About Dextromethorphan

Dextromethorphan is most commonly used in over-the-counter cough suppressants. It was approved for this use by the FDA in 1958 as an alternative to the codeine cough medicines available at that time, because it was less addictive and had fewer side effects. It's a synthetic morphine derivative, and as such can have hallucinatory effects if taken in large doses.

Function

• Dextromethorphan works on the brain to increase the body's tolerance to irritations that cause coughing due to cold or flu. It does not treat the symptoms that cause coughing and won't help a cough caused by smoking, asthma or emphysema.

Side Effects

• Dextromethorphan targets the central nervous system. Side effects include dizziness, nervousness, lethargy, nausea/diarrhea/vomiting, rash or itching. Overdose can cause psychotic behavior, hallucinations, tachycardia, shallow breathing, seizures, vertigo or coma. If prolonged overdose is suspected, there may also be bromide poisoning. There have been no withdrawal symptoms reported, but it does induce craving for continued use.

Features

• Dextromethorphan is readily absorbed through the gastrointestinal tract and is usually taken orally. It's partially metabolized by the liver into dextrorphan, which is an active antitussive compound as well. It's available as a caplet, tablet or in liquid form--some with an extended-release version--and is usually taken every 4 to 2 hours as needed.

Potential

• Dextromethorphan is being looked at as a possible additional treatment for fibromyalgia pain. It has been reported to have a moderate effect on pain from minor repetitive physical contact. It seems to work by blocking the action of chemicals that transmit pain signals to the spinal cord. It blocks the N-methyl-D-aspartate (NMDA) receptor. It also seems to work well in conjunction with morphine-derived pain medication, and will hopefully allow less of the opioids to be used.

Warning

• Dextromethorphan can cause allergic reactions and should not be used for atopic children. If you develop a rash, call your doctor immediately. It should not be taken with antidepressants that are selective seratonin reuptake inhibitors (SSRIs), as it also inhibits the reuptake of serotonin. It should also not be taken with monoamine oxidase inhibitors (MAOIs). If it is taken in conjunction with either of these, it could cause serotonergic syndrome--which is potentially life threatening. It should not be combined with alcohol or any other drugs classified as "downers." If overdose is suspected, it can be detected by urinary analysis.