This is the
talk page for discussing improvements to the
Dextromethorphan article. This is not a forum for general discussion of the article's subject. |
Article policies
|
Find medical sources: Source guidelines · PubMed · Cochrane · DOAJ · Gale · OpenMD · ScienceDirect · Springer · Trip · Wiley · TWL |
Archives: 1 |
Dextromethorphan was a good articles nominee, but did not meet the good article criteria at the time. There may be suggestions below for improving the article. Once these issues have been addressed, the article can be renominated. Editors may also seek a reassessment of the decision if they believe there was a mistake. | ||||||||||
|
This article is rated B-class on Wikipedia's
content assessment scale. It is of interest to the following WikiProjects: | ||||||||||||||||||||||||||||||||||||||
|
Ideal sources for Wikipedia's health content are defined in the guideline
Wikipedia:Identifying reliable sources (medicine) and are typically
review articles. Here are links to possibly useful sources of information about Dextromethorphan.
|
I just removed the claim that the FDA "approved dextromethorphan as a prescription antitussive drug on September 24, 1954" their citation for this fact does not contain the date September 24, 1954 and I cannot find an authoritative source to support it, I suspect all other instances of this date being used in DXM histories online are simply repeating misinformation from this wiki.
ref name="cesar"> "Dextromethorphan (DXM)". Cesar.umd.edu. Retrieved 2013-07-28.</ref>
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)
Recreational use should be moved under "Uses" where it belongs. To have it up front signals a violation of neutrality. Avoid emotionally or politically-biased and non-scientific terms such as "abuse." This entry should not encourage nor discourage its use but remain purely descriptive. A separate article for DXM's non-FDA approved use might fall under a general category along with other disassociates, but does not warrant an entire article on DXM "recreational uses" nor would that be appropriate. The phrase "recreational use" connotes intent of the user and should be stricken in favor of more denotative description of reported effects at varying levels of "overdose." drkull ( talk) 07:11, 26 February 2011 (UTC)
Much of the information in the Chemistry section of this article is either incorrect or problematic.
In any case, just letting everyone know that I am going to try to fix up that section. If anyone has a problem with the way I did it, by all means make your thoughts known. -- SilenceIsPoetry ( talk) 09:36, 29 December 2007 (UTC)
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)
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)
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) I see mention of Romilar like substances preventing ejaculation but what an erection. In 1968 I experienced the ability to support a dripping wet bath towel and the effect lasted for about 24 hours. Yes I copulated many times but never to my satisfaction only to my partners.
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)
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)
It should definitley be "recreational use". Remember that this isn't a middle school anti-drug class.-- Metalhead94 ( talk) 12:17, 30 August 2008 (UTC)
Perhaps it should be mentioned the physical risk under Risks associated with abuse, such as falling and similar. -- 71.126.120.40 ( talk) 00:21, 19 March 2008 (UTC)
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)
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)
I find it unlikely my self that dextromethorphan is reliable in controlling coughs, it affects NMDA, Sigma 1 and 2, serotonin and nicotinic receptors which have nothing to do with coughs as far as I know C6541 ( talk) 06:58, 10 May 2008 (UTC)
I changed the section title that lead to the main article called Non-medical use of dextromethorphan from Abuse which implies something negative to Non-medical use, which seems to be accepted as NPOV. Recreational use may be viewed as some as supporting drug use, but Non-medical just means a use besides for a medical condition, in this case a cough or a cold. Any one agree or disagree? Regards, C6541 ( talk) 03:51, 23 October 2008 (UTC)
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)
Additionally, it would be nice if the structures were oriented similarly to morphine for likewise reasons. The DXO molecule is already oriented like the morphine molecule. -- Jmcclare ( talk) 23:31, 3 January 2009 (UTC)
... "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)
{{
cite web}}
: Check date values in: |accessdate=
(
help)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)
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)
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)
i think that any pharmacological article here should be written primarily for someone seeking info on the drug's therapeutic use, rather than its illicit recreational use. from that perspective,most of your 'side effects' are more properly seen as overdose symptoms. it's easy to miss that perspective when the treatise you cite is from the national highway traffic safety administration (!?), not exactly a front rank pharmacological journal.
Toyokuni3 (
talk)
16:34, 29 April 2010 (UTC)
you want to bet i can't find one or more laws that taking 75 times the therapeutic dose for a cheap high contravenes? Toyokuni3 ( talk) 20:48, 13 May 2010 (UTC)
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)
Someone had written: However the only side effect the rats showed was a change in personality. The following reference was offered (without ref tags): "Hargreaves R, Hill R, Iversen L (1994). "Neuroprotective NMDA antagonists: the controversy over their potential for adverse effects on cortical neuronal morphology". Acta Neurochir Suppl (Wien). 60: 15–9.
PMID
7976530.{{
cite journal}}
: CS1 maint: multiple names: authors list (
link)</ref>/ I removed it given that Carliss et al. (2007) found that dextromethorphan did not lead to vacuolation or other neurotoxic changes.
One final note: please make sure to actually read papers before citing them. Prior to my edit, it appeared as though Olney et al. (1989) were cited as the source of evidence supporting the assertion that rats only showed changes in peronality and Olney's paper says no such thing.
