Evaluation of dextromethorphan with select antidepressant therapy for the treatment of depression in the acute care psychiatric setting.
The mental health clinician March 1, 2019 Jill L Nofziger, Chris Paxos, Jessica Emshoff et al.
Adding dextromethorphan (DXM) to an antidepressant that inhibits CYP2D6 did not speed improvement of depressive symptoms in adults hospitalized for depression. In a retrospective chart review of 40 patients, median time to clinical improvement was 3.00 days for those receiving DXM plus an antidepressant versus 2.83 days for those receiving only an antidepressant, a difference that was not statistically significant. Perceptual disturbances and delusions occurred more often in the DXM group (55% and 35%) than in the control group (30% and 25%). The authors suggest the commonly used 30 mg daily dose may have been too low, and bupropion, the most frequently used antidepressant, has weaker CYP2D6 inhibition than fluoxetine or paroxetine.