Dextromethorphan is available in over-the-counter cough medicines. A person who abuses dextromethorphan may become dependent on it. Discontinuation can precipitate a withdrawal reaction.
Dextromethorphan is an antagonist to N-methyl-D-aspartate and to glutamate. Dextromethorphan and its metabolite dextrorphan have serotonergic and sigma-1 opioidergic properties. Dextrophan has additional activities and is a weak sigma opioid receptor agonist.
Patient selection: dextromethorphan abuse with dependence
Clinical findings during withdrawal:
(1) hypertension
(2) tachycardia
(3) sweating
(4) craving
(5) nausea
(6) changes in mood
While the findings are generally mild and relatively brief detoxification should be done under medical care.
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