gag reflex rather than training yourself out of it, but I'd suggest checking if you can get your meds as capsules rather than pills. Methylphenidate does seem to come in both forms. IMO, capsules are much easier to swallow than tablets, but also, some of the capsule formulations can (with pharmacists' blessings) be opened and sprinkled onto yogurt or applesauce to take the medication that way.
posted by ktkt at 4:44 AM on November 2, 2023

I have this problem and have solved it for myself by taking pills with a small spoonful of yogurt, then following it with a sip of coffee or diet soda. For some reason, water doesn't get things moving down my throat and the warm coffee or bubbles from the diet soda help get it done.
posted by Lynsey at 10:23 AM on November 2, 2023

Finally adding to this thread because I have been trying pretty much everything and the pill has not wanted to go down the back of my throat. Water hasn't worked, a lot of foods have not worked. So far it seems like creamy peanut butter (I tried chunky but then I can't tell if I'm accidentally chewing it), hiding the pill in that, and then slowly sucking it down has had the best results so far.
posted by jenfullmoon at 7:52 AM on November 8, 2023

Marked a few best answers, although all the recommendations are GREAT. What worked for me was taking a sip of something non-water, then pill and another splash of applesauce/yogurt/seltzer before my throat can realize I slipped something else in there.

I do LOVE the thought of smearing my pills in peanut butter or cheese, like I'm trying to give a pill to a dog. :)

Thank you all! You've solved my morning nightmare!
posted by specialagentwebb at 7:04 AM on November 11, 2023

I absolutely think of what I am doing as how you dose a dog!

Got the pill down 4 days in a row now!
posted by jenfullmoon at 9:01 AM on November 11, 2023