Dextromethorphan in Cough Syrup: The Poor Man's Psychosis.
Psychopharmacology bulletin August 12, 2025 Bridgette Martinak, Ramy A Bolis, J. Black et al.
Dextromethorphan (DXM), a common over-the-counter cough suppressant, can cause psychosis when abused at high doses (over 1500 mg/day), producing delusions, hallucinations, and paranoia similar to phencyclidine (PCP). A case of severe DXM use disorder with psychotic disorder in a 40-year-old woman resolved only after treatment with an antipsychotic and mood stabilizer. DXM is not detected on standard urine drug screens, and its abuse may be an under-recognized cause of substance-induced psychosis. Clinicians should be aware of these psychiatric risks.