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Ketamine causes what doctors call a “dissociative experience” and what most anyone else would call a “trip.” That’s how it became a club drug, called K, Special K, Super K, and Vitamin K among others. Partiers inject it, put it in drinks, snort it, or add it to joints or cigarettes. “Ketamine can produce feelings of unreality; visual and sensory distortions; a distorted feeling about one’s body; temporary unusual thoughts and beliefs; and a euphoria or a buzz,” says John Krystal, MD, chief of psychiatry at Yale-New Haven Hospital and Yale School of Medicine in Connecticut, where he is a leader in studying ketamine’s antidepressant effects.
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When used alone, only one in 16 people taking codeine phosphate at a dose of 60mg will receive effective pain relief. When combined with paracetamol (acetaminophen) however, one in two people obtain effective pain relief. There is a dose-response effect, so that the combination of codeine phosphate 60mg plus paracetamol (acetaminophen) 600mg is twice as effective as codeine phosphate 30mg plus paracetamol (acetaminophen) 300mg when used for post-operative pain relief. However, higher doses of codeine increase the chance of side effects. Codeine-based medicines have been found to reduce cough severity, but not cough frequency. The common side effects of codeine phosphate include drowsiness, dizziness, headache, nausea and vomiting.
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.
Whenever the result of taking a drug is less than desired, it might be time to consider changing medication, Goldstein suggests. Some children experience different effects from a different formulation of the same medication. “Many children with appetite, sleep, or irritability problems with a methylphenidate-based medication do very well with an amphetamine-based drug, or vice versa,” he notes. Who prescribes and monitors ADHD medication? A vast majority of children in our survey received medication from a pediatrician (60 percent), followed by a child psychiatrist (18 percent) and a general psychiatrist (15 percent). All of the drugs carry a warning about rare cases of sudden, unexplained death. It is recommended practice to test for life-threatening conditions, including heart-related issues, before prescribing these medications.
Over-the-counter sleep aids: Most of these sleeping pills are antihistamines. There is no proof that they work well for insomnia, and they can cause some drowsiness the next day. They’re safe enough to be sold without a prescription. But if you’re taking other drugs that also contain antihistamines — like cold or allergy medications — you could inadvertently take too much.
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