Related Experiment Videos
Dextromethorphan psychosis, dependence and physical withdrawal
1Addiction Services, Veterans Administration Medical Center and Associate Professor, Department of Psychiatry, Wright State University School of Medicine, Dayton, OH 45428, USA. shannon.miller2@med.va.gov
Addiction Biology
|December 2, 2005
Summary
Dextromethorphan (DM), an OTC cough medicine, can cause dependence and psychosis. Healthcare providers should be aware of its addiction liability and potential for severe psychiatric effects.
Area of Science:
- Pharmacology
- Psychiatry
- Toxicology
Background:
- Dextromethorphan (DM) is a common over-the-counter cough suppressant found in numerous preparations.
- Evidence synthesis was conducted regarding the abuse and addiction potential of DM.
- An uncommon case of DM dependence with rare complications was documented.
Observation:
- A patient presented with a history of substance dependence, substance-induced psychosis, and withdrawal symptoms related to DM abuse.
- Medical databases (Medline, PubMed) were reviewed for literature on dextromethorphan, abuse, dependence, addiction, withdrawal, and psychosis.
- DM exhibits serotonergic and sigma-1 opioidergic properties, with its active metabolite, dextrorphan (DOR), possessing similar but distinct receptor interactions.
Findings:
- DM and its metabolite DOR show biological markers for addiction and can induce psychiatric sequelae.
- Abuse of DM at supra-therapeutic doses can lead to a reproducible toxidrome with significant psychiatric effects, including psychosis.
- DOR may be primarily responsible for the dissociative effects sought by abusers, but also contributes to psychosis, accidents, and addiction.
Implications:
- Healthcare providers may be largely unaware of the significant addiction liability and toxidrome associated with DM.
- The findings highlight the need for increased awareness and education regarding DM's potential for abuse and associated psychiatric risks.
- Understanding the pharmacodynamics of DM and its metabolite is crucial for managing abuse cases and preventing adverse outcomes.