What is Dextromethorphan, and What Are Its Risks?

One of the most often-used drugs is dextromethorphan (DXM), which can be obtained in a variety of cough syrups, lozenges, and tablets. DXM targets the brain's cough center, lowering the urge to cough through this mechanism. This drug is usually very safe at therapeutic levels, but abuse can cause serious negative effects, and if used long enough, it can even cause dependence.

This article will describe DXM's purpose, operation, indications, and risks so you can make informed decisions about its use.

What is DXM and How Does It Work?

DXM is a cough suppressant used in several over-the-counter cold and cough medications. It works by working on the brain to suppress the urge to cough, relieving people suffering from colds, the flu, and other respiratory diseases. DXM is a popular ingredient in many household cough and cold medicines, available in various forms such as syrups, tablets, and lozenges.

This drug is most recognized for its cough suppressant properties, but due to its central nervous system action, it also affects a variety of other neurological processes. When taken at therapeutic quantities, DXM largely suppresses the cough reflex through the medulla in the brainstem. Furthermore, it influences many neurotransmitter systems and receptors in the brain, which is its main objective.

DXM affects neurotransmitters such as norepinephrine and serotonin, which can alter mood and perception of stimuli. It also inhibits NMDA receptors involved in memory, pain perception, and synaptic plasticity. These alterations influence both our senses and our thinking. When used at doses higher than those typically used for treatment, DXM acts on NMDA receptors to make people disconnected and psychedelic. Finally, DXM alters sigma-1 receptors, which assist in controlling pain and protecting the nervous system.

Here is a summary of the effects of DXM on the neurotransmitters, the area of the brain affected, the physiological effects, and the psychological effects:

 When is DXM Indicated?

DXM generally suppresses coughs caused by upper respiratory tract infections such as the common cold and flu. It is useful in treating acute cough by working on the brain to lessen the desire to cough, relieving the discomfort produced by prolonged coughing. DXM is also sometimes used to treat long-term cough conditions like bronchitis or chronic obstructive pulmonary disease (COPD), but this is less common and is generally done under the supervision of a doctor.

DXM can be used to relieve more than just coughs. For example, it can be mixed with quinidine to treat pseudobulbar affect (PBA), a condition in which people cry or laugh out loud without being able to stop; the mix of these drugs makes emotional outbursts less likely to happen and less severe when they do. Also, studies are still being done on how DXM can be used to treat some types of neuropathic pain by using its effect on NMDA receptors. While these applications are unusual and usually require medical supervision, they demonstrate DXM's greater potential beyond its common over-the-counter use.

Other experimental applications include the therapy of depression and migraines due to its effects on serotonin and other neurotransmitters, though these are not commonly used in clinical practice.

What are the Risks of Using DXM?

Using Dextromethorphan (DXM) carries various dangers, especially when it is abused or used in higher-than-recommended quantities. At therapeutic doses, DXM is generally safe, but its misuse potential and adverse effects should not be underestimated.

One of the most significant hazards of utilizing DXM is the possibility of misuse and abuse. In more substantial amounts, DXM acts as an NMDA receptor blocker, producing effects similar to ketamine and PCP in terms of dissociative and hallucinogenic states. This can lead to mental dependence and, in some cases, disordered drug use. In this way, abusing DXM can lead to a lot of bad things, like severe agitation, psychosis, hallucinations, and losing control of your muscles.

Regular or excessive doses of DXM might also pose severe physical health hazards. These include an elevated heart rate (tachycardia), high blood pressure (hypertension), and probable liver damage, particularly when taken with other chemicals such as acetaminophen, which is found in many over-the-counter cold medications. In addition, taking too much DXM can decrease respiratory drive, which is especially bad when mixed with other drugs that slow down the central nervous system, like alcohol or antidepressants.

Other big risks include the chance of getting serotonin syndrome, a disease that can be fatal and happens when DXM is mixed with other serotonergic drugs, like some antidepressants. Serotonin syndrome symptoms include disorientation, fever, shivering, sweating, and muscle stiffness. Long-term DXM misuse can also cause cognitive problems such as memory loss and difficulty learning and concentrating.

Overall, DXM is effective as a cough suppressant, but misuse or abuse can have serious psychological, physical, and neurological consequences. It is critical to use DXM exactly as prescribed and to be aware of any potential interactions with other drugs.

Here is a table summarizing the risks of DXM by system:

What are the signs that someone is abusing DXM?

Abusing DXM can cause a variety of medical, psychological, and behavioral symptoms. Physical signs of DXM abuse include dilated pupils, frequent nausea and vomiting, dizziness, lack of coordination, slurred speech, high blood pressure, increased heart rate, heavy sweating, face flushing, and tremors. These symptoms frequently occur without a clear cause and can be quite noticeable.

Psychologically, DXM abuse can result in euphoria, hallucinations, paranoia, anxiety, irritability, disorientation, memory problems, and depression. A person may appear overly elated, distrustful of others, impatient, and unable to concentrate or recall recent events. Mood swings, such as emotions of despair or hopelessness, might also occur.

Those who abuse DXM may visit the pharmacy regularly for over-the-counter cough medications and have an unusually large supply of DXM-containing goods. Social withdrawal is common in which the individual withdraws from family and friends. Responsibilities at work, school, or home may be overlooked, and the individual may become secretive about their activities and location. The high expense of purchasing significant volumes of DXM can cause financial problems. Sleep disturbances, such as insomnia or excessive sleeping, are also common. These indications point to possible DXM addiction.

How to Recover from DXM Dependence?

DXM addiction treatment entails a comprehensive approach that addresses both physical and psychological concerns. The first step is to consult an addiction medicine professional. They can assess your situation and recommend a medically supervised detox program or therapy that matches your requirements. Also, you should remember that dependence should be addressed with patience, commitment, and ongoing assistance.