Concomitant use of dextromethorphan and alcohol-induced dissociation in a patient with alcohol dependence.
Yasuhito Nagai, Yuko Tajima, Koichi Miyakawa
Psychiatry and Clinical Neurosciences Reports December 1, 2024 DOI: 10.1002/pcn5.70011 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Case report Peer reviewed |
|---|---|
| Sample size | 1 |
| Population | A patient with alcohol dependence |
| Intervention | haloperidol |
| Topics | Addiction |
| Keywords | Alcohol dependence Dextromethorphan Over‐the‐counter otc drug |
| Key findings | Concomitant use of DXM and alcohol can cause acute psychotic dissociation that is difficult to distinguish from alcohol withdrawal symptoms. |
Abstract
Dextromethorphan (DXM) is an over-the-counter drug that is commonly abused by teenagers. Its main pharmacological property is a low-affinity N-methyl-d-aspartate (NMDA) receptor antagonist. We report acute psychotic dissociation induced by DXM and alcohol in a patient with alcohol dependence, which made it difficult to distinguish alcohol withdrawal symptoms with limited information. The psychotic symptoms were ameliorated by haloperidol; however, in cases of DXM abuse, haloperidol treatment should be avoided. In the consultation of patients with addiction, the possibility of various addictive drugs must be kept in mind. The concomitant use of DXM and alcohol causes easy dissociation and high-dose usage of DXM and alcohol withdrawal symptoms are difficult to distinguish.
Comparable studies
Other case reports and case series on addiction, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Ecstasy (MDMA) dependence Individuals meeting criteria for MDMA dependence | 1999 | Case series | n = 3 |
| Potential Human Neurotoxicity of MDMA (‘Ecstasy’): Subjective Self-Reports, Evidence from an Italian Drug Addiction Centre and Clinical Case Studies Polydrug consumers attending a Public Health Addiction Treatment Unit in Italy | 2000 | Review and clinical case series | |
| A case report SPECT study and theoretical rationale for the sequential administration of ibogaine and 5-MeO-DMT in the treatment of alcohol use disorder. 31-year-old male military veteran with moderate alcohol use disorder | 2018 | Case study | n = 1 |
| LSD Overdoses: Three Case Reports Three individuals who experienced accidental LSD overdose | 2020 | Case series | n = 3 |
| Remission of Severe Opioid Use Disorder with Ibogaine: A Case Report. 37-year-old female with severe opioid use disorder | 2016 | Case study | n = 1 |
Citations in the library
Cites 3
- Dextromethorphan in Cough Syrup: The Poor Man's Psychosis. Psychopharmacology Bulletin August 12, 2025
- Antipsychotic Drugs Efficacy in Dextromethorphan-Induced Psychosis. Biomedicines January 3, 2023
- Five deaths resulting from abuse of dextromethorphan sold over the internet. Journal of Analytical Toxicology March 1, 2009