Classics in Chemical Neuroscience: Dextromethorphan (DXM).
Elliot W McClure, R Nathan Daniels
ACS chemical neuroscience June 21, 2023 DOI: 10.1021/acschemneuro.3c00088 via PubMed
Summary
AI-generated from the abstractDextromethorphan (DXM), introduced in 1958 as the first non-opioid cough suppressant, has become the most used over-the-counter cough medicine. While its antagonism at NMDA receptors underlies its effectiveness for cough, large doses produce intoxicating and psychedelic effects similar to dissociative hallucinogens like phencyclidine and ketamine. This review covers DXM's synthesis, metabolism, pharmacology, adverse effects, recreational use, abuse potential, and therapeutic history, presenting it as a classic compound in chemical neuroscience.
Study at a glance
| Characteristics | Review Peer reviewed |
|---|---|
| Keywords | Dextromethorphan Nmda receptor antagonist Cough Dextrorphan Dissociative hallucinogen |
| Key finding | Dextromethorphan, the first non-opioid cough suppressant, has NMDA receptor antagonism that explains both its antitussive efficacy at therapeutic doses and its dissociative hallucinogen-like effects at supratherapeutic doses. |
Abstract
Dextromethorphan (DXM) was introduced in 1958 as the first non-opioid cough suppressant and is indicated for multiple psychiatric disorders. It has been the most used over-the-counter cough suppressant since its emergence. However, individuals quickly noticed an intoxicating and psychedelic effect if they ingested large doses. DXM's antagonism at N-methyl-d-aspartate receptors (NMDAr) is thought to underly its efficacy in treating acute cough, but supratherapeutic doses mimic the activity of dissociative hallucinogens, such as phencyclidine and ketamine. In this Review we will discuss DXM's synthesis, manufacturing information, drug metabolism, pharmacology, adverse effects, recreational use, abuse potential, and its history and importance in therapy to present DXM as a true classic in chemical neuroscience.