Talk:Dextromethorphan

message: Proposing split of "Recreational use" section to new article. This is a large and controversial issue that is a highly notable topic unto itself. Section has grown too large for, and beyond the relevance of, this article. Note: A separate article on Recreational use once existed (see here), but was merged into this article (on 10 Feb 2007, see AfD here). Equazcion •✗/C • 23:55, 27 December 2007 (UTC)
thread_title:  Proposed split of Recreational use section to new article 

message: The article currently says:
"Dextromethorphan is rapidly absorbed from the gastrointestinal tract and converted into an active metabolite within 15 to 60 minutes of ingestion"
that is somehow confusing, because someone reading it may think that DXM is a complete pro-drug which needs to be converted to its metabolite in order to have an effect, it is wrong as DXM itself is active. This fact is even mentioned in "Clinical pharmacology" section but I think every section should be correct and clear. 
Any ideas?
Arman4 (talk) 18:41, 16 January 2008 (UTC)
replies: text: Your completely right, Dextrorphan is apparently responsible for the stoning body high, while DXM is responsible for the mental effects. Try this by taking a small dose (2nd plat) and allowing yourself to get halfway in comeup, then take a higher dose of DXM, you'll notice a strong mental effect as the amount of Dxm to Do is increased (Dxm:Do). --68.45.219.63 (talk) 18:26, 6 March 2008 (UTC)
replies: text: NMDA receptor antagonism is responsible for the mental effect, and dextrorphan is the more potent NMDA receptor antagonist, so dextrorphan is more responsible for the mental effect. But the original poster is correct that DXM itself is also active, especially as an antitussive, for which it is the more potent agent. Equazcion •✗/C • 18:30, 6 Mar 2008 (UTC)
replies: text: Hmmm, thanks for the information Equazcion, I have read from various people the explanation I used. I assume they were wrong then. --68.45.219.63 (talk) 18:58, 6 March 2008 (UTC)
thread_title:  Pharmacokinetics: DXM is active by itself 

message: whenever i take dayquil with this stuff, or tylenol cough etc, i cannot ejaculate for about 4-5 days. i was wondering if anyone has read this anywhere about dxm, and if so could add it to the article. thank you
-stuck with a boner 96.227.101.251 (talk) 17:11, 21 January 2008 (UTC)
replies: text: Ha. Equazcion •✗/C • 17:16, 21 Jan 2008 (UTC)

text: *Dextromethorphan, like all dissociative drugs, reduces physical sensation temporarily. -Muugokszhiion (talk) 23:31, 29 November 2008 (UTC)
thread_title:  prevents ejaculation? 

message: I have removed this para from under the Additional Use section of the article. A reference to a patent application is not sufficient citation and this particular application is unproven Plutonium27 (talk) 02:14, 29 January 2008 (UTC)
thread_title:  Alleged use in drug dependency 

message: Good edit on under the effects section regarding poli and Hbr, I added this but I am sure I explained it pretty bad. --68.45.219.63 (talk) 18:37, 6 March 2008 (UTC)
replies: text: Thanks :) Equazcion •✗/C • 02:34, 7 Mar 2008 (UTC)
thread_title:  Dextromethorphan Hbr versus Polix 

message: The term abuse just sounds like a negative term and something that a anti-drug company would say in all of their stories. --PA1412 (talk) 20:37, 6 March 2008 (UTC)
replies: text: The term "abuse", when used to describe the self-administration of a drug, is defined as using it in a manner not in accordance with medical or label recommendations. People who take more cough medicine than they're supposed to according to the label in order to achieve a high are by definition abusing the drug. It isn't necessarily a negative term, though it may sound that way to some people due to its other uses in other contexts. Equazcion •✗/C • 00:59, 7 Mar 2008 (UTC)

text: Okay, I usually see it as a negative term, perhaps it isn't, but thats what I would commonly hear in articles regarding DXM. --PA1412 (talk) 02:31, 7 March 2008 (UTC)

