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Dextromethorphan Addiction Mediated Through the NMDA System: Common Pathways With Alcohol?
A Kenison Roy1, Chenen Hsieh, Kathleen Crapanzano
1Addiction Recovery Resources; River Oaks Psychiatric Hospital; Tulane University School of Medicine Department of Psychiatry, New Orleans; Louisiana State University Health Sciences Center Department of Psychiatry, Baton Rouge (A.K.R.); Louisiana State University Health Sciences Center Department of Psychiatry (C.H.); Louisiana State University Health Sciences Center Department of Psychiatry (K.C.), Baton Rouge, LA.
Journal of Addiction Medicine
|October 7, 2015
Summary
Topiramate effectively resolved cravings in a dextromethorphan use disorder case. Genetic testing revealed a susceptibility allele, suggesting personalized medicine approaches for substance abuse treatment.
Area of Science:
- Neuroscience
- Pharmacology
- Genetics
Background:
- Dextromethorphan, an antitussive, is increasingly abused, leading to dextromethorphan use disorder.
- Abuse is prevalent globally, particularly among young adults, presenting significant public health challenges.
- Conventional treatments often fail due to persistent, intense cravings.
Observation:
- A 45-year-old woman with dextromethorphan use disorder experienced persistent cravings despite multiple abstinence attempts.
- Topiramate treatment led to a complete cessation of cravings.
- The patient was found to be a carrier of the GRIK1 rs2832407(C:C) allele.
Findings:
- Topiramate's efficacy may stem from its shared action on the NMDA system with dextromethorphan.
- The identified genetic allele is linked to increased alcohol use disorder risk and topiramate treatment response in heavy drinkers.
- This case highlights a potential shared genetic susceptibility between dextromethorphan and alcohol dependence.
Implications:
- Personalized medicine, utilizing genetic testing, can guide tailored treatment strategies for substance use disorders.
- Understanding shared genetic factors could lead to novel therapeutic targets for multiple substance abuse.
- This case underscores the importance of considering genetic predispositions in managing complex substance use disorders.