Drug of the Week: Dextromethorphan

Our friends, Rebecca and Brooklyn, are off in a land with little to no internet during their summer breaks, so they are graciously allowing me to make a celebrity post to keep you informed over the summer. My name is Nick and I am in my 6th and final year of pharmacy school at Purdue University, and today I'd like to give you some information on dextromethorphan (or DXM.)

When taken correctly, DXM is an effective cough suppressant that can be purchased over the counter. Due to the long, science-y name, you will rarely find it labeled as such and you may have to check the active ingredients on the package to find it. A brand name you may be familiar with is "Robitussin" and store brands are generally labeled as "cough suppressant."

DXM is a product commonly abused by adolescents because it is easily available as an over the counter product. If taken in doses larger than the recommended medical use, DXM behaves similar to drugs like PCP and ketamine and can cause euphoria (extreme, artificial happiness or feelings of wellness), psychosis (hallucinations and other psychedelic effects), and dissociation (out of body experiences and alterations in the perception of time.) Abusers call this "robo-tripping" or "tripping-cees" which stems from the brand names of the products.

Abuse of DXM has many unwanted effects, including nausea, vomiting, diarrhea, and headaches. One of the biggest dangers is that DXM almost never comes alone in any over the counter product. When abusers take high doses of DXM, they are also taking unsafe doses of things like acetaminophen (Tylenol) and antihistamines, which leads to more side effects and drug interactions. Overdosing on acetaminophen causes liver damage and failure, especially when mixed with alcohol, as abusers are likely to do. Mixing high doses of DXM with certain prescriptions that affect serotonin, like antidepressants, can lead to a serious and deadly reaction called serotonin syndrome. This does not happen when DXM is taken at normal doses though.

For the safest use of DXM, you should speak with your doctor or pharmacist (it's what we're here for!) when considering using DXM products. We can help you to take the correct dose, make sure that the medication will actually help you, and ensure that there isn't something else out there that might help you more.

Thanks for reading! Have great summers and be sure to apply sunscreen thoroughly and often!

Nick