text: Middle-school anti-drug classes have their purpose. Proponents of the euphemism "recreational use" appear to rail against any suggestion that drug abuse is bad. Well, it is bad. Any hint otherwise should be immediately quashed, as there is no excuse for improper drug use. One might be of the opinion that drug abuse is perfectly acceptable, but that opinion will run right up against the moral stand that it's not acceptable, and that's a tough one to get past.  —Preceding unsigned comment added by Dks2855 (talk • contribs) 14:17, 14 May 2010 (UTC)
replies: text: The only purpose that middle school anti-drug classes truly serve, when you dissect the problem to it's core, is to spread the state's totally unfounded prohibitionist bias against psychoactive substances. You, my friend, when you are operating on a neutral encyclopedia project and at the same time screaming such biases as "drug abuse is bad" represents a totally uninformed view against that which is not understood. Use of products intended for medical use to achieve psychedelic effects could be described within the literature as 'misuse' at best. But to outright label all informed recreational use as "abuse" would be totally unencyclopedic. This molecule is being studied as a possible treatment for depression, for example.--Metalhead94 T C  01:09, 8 July 2010 (UTC)

text: Actually Equazcion, according to wiktionary abuse does seem to involve a negative tone - "1. Improper treatment or usage; application to a wrong or bad purpose; misuse; perversion". The other definition of abuse that would apply here is "2. Physical maltreatment; injury" which in my opinion also implies a negative tone. It should be made clear that everyone who uses drugs is not a "drug abuser" and there are such people as "drug users". The term abuse should be replaced with misuse - "1. An incorrect, improper or unlawful use of something", which seems to describe people who use dextromethorphan in anyway other than the recommended in the least biased fashion. If not misuse, I would vote for 'recreational use' for the sake of maintaining WP:NPOV. Best regards.--Astavats (talk) 19:39, 30 August 2008 (UTC)
thread_title:  Should "abuse" be mentioned as "recreational use"? 

message: Recreational use and medical use of dextromethorphan should be split into two separate sections. The rec section is becoming far too large for relevance to anything to do with the medical uses. It is a noteworthy topic of recent media attention and debate. --C6541 (talk) 21:17, 25 March 2008 (UTC)
replies: text: Done. Equazcion •✗/C • 22:09, 25 Mar 2008 (UTC)
thread_title:  Once again 

message: Just recently I read a debate in a medical journal on whether or not Dextromethorphan cough medicine is relevant at for treating cough. The MD's were pondering on this because of the abuse potential. So I was wondering whether there are any experimental double-blinded placebo controled experiments on the supposed antitussive effects? Couldn't find any. 80.221.34.239 (talk) 05:23, 9 May 2008 (UTC)
replies: text: Slash that, after a recent recreational use during a nasty dry cough, the cough was alleviated. It seems it doesn't work for wet coughs alone (productive coughs; bringing up phlegm), hence why an expectorant is probably added to certain preperations. Still opioids are much more effective at alleviating coughs, they should make a preperation with codeine + an anti-histamine to prevent itching and recreational use, that would help a lot, especially me as I get viral episodes a lot. But I'll see if I can or can't find anything regarding dextromethorphan + placebo studies regarding antitussive effects. Regards, C6541 (talk) 03:47, 23 October 2008 (UTC)
replies: text: It's not the cough itself that DXM interacts with. It's the reflex. Or rather, your body's system of reflexes in general. NMDA receptors really mean glutamate, which is fundamentally responsible for your nervous system working at all. Take that away, and your reflexes go with it, including the cough reflex. That disconnected, dissociated, wonderfully numb feeling you get from recreational use is just an extreme version of the slight disconnection you get from a small medical dose. The more you take, the more your reflexes are deactivated -- from the need to scratch an itch, to the need to bite your nails, to -- with extreme doses -- the need to shift your weight to keep your balance. With a medical dose, which is tiny in comparison, you only feel the slightest disconnection, which lucky for Robitussin happens to include the deadening of that need to cough when a tickle is detected in your throat. Equazcion •✗/C • 00:41, 20 Dec 2008 (UTC)
thread_title:  antitussive effect?? 

