COGNITIVE DETERIORATION FROM LONG-TERM ABUSE OF DEXTROMETHORPHAN - A CASE-REPORT

Dextromethorphan (DM), the dextrorotatory isomer of 3-hydroxy-N-methyl morphinan, is the main ingredient in a number of widely available, ove r-the-counter antitussives. Initial studies (Bornstein 1968) showed th at it possessed no respiratory suppressant effects and no addiction li ability. Subsequently, however, several articles reporting abuse of th is drug have appeared in the literature. The drug is known to cause a variety of acute toxic effects, ranging from nausea, restlessness, ins omnia, ataxia, slurred speech and nystagmus to mood changes, perceptua l alterations, inattention, disorientation and aggressive behavior (Ra mmer et al 1988; Katona and Watson 1986; Isbell and Fraser 1953; Devli n et al 1985; McCarthy 1971; Dodds and Revai 1967; Degkwitz 1964; Hild ebrand et al 1989). There have also been two reported fatalities from DM overdoses (Fleming 1986). However, there are no reports describing the effects of chronic abuse. This report describes a case of cognitiv e deterioration resulting from prolonged use of DM.