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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 is sometimes prescribed as a second-line medicine to patients with neuropathic pain,8 although the evidence supporting this practice is weak.9 It is recommended to use a validated tool, such as the Leeds Assessment of Neuropathic Symptoms and Signs (LANSS), to diagnose or exclude neuropathic pain. If neuropathic pain is present, the first-line pharmacological options would be a tricyclic antidepressant, gabapentin* or carbamazepine, which may be used in combination with an analgesic for nociceptive pain. In this scenario, it may be reasonable to select tramadol, in preference to codeine or dihydrocodine, if a Step 2 analgesic is required. As with any opioid, tramadol should be used for the shortest possible time, at the lowest effective dose, with a plan in place to reduce and withdraw treatment. Tramadol may have less potential for misuse and dependency than other opioids as it is an atypical analgesic, however, the same prescribing cautions should be applied to tramadol as to other opioids to minimise the risk of inappropriate use.

We also asked parents about other things they wished their prescribing physician had done. While 43 percent didn’t express any concerns with the physician prescribing ADHD medication for their child, 29 percent said they wished the physician would “welcome their input about their child more than he/she currently does.” Twenty-six percent said they wished doctors would “provide information about any financial relationships he/she may have with companies that sell ADHD medications,” and 25 percent said they wished doctors would “discuss the long-term safety of prescription medications for my child.” Parents didn’t rate doctors well for managing their child’s medication. “Patients or families should call whenever they have questions about a medication,” Goldstein urges. He offers these additional tips: Always call the doctor with questions. Even if all is well, check in by phone two weeks after beginning medication and schedule a visit one month after for a follow-up. After that, return visits will depend on the success of the treatment and side effects. In general, children doing well can be seen every six months.

Ramelteon ( Rozerem ): This sleep medication works differently than the others. It works by targeting the sleep-wake cycle, not by depressing the central nervous system. It is prescribed for people who have trouble falling asleep. Rozerem can be prescribed for long-term use, and the drug has shown no evidence of abuse or dependence.

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