Antipsychotic Drugs Efficacy in Dextromethorphan-Induced Psychosis.

Dextromethorphan (DXM), a common cough suppressant that is not a controlled substance in the US, can induce psychosis characterized by disorganized behavior, thinking, and perception. Management of DXM-related psychosis depends on the type of symptoms. Atypical neuroleptics such as olanzapine, risperidone, and quetiapine, as well as typical haloperidol, are used for symptomatic treatment, particularly for positive symptoms like hallucinations and delusions. Atypical antipsychotics are preferred over haloperidol due to their better efficacy and safety profile in the short term. This review summarizes current knowledge on DXM's psychotic potential and the management of DXM-related psychoses, focusing on atypical antipsychotic drugs.

Study at a glance

Abstract

Psychosis is known as a broad term of symptoms that cause serious disorganization of behavior, thinking, and perception of reality. One of the medicines that recently gained much attention in terms of its psychotic potential is dextromethorphan (DXM). DXM, a widely used antitussive drug, is a commonly abused drug because of its euphoric, hallucinogenic, and dissociative properties. To date, DXM is a legally marketed cough suppressant that is neither a controlled substance nor a regulated chemical under the Controlled Substances Act. The management of DXM-related psychosis is dependent on the type of psychotic symptoms. Atypical neuroleptics (i.e., olanzapine, risperidone, quetiapine) and typical haloperidol have been used in symptomatic treatment due to their efficacy, especially in positive symptoms (hallucinations and delusions). These agents are also recognized as the preferred option in the symptomatic treatment of DXM-related psychosis due to their better efficacy and safety profile than typical haloperidol in the short-term course. The focus of the present review concerns the current stage of knowledge about DXM psychotic potency as well as the management of DXM-related psychoses with a special emphasis on atypical antipsychotic drugs (i.e., olanzapine, risperidone, quetiapine, and haloperidol).