Dextromethorphan (DXM)

dextromethorphan relieve cough

Defining Dextromethorphan

Dextromethorphan (DXM) is one of the main constituents of most cough syrups, like NyQuil, Robitussin and TheraFlu etc. It belongs to a category of drugs called antitussives. Antitussives are cough suppressants that work by affecting the brain signals that make a person cough. Dextromethorphan is used to treat dry cough but has no effect on cough that results due to asthma, emphysema, or smoking-related coughing.

Dextromethorphan behaves like an NMDA receptor antagonist. Like other NMDA receptor antagonists, such as ketamine and PCP, dextromethorphan, at higher doses, also causes the user to experience dissociative hallucinations, which make the user feel detached from their body and surroundings. It also induces a strong feeling of euphoria. Due to these side effects, Dextromethorphan has a high potential for abuse.

Side Effects of Dextromethorphan


  • Dizziness
  • Drowsiness
  • Nausea
  • Vomiting
  • Stomachache
  • Headache
  • Constipation
  • Confusion


  • Psychosis
  • Liver damage
  • Depression
  • Memory and learning problems

Addiction and Overdose

Dextromethorphan addiction depends on the quantity, frequency, and duration in which it is consumed. If consumed regularly over a long period of time, a patient is likely to develop tolerance for the drug and will require higher doses of it to feel the same effects. This may eventually lead to addiction and dependence. Continued heavy use may cause a user to develop a condition known as toxic psychosis, which causes the user to lose touch with reality and feel confused. It may also bring about behavioral and physiological abnormalities.

An overdose of dextromethorphan can have severe side effects and over a period of time and can eventually even cause death due to liver failure. In case of an overdose, the patient should get medical attention. Symptoms of an overdose include:

  • Dissociative hallucinations
  • Nausea
  • Vomiting
  • Extreme restlessness
  • Confusion
  • Euphoria
  • Blurry vision
  • Severe drowsiness
  • Severe dizziness
  • Impaired motor function
  • Shallow breathing
  • Anxiety
  • Severe irritability
  • Difficulty urinating

If a patient presents any of the symptoms mentioned above, he/she should be taken to a health care facility to get immediate medical attention. If DXM is taken in combination with MAO inhibitors or alcohol, it can have serious life threatening side effects.


The treatment for dextromethorphan overdose primarily consists of supportive care, which includes closely monitoring and supporting respiration and circulation throughout the body. A patient who goes into respiratory arrest due to DXM overdose might be treated with Naloxone, which counteracts the effects of an overdose and restores respiration. Dissociative side effects such as hallucinations, psychosis and agitation should be anticipated and treated accordingly. The patient might also be treated with activated charcoal to prevent further absorption of the drug. Gastric lavage might be performed to flush out the remaining unabsorbed medicine from the body.

Treatment for dextromethorphan addiction involves the same set of techniques and therapies used for other types of drug addiction. DXM addiction treatment is best provided at a rehabilitation facility. This may involve group therapy, family therapy, behavioral therapy, mood therapy etc. The rehabilitation facility will help individuals addicted to DXM realize they are causing themselves physical and psychological problems, and overcome their addiction.


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