Classics in Chemical Neuroscience: Dextromethorphan (DXM).
Elliot W McClure, R Nathan Daniels
ACS Chemical Neuroscience June 21, 2023 DOI: 10.1021/acschemneuro.3c00088 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Review Peer reviewed |
|---|---|
| Keywords | Dextromethorphan Nmda receptor antagonist Cough Dextrorphan Dissociative hallucinogen Pseudobulbar affect |
| Key findings | Dextromethorphan, the first non-opioid cough suppressant, has NMDA receptor antagonism that explains both its antitussive efficacy at therapeutic doses and its dissociative hallucinogen-like effects at supratherapeutic doses. |
Abstract
Dextromethorphan (DXM) was introduced in 1958 as the first non-opioid cough suppressant and is indicated for multiple psychiatric disorders. It has been the most used over-the-counter cough suppressant since its emergence. However, individuals quickly noticed an intoxicating and psychedelic effect if they ingested large doses. DXM's antagonism at N-methyl-d-aspartate receptors (NMDAr) is thought to underly its efficacy in treating acute cough, but supratherapeutic doses mimic the activity of dissociative hallucinogens, such as phencyclidine and ketamine. In this Review we will discuss DXM's synthesis, manufacturing information, drug metabolism, pharmacology, adverse effects, recreational use, abuse potential, and its history and importance in therapy to present DXM as a true classic in chemical neuroscience.
Citations in the library
Cited by 5
- The role of NMDA-receptor type glutamatergic antagonists dextromethorphan or ketamine in the treatment of nonketotic hyperglycinemia: A critical reassessment. Molecular genetics and metabolism November 1, 2024
- Inhibition of NMDA receptors and other ion channel types by membrane-associated drugs. Frontiers in Pharmacology 2025
- Bupropion-Memantine Combination in the Treatment of Major Depressive Disorder and Treatment-Resistant Depression. Human psychopharmacology May 2026
- Abuse liability of dextromethorphan and its combinatory formulation dextromethorphan/bupropion: a pharmacologic perspective. Expert Opinion on Drug Metabolism & Toxicology 2026
- The Association Between Dextromethorphan/Bupropion with Alcohol and Substance Misuse: Reports to the Food and Drug Administration Adverse Event Reporting System (FAERS) CNS Spectrums October 1, 2024
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