Classics in Chemical Neuroscience: Dextromethorphan (DXM)

Dextromethorphan (DXM) was introduced in 1958 as thefirst non-opioidcough suppressant and is indicated for multiple psychiatric disorders.It has been the most used over-the-counter cough suppressant sinceits emergence. However, individuals quickly noticed an intoxicatingand psychedelic effect if they ingested large doses. DXM'santagonism 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 discussDXM'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 trueclassic in chemical neuroscience.