Published online November 1, 2006
PEDIATRICS Vol. 118 No. 5 November 2006, pp. 2267-2269 (doi:10.1542/10.1542/peds.2006-2050)
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LETTER TO THE EDITOR

The Prevalence of Dextromethorphan Abuse Among High School Students

Russel Falck, MA
Linna Li, MS
Robert Carlson, PhD
Jichuan Wang, PhD
Department of Community Health,
Center for Interventions, Treatment and Addictions Research,
Wright State University,
Boonshoft School of Medicine,
Dayton, OH 45435

The first 20% of the full text of this article appears below.

To the Editor.—

Dextromethorphan is the d-isomer of the codeine analog, levorphanol, and the active ingredient in >100 over-the-counter cough and cold preparations. Reports of dextromethorphan abuse date back to the 1960s.1,2 There is some evidence suggesting that when used inappropriately at very high doses (eg, 1500 mg/day), dextromethorphan can result in a dependence-like syndrome.2 Psychological symptoms of dextromethorphan intoxication can include euphoria, an altered sense of time, paranoia, and disorientation as well as tactile, visual, and auditory hallucinations. Physical symptoms include but are not limited to hyperexcitability, ataxia, and nystagmus.3 These symptoms bear a remarkable similarity to those seen with phencyclidine (PCP), a powerful dissociative anesthetic that has also been abused since the 1960s.4 Research on the pharmacology of dextromethorphan shows that it is metabolized by the liver enzyme CYP2D6 to dextrorphan, a metabolite with an affinity for N-methyl-D-aspartate receptors, which explains the PCP-like effects that can result from consuming higher-than-recommended doses of the drug.5,6 Earlier . . . [Full Text of this Article]


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 Arch Pediatr Adolesc MedHome page
I. M. Paul, J. Beiler, A. McMonagle, M. L. Shaffer, L. Duda, and C. M. Berlin Jr
Effect of Honey, Dextromethorphan, and No Treatment on Nocturnal Cough and Sleep Quality for Coughing Children and Their Parents
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[Abstract] [Full Text] [PDF]