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Other forms of ketamine not approved by the FDA for mental health conditions include IV infusion, a shot in the arm, or lozenges. Most research looks at ketamine given by IV. You can only get it by IV or shot in a doctor’s office. Some doctors will prescribe lozenges for at-home use — often to keep depression at bay between infusions. Christa Coulter-Scott says ketamine treatment eased the depression she’s had for most of her life. Yet, after ketamine therapy, she says, “My head feels lighter, and I don’t have that gloomy, dark, heavy feeling in my mind. And everything around me looks brighter — the sun, the lights in my office.” When she returned to work the next day after an infusion, she asked a co-worker whether the lighting had been changed. It hadn’t. “I don’t know if it’s a side effect of ketamine or a side effect of being less depressed.”
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Dihydrocodeine is an opiate pain killer, similar to codeine, but more powerful. Dihydrocodeine is usually reserved to treat acute moderate pain which has not responded to paracetamol, ibuprofen or aspirin alone. It can be used to treat acute, moderate headache, migraine, period pains, dental pain, pain associated with cough, muscle pain and back ache. Dose: Depends on the formulation and how much paracetamol is also present. See instructions provided with each product. Dihydrocodeine is a more powerful version of codeine which is suitable for more severe pain. Until recently, it was only available on prescription. A formulation that combines dihydrocodeine with paracetamol is now available from pharmacies, but its use is carefully monitored as it has a potential for addiction.
Tramadol should also be used cautiously in patients with impaired respiratory function, e.g. asthma, chronic obstructive pulmonary disease and sleep apnoea, and in patients with hypotension, shock, impaired consciousness or obstructive bowel disorders.5 If tramadol is prescribed to a patient taking warfarin, close monitoring of INR levels is recommended due to an increased risk of bleeding, particularly during the first week of treatment. Tramadol is contraindicated in children aged under two years due to the limited amount of safety and efficacy data.7 Liquid tramadol is sometimes given to children in a secondary care setting for post-operative pain; care is required to avoid over-dose as two strengths are available, i.e. 10 mg/mL and 100 mg/mL, however, these formulations are not subsidised for use in the community.
All of the ADHD stimulant medicines have been linked to rare cases of heart attack, stroke, and sudden death, so children should first be evaluated for underlying heart problems. The severity of symptoms and abnormal behavior patterns in children and teenagers with ADHD varies widely. Diagnosis, too, can be quite subjective, varying from doctor to doctor. Because diagnosis of the condition can be difficult, and a variety of medical and psychiatric disorders can cause symptoms that mimic ADHD, many children and teenagers taking medication might not have ADHD or have only mild symptoms that do not require it. Be sure to get a diagnosis from a physician or mental-health professional with expertise in ADHD and a second opinion if you have doubts. Even if your child meets the criteria for ADHD, he or she might not need a drug. A pediatrician can refer you to a mental-health specialist (some specialize in ADHD), who should begin by ruling out other possible reasons for the behavior.
Zolpidem ( Ambien , Edluar, Intermezzo): These medicines work well at helping you get to sleep, but some people tend to wake up in the middle of the night. Zolpidem is now available in an extended release version, Ambien CR. This may help you go to sleep and stay asleep longer. The FDA warns that you should not drive or do anything that requires you to be alert the day after taking Ambien CR because it stays in the body a long time. You should not take zolpidem unless you are able to get a full night’s sleep — at least 7 to 8 hours. The FDA has approved a prescription oral spray called Zolpimist, which contains zolpidem, for the short-term treatment of insomnia brought on by trouble falling asleep.
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