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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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If you don’t respond to one painkiller, you may respond to another. An exhaustive review of all the evidence from clinical trials that the most effective analgesic is a combination of ibuprofen plus paracetamol which has a success rate of up to 70%, where success was defined as cutting pain by at least half over four to six hours, compared with an inactive placebo. This level of pain relief is considered effective treatment for improving quality of life. According to a gold-standard, Cochrane systematic review, the effectiveness of different non-prescription (over the counter) oral pain killers in thousands of people, is as follows: The combination of ibuprofen plus paracetamol (acetaminophen) was significantly more effective at relieving pain than any other oral, over-the-counter pain killer, with a success rate of up to 70%. That means seven out of ten people taking a product that contains ibuprofen plus paracetamol (acetaminophen) will experience effective pain relief (symptoms reduced by at least half).
Prescribing tramadol to minimise adverse effects. The usual dose of tramadol is 50–100 mg per dose, with a maximum daily dose of 400 mg, and at least four hours between doses.5 Older patients are most at risk of developing tramadol-related adverse effects, in which case the maximum daily dose should be reduced to 300 mg.5 In patients with hepatic or renal dysfunction, who may have reduced elimination of tramadol, a low starting dose of immediate-release tramadol, e.g. 50 mg, with titration to effect and 12-hour dosing is appropriate;3,4 modified-release tramadol should be avoided in these patients.5 Tramadol should be avoided in patients with severe renal dysfunction, i.e. a creatinine clearance < 10 mL/minute. If patients experience nausea with the use of tramadol, consider lowering the dose and concurrently using paracetamol (see below) or switch the patient to codeine, dihydrocodeine or a NSAID. Modified-release tramadol may be associated with fewer adverse effects in some patients.
We asked parents to rate how helpful each medication was in the following areas: academic performance, behavior at school, behavior at home, self-esteem, and social relationships. Both amphetamines and methylphenidates were equally likely to be helpful in all areas with the exception of behavior at school, where amphetamines were rated as slightly more helpful. Although we don't have enough cases of children taking "second line" medications (e.g. Straterra) to report specific findings, the data we have indicates that they were generally less likely to be "very helpful" than amphetamines or methylphenidates in the areas we asked about. If a child is struggling in the areas of self-esteem and relationships, and medication is not helpful, it might be useful to have him or her see a clinical psychologist or other mental-health professional.
Zaleplon ( Sonata ): Of all the newer sleeping pills, Sonata stays active in the body for the shortest amount of time. That means you can try to fall asleep on your own. Then, if you're still staring at the clock at 2 a.m., you can take it without feeling drowsy in the morning. But if you tend to wake during the night, this might not be the best choice for you.
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