Hi,

Thanks for your query.

Neurofen plus contain pain killer (NSAID) ibuprofen and codeine phosphate. Both of these drugs have addiction potential. Ibuprofen is comparatively less addictive so its withdrawal reactions are not severe so treatment is to stop the drug by gradually tapering the dose under a psychiatrist.
Codeine has very severe withdrawal reactions so its detoxification needs to be done under a psychiatrist or in a de- addiction centre. I suggest you to attend an addiction centre (methadone clinic maybe) or a psychiatrist.

The withdrawal symptoms persist around 7-14 days after stoppage of drugs when you need –

1). Clonazepam (will make you drowsy).
2). Clonidine (to decrease the withdrawal reaction).
3). Imodium or some other anti-diarrhoea medications (if you have withdrawal diarrhoea).
After overcome of withdrawal symptoms you have to take one opioid agonist/partial agonist (like methadone, buprenorphine, tramadol) for replacement for prevention of relapse.

All drugs mentioned to be taken after opinion from the treating psychiatrist.

Side by side psycho education and counselling should be done that is called relapse prevention counselling (RPC) that help you to avoid situation which provoke you to take drugs and also to control yourself during craving.

Psycho education of the family member also should be done that how they behave with you.

For the whole thing you need to be admitted for 4-6 weeks and you become free of codeine and will be able to lead normal life.

About the side effect ibuprofen has been deleterious effect on stomach. It causes gastritis/gastric ulcer/gastric erosion which is usually reversible. After stoppage of the drug, Prostaglandin analogue and proton pump inhibitors combination for 6 weeks can cure the condition.

Hope I have answered your query. If you have any further questions I will be happy to help.

Wish you a speedy recovery.

Best Wishes,
Dr Sourav Ganguly

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