Concomitant use of dextromethorphan and alcohol-induced dissociation in a patient with alcohol dependence.
PCN reports : psychiatry and clinical neurosciences December 1, 2024 Yasuhito Nagai, Yuko Tajima, Koichi Miyakawa
Dextromethorphan (DXM), an over-the-counter drug commonly abused by teenagers, acts as a low-affinity NMDA receptor antagonist. A patient with alcohol dependence experienced acute psychotic dissociation after using DXM and alcohol together, making it difficult to distinguish from alcohol withdrawal symptoms. The psychotic symptoms improved with haloperidol, but haloperidol should be avoided in cases of DXM abuse. Clinicians should consider the possibility of various addictive drugs when consulting patients with addiction. Concomitant use of DXM and alcohol causes easy dissociation, and high-dose DXM usage and alcohol withdrawal symptoms are hard to distinguish.