Our expert says:
In South Africa there are, unfortunately, many products sold over the counter and without prescription which have a high potential for causin dependence. Some of the pain-killing ingredients, ( such as Codeine in Stilpane ) are opiates related to morphine and can cause dependency on their own ; and they include sedatives, often anti-histamines, which can produce drowseiness and relaxation and cause dependence in their own right.
One should NEVER EVER take more than the recommended maximum daily dose ( usually at most 4 tabs a day ) or for more than a week or 19 days at most. If you feel the need for more, or for longer, it is essential to see a doctor to make sure what is causing the pain, and to deal with the cause, and not only the symptom.
He should have told ( and should now, urgently, tell ) his psychiatrist about this dependency and the dose he is taking. His psychiatrist should have asked, though there can be a problem that people often assume that when the doctor asks if they're taking any meds, that this only means prescription meds, and they don't mention the VERY relevant over-the-counter meds they are also taking. There may be significant drug interactions to cause problems, and the effects of the drugs being taken without prescription could be mistaken for symptoms of the psychiatric illnes being diagnosed.
I don't understand what this "well-known" psychiatrist was doing. It is not adequate or up-to-standard practice to see some one for a single session ( let alone one lasting only 15 minutes ), diagnose a serious and complex condition such as Bipolar Disorder, prescribe a bunch of drugs, and then only see the person again after 3 months or so. Frequent follow-up and re-assessment and adjustment of the meds is essential to manage bipolar disorder properly. I wonder whether he might need to see a different psychiatrist who can see him more frequently, and take this Stopayne dependency into account in a diagnosis and treatment plan based on a proper length consultation.
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