4.7 Review

Antipsychotic Drugs Efficacy in Dextromethorphan-Induced Psychosis

Journal

BIOMEDICINES
Volume 11, Issue 1, Pages -

Publisher

MDPI
DOI: 10.3390/biomedicines11010123

Keywords

dextromethorphan; toxicity; robotripping; antipsychotics; neuroleptics; psychosis

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Psychosis refers to symptoms that cause serious disorganization of behavior, thinking, and perception of reality. The antitussive drug dextromethorphan (DXM) has gained attention for its potential to induce psychosis. DXM is commonly abused for its euphoric, hallucinogenic, and dissociative effects. Currently, DXM is a legally marketed cough suppressant that is not classified as a controlled substance. The management of DXM-related psychosis depends on the type of symptoms, and atypical antipsychotic drugs are considered the preferred treatment option due to their efficacy and safety profile.
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).

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