message: I apologize as I am basically copy my post on the DXO discussion page. I just want to make sure someone sees this.
I'm not good with graphics or I would correct this. It's not so much a problem, but the molcular structures for DXO and DXM are oriented completely differently from one and another. This makes it very difficult for someone to see the structural similarities/differences. It would be nice if they could be oriented the same way. --Jmcclare (talk) 20:46, 3 January 2009 (UTC)
thread_title:  Inconsistent Molecular Structure Orientation 

message: ... "fever" "hypertension" and "Can include increases in: temperature and blood pressure" separately??  Isn't that pretty much a given with one or the other.  Someone with more medical sophistication can pick either one, but both are certainly redundant. Rachaella (talk) 23:42, 7 January 2009 (UTC)
replies: text: The list of side-effects comes directly from the source: http://www.nhtsa.dot.gov/PEOPLE/injury/research/job185drugs/dextromethorphan.htm. Looking there, a lot of the listed effects are actually only in the case of overdose, so the list is inaccurate in that regard. However things like fever and increased body temp are listed as separate effects, both as overdose symptoms, so I think we need to go with that. Equazcion •✗/C • 00:25, 8 Jan 2009 (UTC)
thread_title:  Do we really need... 

message: :Other Active ingredients Most of the over-the-counter cough medications containing dextromethorphan also contain other active ingredients. Active ingredients are chemicals that may have a strong effect on the body or mind. Some of these chemicals may be harmful to take above the recomended dosage. It's extremely important that people using dextromethorphan for recreational purposes pay close attention to the active ingredients list, and only use products containing solely dextromethorphan. Products that exclusively treat cough are less likely to contain the other harmful chemicals. The most common active ingredients found in combination with DXM are: Paracetamol, Aspirin, Chlorpheniramine, Guaifenesin, Phenylephrine, Pseudoephedrine, Sorbitol 
This section was placed under "non-medical use". Two problems with that, one being WP:NOTGUIDE (basically article content can't be in the form of instructions). Also the general info is already available in the main non-medical use of dextromethorphan article, so see that article and maybe edit that to include this info. Thanks :) Equazcion •✗/C • 07:01, 11 Jan 2009 (UTC)
thread_title:  "other active ingredients" 

message: why is there a separate article for recreational use of dxm? no other drug that can be used recreationally on wikipedia gets the same treatment. in the other articles theres is always a sub section dealing with it rather than a separate article. the reasons stated above dont seem to justify the split. the pharmacology section of the recreational use of dxm could easily be merged with the original article and the "dxm "faq"" is an article off of erowid which doesnt really have a place here, its not a scholarly source. there is also already a side effects section in the original article. what im getting at is that the two are fairly similiar and the info that one article has could easily be added to the other.  —Preceding unsigned comment added by 69.206.78.252 (talk) 05:51, 17 April 2010 (UTC)
thread_title:  article split 

message: Various results of Ki values, e.g. for opioid receptors have been listed as pharmacological actions. Many of them are seemingly spurious binding to non-target protein in vitro. These have to be precisely cited as such, i.e. what receptors, what species etc. to not be confused with pharmacological actions. There is a difference between a binding assay and a pharmacological effect, as is known from immunological detection methods. So I ask for more precise citation. The ref abstract gives no hint of this ref being relevant for the substance.
70.137.131.62 (talk) 11:49, 17 April 2010 (UTC)
thread_title: Binding and Ki values vs. action

message: The subject of whether cough suppressants are actually effective is discussed primarily in the Wikipedia article Cough medicine. The material here was overweight, and I reduced it and moved it to the right section.  The use of alternative medicines for cough is irrelevant to the present  topic; I removed that material and it should not be reinserted.    DGG ( talk ) 00:40, 17 June 2010 (UTC)
thread_title: uses

message: A reuptake inhibitor either selectively inhibits reuptake of one neurotransmitter, or it inhibits reuptake of several, and thus would not be called selective.  The phrase "nonselective serotonin reuptake inhibitor" is an oxymoron.  I'd like to remove the term "nonselective".  —Preceding unsigned comment added by 71.79.30.121 (talk) 11:34, 3 February 2011 (UTC)
thread_title:  "nonselective serotonin reuptake inhibitor" 

