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Simply switching the patient from 40 mg of morphine to 10 mg of levorphanol would be dangerous due to dose accumulation, and hence frequency of administration should also be taken into account. There are other concerns about equianalgesic charts. Many charts derive their data from studies conducted on opioid-naive patients.
MDMA/citalopram is a combination of the entactogen and monoamine releasing agent 3,4-methylenedioxymethamphetamine (MDMA; also known as midomafetamine or "ecstasy") and the selective serotonin reuptake inhibitor (SSRI) citalopram which is under development for the treatment of post-traumatic stress disorder (PTSD).
SSRIs, including citalopram, can increase the risk of bleeding, especially when coupled with aspirin, NSAIDs, warfarin, or other anticoagulants. [37] Taking citalopram with omeprazole may cause higher blood levels of citalopram. This is a potentially dangerous interaction, so dosage adjustments may be needed or alternatives may be prescribed.
This change appears to remove the antihistaminic properties of the drug. By removing the ( R )-enantiomer, the lowest dose of escitalopram becomes more efficacious and faster onset than comparable dose of citalopram, where escitalopram has twice the activity of citalopram and is at least 27 times more potent than the ( R )-enantiomer. [ 6 ]
Medicare does not typically cover ketamine infusions for mental health conditions. However, it may cover Spravato, an FDA-approved drug deriving from ketamine, for treatment-resistant depression.
Mirtazapine is sometimes described as a noradrenergic and specific serotonergic antidepressant (NaSSA), [11] although the actual evidence in support of this label has been regarded as poor. [17] It is a tetracyclic piperazine-azepine. [85] Mirtazapine has antihistamine, α 2-blocker, and antiserotonergic activity.
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