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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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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.

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tramadol and codeine use thereby improving patient safety and providing pain relief as these Step 2 analgesics are withdrawn.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.

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.

Suvorexant (Belsomra). It works by blocking a hormone that promotes wakefulness and causes insomnia. It is approved by the FDA to treat people that have insomnia due to an inability to fall asleep or to stay asleep. The drug may cause you to feel sleepy the following day.

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