message: The following is an article from the Sacramento Bee date July 8, 2011
A drug used in over-the-counter cough medicine may treat symptoms of multiple sclerosis -- offering inexpensive therapy for a disease with few treatment options, according to UC Davis researchers.
In tests using mice, the drug, dextromethorphan, was found to significantly reduce the loss of myelin, the fatty sheath surrounding nerve fibers in the central nervous system. It also minimized the development of paralysis during MS attacks.
The finding provides an opportunity to pursue a new treatment strategy "with a drug that is widely available, inexpensive and known to be safe," said Wenbin Deng, principal investigator of the study and a UC Davis assistant professor.
MS affects about 400,000 people in the United States and 2.5 million worldwide. It is caused by cells of the immune system attacking the myelin.
Symptoms of the disease vary and often involve periods of motor problems, including paralysis of a limb or poor coordination. It may either go away or become permanent.
As the disease progresses, it causes increased disability and has no known cure, according to a UC Davis Health System press release.
Researchers induced mice to have moderate or severe MS and treated them with either very low or high doses of dextromethorphan. Investigators found that very low amounts given to mice with moderate disease signficantly reduced the loss of myelin and the development of paralysis during acute attacks. High doses didn't help at all.
"Finding that a chemical like dextromethorphan might be useful for treating multiple sclerosis is especially significant because we already know it is safe," said David E. Pleasure, director of research at the Institute for Pediatric Regenerative Medicine at Shriners Hospitals for Children Northern California in Sacramento and one of the authors of the study. "Normally, a possible new treatment must first undergo years of clinical trials to prove this."
Source: The Sacramento Bee Copyright © The Sacramento Bee 2011 (07/08/11)
— Preceding unsigned comment added by Leonkingcpa (talk • contribs) 17:37, 13 July 2011 (UTC)
thread_title:  Possible benefits for Multiple Sclerosis 

message: As a Canadian child of the 60s and 70s, I had no access to an efficient antitussive. I spent my 20 first years of life coughing 6 months a year. Coughing for me was no longer a symptom but a problem in of itself. I would be very curious to know when Dextromethorphan made it to Canadian markets. I hope someone can provide this sort of information. I only found out about Dextromethorphan in 2000! I now use it 2-3 times a year, in strip form (now only available for children in Canada) or liquid. It has changed my life. I usually use it as a solo ingredient, without all the other cold/flu medications. It allows me to cough a couple of times, just enough to move the phlegm, and completely prevents me from having coughing fits. It's one of the only completely efficient drugs I've ever used in my life. I really wish I had known about it sooner, or that my parents could have known about it. I would find it very interesting to read how this product evolved in Canada. Thank you.  — Preceding unsigned comment added by 207.189.245.231 (talk) 00:07, 3 September 2011 (UTC)
thread_title:  International History 

message: Under the Adverse Effects sub-heading, the first bullet point is "Sudden Infant Death Syndrome" referenced by Footnote 17. The article linked to footnote 17 doesn't support a link between DXM and SIDS - it refutes it. I'm going to remove this bullet point. If anyone has real supporting evidence of a link between DXM and SIDS, by all means put the bullet point back in with a new footnote.
125.209.146.230 (talk) 12:55, 3 January 2013 (UTC)
thread_title:  Dextromethorphan NOT related to SIDS 

message: After reading the 2008 article by Schwartz, Pizon, and Brooks, I felt the text which introduced their findings with "research has shown..." was too sweeping a claim, so I have tried to rephrase the statement to make it more in line with the strength of their findings. What the authors do claim is that none of the pre-2008 case studies purporting to link dextromethorphan with serotonin syndrome include objective evidence of the dosages consumed by the patient, for example in the form of serum drug levels. (For what it's worth, up until this paper was published, the same lack of evidence existed in cases documenting recreational use). So I think it's incorrect to say they have "shown" (proven) that therapeutic doses can't cause serotonin syndrome. The authors themselves wrote that "More information is required to confirm our findings" which I think more accurately represents the current state of the literature.
I did a quick follow-up in Google Scholar and nothing immediately jumped out at me as backing up or refuting their conclusions. Perhaps someone more familiar with the area will be able to confirm.
Bartleby62 (talk) 00:58, 3 March 2014 (UTC)
thread_title:  Dextromethorphan and serotonin syndrome 

message: The section on food interaction suggests that Dextromethorphan metabolism is modified by p450 inhibition via dietary sources such as grapefruit.  While true of some drugs, this is not generally true.  The article needs to cite an original source that directly connects  to dextromethorphan metabolism,  otherwise it is just speculation.  
I would change it, but I'm personally not sure if it does or does not connect--I can't find a clear answer right now.
PeterWoolf (talk) 13:51, 4 April 2014 (UTC)
thread_title:  food interaction? 

