Dextromethorphan psychosis, dependence and physical withdrawal.
Shannon C Miller
Addiction Biology December 1, 2005 DOI: 10.1080/13556210500352410 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Case study with literature review Case report Peer reviewed |
|---|---|
| Sample size | 1 |
| Population | Individual with dextromethorphan dependence |
| Topics | Addiction |
| Key findings | Dextromethorphan abuse can cause substance dependence, substance-induced psychosis, and substance withdrawal, with its active metabolite dextrorphan contributing to dissociative effects and risks. |
Abstract
As part of a synthesis of evidence regarding the abuse and addiction liability of dextromethorphan (DM), an over-the-counter cough medicine available in over 140 preparations, an uncommonly published case of dextromethorphan dependence (addiction) is described, with specific, rarely published complications. The individual was interviewed and several medical databases were also reviewed (Medline, 1966-present; PubMed) for all content relating to the Keywords: dextromethorphan, abuse, dependence, cough medicine, addiction, withdrawal, psychosis. The patient evidenced history suggesting substance dependence, substance-induced psychosis and substance withdrawal in relation to DM. A literature review revealed that DM has specific serotonergic and sigma-1 opioidergic properties. Dextrorphan (DOR), the active metabolite of DM, has similar properties; however, DOR is a weaker sigma opioid receptor agonist, and a stronger NMDA receptor antagonist. DM and DOR display specific biological features of addiction, and are capable of inducing specific psychiatric sequelae. A specific, reproducible toxidrome with significant psychiatric effects occurred, when DM was abused at greater than indicated doses, with more profound and potentially life-threatening effects at even higher doses. DM withdrawal appears evident. DM's active metabolite, DOR, has pharmacodynamic properties and intoxication effects similar to dissociatives, and may be more responsible for the dissociative effect that this DM abuser sought. However, it is this same metabolite that may be fraught with the potentially life-threatening psychoses and dissociative-induced accidents, as well as addiction. While DM has been hypothesized as the most commonly abused dissociative, health-care providers seem largely unaware of its toxidrome and addiction liability.
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
Cited by 12
- Novel psychoactive substances of interest for psychiatry World Psychiatry February 1, 2016
- The Prevalence of Dextromethorphan Abuse Among High School Students Pediatrics November 1, 2006
- 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
- Glowing Experience or Bad Trip? A Quantitative Analysis of User Reported Drug Experiences on Erowid.org International Conference on Web and Social Media January 31, 2022
- Potential effect of ketamine in treatment for dextromethorphan use disorder exploding in Japanese young population. Asian Journal of Psychiatry September 1, 2024
and 7 more in the library