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“Someone is trying to jump off a bridge and they give him ketamine in the ambulance to calm him down and 9 months later, he says, ‘I haven’t felt suicidal for 9 months.’ “When enough stories like that started to pile up, doctors said, ‘Maybe there’s something here,’” says Stewart, an emergency physician and founder of Insight Ketamine in Santa Fe, NM. Like the drug itself, Stewart got his start in combat medicine during the Vietnam War. Some doctors also use ketamine to treat suicidal thoughts.

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Ibuprofen is related to aspirin and is classed as a non-steroidal anti-inflammatory drug (NSAID). Ibuprofen is used to relieve the pain of sports injuries (eg sprained ligaments, strained muscles), stiff or painful joints, heavy or painful periods, dental pain and headaches. Like aspirin, ibuprofen works by inhibiting cyclo-oxygenase enzymes (COX-1 and COX-2) which are involved in the generation of pain. In single doses, ibuprofen reduces fever and has a pain-killing action comparable to that of paracetamol. When used in regular full dosage, ibuprofen has an additional anti-inflammatory action to reduce redness, stiffness and swelling (but beware of rebound headache). Dose: A typical adult dose is 200mg – 400mg ibuprofen, after food, at intervals of at least four hours. Do not take more than 6 x 200mg tablets in 24 hours unless otherwise instructed by a doctor. Always follow the on-pack instructions. Higher doses are available on prescription for use under medical supervision.

Use paracetamol concurrently. The concurrent use of paracetamol with tramadol or codeine is more effective than tramadol or codeine alone.2 Co-prescribing of paracetamol is an effective and widely used strategy for reducing tramadol and codeine use thereby improving patient safety and providing pain relief as these Step 2 analgesics are withdrawn. Tramadol is associated with a decreased risk of respiratory depression and is therefore often preferred over codeine or dihydrocodeine in patients who are at increased risk of breathing difficulties, e.g. for musculoskeletal pain in a person with chronic obstructive pulmonary disease (COPD).2 Tramadol may also be preferred over codeine or dihydrocodeine in patients with a history of constipation or in those taking anticholinergic medicines. There is weak evidence that tramadol is effective in patients with neuropathic pain.

Most children in our survey who were taking medication for ADHD had tried methylphenidate (84 percent) or an amphetamine (51 percent) in the past three years. A smaller percentage (17 percent) had tried a nonstimulant medication. There were no differences in the type of medication children were prescribed either by age or length of time since they had been diagnosed. Most children taking these medications had been taking them for longer than two years (35 percent overall), while 22 percent had been taking them for one to two years. Our survey found there were no major differences in effectiveness between amphetamines and methylphenidates. But there were more reports of “irritability and anger” and “high mood/energy (manic behavior)” among children who used amphetamines.

Doxepine ( Silenor ): This sleep drug is approved for use in people who have trouble staying asleep. Silenor may help with sleep maintenance by blocking histamine receptors. Do not take this drug unless you are able to get a full 7 or 8 hours of sleep.

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