message: Apparently it increases glucose sensitivity in the pancreas. -- 65.94.43.89 (talk) 07:41, 19 March 2015 (UTC)
thread_title:  Diabetes 

message: The section seems to lack some of the reasons as to why people use this . The section talks of what the drug does and goes into more detail of the science behind it. I think there needs to be more on the social reasons for use and propose adding a few citations to help give a broader understanding of uses than just the psychological effects. --Escott25 02:42, 19 April 2016 (UTC)
thread_title:  What is the Recreational Use? 

message: Hello fellow Wikipedians,
I have just modified  on Dextromethorphan. Please take a moment to review my edit. If you have any questions, or need the bot to ignore the links, or the page altogether, please visit this simple FaQ for additional information. I made the following changes:
*Added  tag to http://web-beta.archive.org/web/20121016221008/http:/
*Added archive https://web.archive.org/web/20101125083631/http://treatmentsclerosis.com:80/index.php/drugs-meds/nuedexta to http://treatmentsclerosis.com/index.php/drugs-meds/nuedexta
When you have finished reviewing my changes, please set the checked parameter below to true or failed to let others know (documentation at ).
Cheers.—InternetArchiveBot (Report bug) 04:06, 12 December 2016 (UTC)
thread_title:  External links modified 

message: I'm not technically competent to edit this article. However, the assertion in this section in this section that something formerly believed was "proven inconclusive" strikes me as odd. I checked, and found that this was changed from "proven not to be true" in this 2010 edit. I'm out of my depth here; Would an editor more technically capable than I please take a look at this? Wtmitchell  (talk) (earlier Boracay Bill) 05:42, 20 September 2022 (UTC)
replies: text: It's not my edit so I'm just speculating, but it might have had something to do with the fact that scientific inquiry  can't prove a negative. Maybe someone thought more precise wording about inconclusively would be better. 2001:448A:1082:1F97:F5CC:2705:37C3:C671 (talk) 05:00, 30 October 2023 (UTC)
thread_title:  Neurotoxicity 

message: My first impression upon reading this article is that it seems strange the introduction obsesses with depression and psychoactive mechanisms. This venerable and ubiquitous OTC agent has been known as a cough suppressant for decades, yet the intro launches into a plug for novel uses associated with a new pharma product right after the first sentence. Psychoactivity and anti depression dominate the intro as if antitussant activity is just an off-label afterthought. Weird... Unless it was edited for hire to promote Auvelity, a product that's only been on the market for a year (as of this entry). The weird thing isn't that the article mentions the indication of depression and the new product of Auvelity, but just the kind of suspicious fact that it appears as if it is the article's primary topic. Wouldn't coverage of the novel use and new product be more appropriately located further down in another section? 2001:448A:1082:1F97:F5CC:2705:37C3:C671 (talk) 04:07, 30 October 2023 (UTC)
replies: text: I don't get that impression. The first paragraph mentions it being used as a cough-suppressant and being part of Auvelity, and it mentions the cough-suppressant part first. The rest of the opening/top section doesn't appear to have anything out of place. The next place the use for depression is mentioned is in the Medical Uses section, in a small 1 sentence subsection mentioning Auvelity; it's also at the bottom of the Medical Uses section, below not only Cough Suppression but also Pseudobulbar affect. Then I don't see it mentioned in the context of depression again anywhere in the article; even in the Pharmacology section, the article is mostly indifferent to how the drug is to be used, but in one instance it mentions an effective antitussive dose (and doesn't mention depression in this section at all). Auvelity is not even mentioned in the Research section. So, it is mentioned twice: once in the top matter but not in a suspicious way, and then once in Medical Uses, also not in a suspicious way. Obviously I could be wrong and this is just my opinion from how I see the article, and I do care about integrity regarding paid editing, but this doesn't look like it to me. Kimen8 (talk) 12:01, 30 October 2023 (UTC)
thread_title:  Commercial product placement