Dextromethorphan/quinidine: a novel dextromethorphan product for the treatment of emotional lability

Dextromethorphan (DM) is among the most widely used, non-narcotic antitussives, with a predictable safety profile. In 1981, a non-opioid, high-affinity brain recognition site for DM was discovered, and since then a unique neuropharmacological profile has emerged for this 'old' drug , suggesting novel applications. However, an extensive body of research for DM alone in treating various neurological conditions has been inconsistent. This may be largely due to its rapid first-pass metabolism. DM is currently being reintroduced as the active ingredient in a novel combination product in which low-dose quinidine is added to inhibit its breakdown, elevating blood levels of DM and increasing its likelihood of reaching neuronal targets . This has opened new possibilities for therapeutic use; the best evidence at present being for neurological disorders affecting emotional control.