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)
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)
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)
wow keren — Preceding unsigned comment added by 180.254.254.228 ( talk) 01:31, 26 February 2015 (UTC)
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)
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)
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)
[1] Apparently it increases glucose sensitivity in the pancreas. -- 65.94.43.89 ( talk) 07:41, 19 March 2015 (UTC)
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) — Preceding unsigned comment added by Escott25 ( talk • contribs)
Hello fellow Wikipedians,
I have just modified one external link 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:
{{
dead link}}
tag to
http://web-beta.archive.org/web/20121016221008/http:/When you have finished reviewing my changes, please set the checked parameter below to true or failed to let others know (documentation at {{
Sourcecheck}}
).
This message was posted before February 2018.
After February 2018, "External links modified" talk page sections are no longer generated or monitored by InternetArchiveBot. No special action is required regarding these talk page notices, other than
regular verification using the archive tool instructions below. Editors
have permission to delete these "External links modified" talk page sections if they want to de-clutter talk pages, but see the
RfC before doing mass systematic removals. This message is updated dynamically through the template {{
source check}}
(last update: 5 June 2024).
Cheers.— InternetArchiveBot ( Report bug) 04:06, 12 December 2016 (UTC)
I am mystified why the recreational abusers of DXM talk about plateaus and mg/kg dosage precision, yet for use as an actual medicine, that sort of precision does not seem to be used at all, as if it is not important. It looks to me like mg/kg dosage precision probably is important as an antitussive, and as such larger adults are probably being far underdosed using DXM for its labeled usage.
Robitussin / Catalent Pharma Solutions has a standard dosage of 30 mg of dextromethorphan HBR for anyone 12 years of age or older for the standard non time release product. Based on my web searching the average body weight of a 12 year old human is about 90 pounds or 40.8 kg. So this works out to an effective dosage of 0.70 mg/kg
https://www.cdc.gov/growthcharts/data/set1/chart03.pdf
https://www.cdc.gov/growthcharts/data/set1/chart04.pdf
Though the standard dosage may really be more of a "maximum safe dosage for the minimum body weight". If we look at those same CDC charts, the minimum body weight of a 12 year old is about 65 lb / 29.4 kg. That then works out to 1.02 mg/kg.
Speaking personally as a 240 lb / 108.86 kg man, I find that Robitussin softgels do nothing for my coughing unless I at least double the dosage to 60 mg, and I find it most effective at 75mg (5 Robitussin softgels). If I do the math, this works out to 75 mg / 108 kg = 0.69 mg/kg ..... which as you can see is very close to and just slightly under the standard 0.70 mg/kg body-weight compensated dosage for an average sized 12 year old. I do not experience any sort of unusual dissociative effects at this dosage.
For me at 240 lb / 108.86 kg, this is also quite a bit below what appears to be the maximum safe dosage of 110mg (1.02 mg/kg), which would require 7.3 softgels.
Comparing this to the recreational drug use guide (which obviously is not a reliable source but the only source available, so I have to mention it), the first stage of dissociative effects begin at about 1.5 - 2.5 mg/kg. This is in general agreement with my extrapolated maximum safe dosage for a minimum weight 12 year old.
According to the softgel product label, users are warned "not to exceed 8 softgels (120mg) in any 24 hour period", yet at the 0.69 mg/kg antitussive dosage rate, I am using 20 softgels per day to effectively control my cough. No explanation is provided on the product packaging for why 120mg is intended as the maximum dosage per day.
So, if you are an adult and DXM isn't doing anything for your cough at the standard labeled dosage, there is probably a reason for that. It is a mystery to me why the product is allowed to be labeled and dosed to adults in a manner that renders it less effective, to the point of being ineffective, for adults with a body weight that is normally beyond 90 lbs / 40.8 kg.
I am trying to hunt down official numbers and sources for the clinically tested effective mg/kg dosage and maximum standard mg/kg dosage amounts for DXM HBr as an antitussive, but so far I have not found anything. -- Pikonuk ( talk) 11:30, 13 January 2017 (UTC)
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)
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)
Irruptive Creditor, I see you are having some issue accepting Dissociative drug as the drug class on this article. Drugs can be classified by their chemical structure, as you're trying to do, or by their effect. Your complaint:
The term morphinan class actually describes dextromethorphan. Dissociative class is a vague and useless term since it neither describes the type of dissociative (anesthetic, hallucinogen, psychology term; what is even being said) and I can find no other antitussives part of this made-up class. This is complete mumbo jumbo.
"Dissociative class" is not too vague nor useless; if you read that article, it describes the class well enough: they are a subclass of hallucinogens, that induce the psychological/physiological effect of dissociation, and at high enough doses are used as anaesthetics. This is all very cut and dry; it is not "made-up" as you seem to think, nor is it "mumbo jumbo". The class is well defined, and the term is commonly used and perfectly descriptive.
That there are no other antitussives in the dissociative class is a meaningless complaint. There is no reason that other antitussives need be dissociatives. To my knowledge, the dissociative effects of DXM are not responsible for its antitussive effects; as such, there is no reason to assume that other antitussive should be in the dissociative class.
For consistency, you should look at practically any pharmaceutical's article: they are going to use the drug class defined by the drug's effect when possible; in some cases both chemical structure and effect are mentioned (specifically in the case of, e.g., "subtituted amphetamine stimulant", or "substituted cathinone stimulant", etc.) when it may be useful to do so.
Please discuss this here; barring any reasonable discussion or convincing rebuttal, I am going to revert your change as it is not an improvement and is inconsistent with other articles. Kimen8 ( talk) 08:17, 22 December 2023 (UTC)