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Patients who have been taking an opioid for a short period of time for acute pain, e.g. one to two weeks, can usually stop it abruptly without the need for tapering the dose. However, a slower withdrawal may be considered for patients who have been taking frequent, higher doses.11 There is no specific guidance for a structured tapering regimen for short-term use of tramadol, but a pragmatic approach would be to reduce the dose by 25–50% each day. Ensure that when tramadol is withdrawn (either abruptly or tapered), analgesic cover is provided by concurrent use of paracetamol or a NSAID, until the pain is manageable without pharmacological treatment.
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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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.
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If you experience mild to moderate pain, try to rest and take things easy while your chosen pain killer gets to work. Take your mind off things by reading, watching television, listening to music. Write down how you feel – researchers have found that writing about negative experiences seems to reduce pain perception. Rubbing the area or applying hot or cold packs can reduce pain by stimulating other nerve endings that block transmission of pain messages. Like all drugs, painkillers can have side effects. If you are not sure which analgesic is most likely to suit you, always seek advice from a pharmacist or doctor. Always read the information provided with your painkillers and never exceed the stated dose. If pain persists, or becomes worse, always seek medical advice – both to find out the cause, and to see if you need a stronger prescription-only treatment.
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