DXM

• euphoriafeelings of joy and happiness,
• mood lift,
• increased giggling and laughing,
• dissociation of mind from body,
• creative dream-like experiences,
• increased tactile sensation ⁷.

• vomiting,
• dizziness,
• body itching,
• rash, red blotchy skin,
• diarrhoeaWhere you frequently pass watery or loose faeces,
• fever,
• tachycardiarapid pulse rate ⁷.

• oral – 30 – 120 minutes ¹.
• all ROA’sroute of administration - where the drug gets into your body – 20 – 60 minutes ¹¹.

• oral – 60 – 120 minutes ¹.

• oral – 3 – 6 hours ¹.

• oral – 2 – 4 hours ¹.

• oral – 8 – 12 hours ¹.
• all ROA’sroute of administration - where the drug gets into your body – 6 – 8 hours ¹¹.

• oral – 4 – 24 hours ¹.
• all ROA’sroute of administration - where the drug gets into your body – 1 – 12 hours ¹¹.

Dextromethorphan suppresses the cough reflex by a direct action on the cough centre in the medulla of the brain. Dextromethorphan shows high affinity binding to several regions of the brain, including the medullary cough centre. This compound is an NMDA receptor antagonist and acts as a non-competitive channel blocker. It is one of the widely used antitussives, and is also used to study the involvement of glutamate receptorsnerve endings that sense changes in the body More in neurotoxicity ³.

The antitussivea cough suppression medication. More effects of dextromethorphan and the metabolite dextrorphan are secondary to binding in the CNSthe Central Nervous System, upon which certain drugs act at non-opioid receptorsnerve endings that sense changes in the body More. Dextromethorphan does not have analgesicpain relieving or addictive properties, although abuse and dependence have been described ¹². One of the major metabolites, dextrorphan has cough suppressant activity ⁶.

Rapidly absorbed from the gastrointestinal tract ³.

Hepatic. Rapidly and extensively metabolised to dextrorphan (active metabolite). One well known metabolic catalyst involved is a specific cytochrome P450 enzyme known as 2D6, or CYP2D6 ³.

Following oral administration, dextromethorphan is rapidly absorbed from the gastrointestinal tract, where it enters the bloodstream and crosses the blood-brain barrier. Dextromethorphan shows high affinity binding to several regions of the brain, including the medullary cough centre. The first-pass through the hepatic portal vein results in some of the drug being metabolised into an active metabolite of dextromethorphan, dextrorphan, the 3-hydroxy derivative of dextromethorphan. The therapeutic activity of dextromethorphan is believed to be caused by both the drug and this metabolite. Dextromethorphan is predominantly metabolised by the liver, by various hepatic enzymes. Through various pathways, the drug undergoes (O-demethylation (which produces dextrorphan), N-demethylation, and partial conjugation with glucuronic acid and sulfate ions ⁴.

3 – 6 hours ³. The half life of the parent compound is approximately 2 to 4 hours in people with normal metabolism ⁶.

Dextromethorphan and its metabolites are excreted via the kidney. Depending on the metabolism phenotype up to 11% may be excreted unchanged or up to 100% as demethylated conjugated morphinan compounds ¹³. In the first 24 hours after dosing, less than 0.1% is eliminated in the faeces ¹⁴, ⁶.

LD50the amount of a material, given all at once, which causes the death of 50% (one half) of a group of test animals. The LD50 is one way to measure the short-term poisoning potential (acute toxicity) of a material 3.3377 mol/kg in rats ³.

Dextromethorphan is an opioid-like drug that binds to and acts as antagonist to the NMDA glutamatergic receptor, it is an agonist to the opioid sigma 1 and sigma 2 receptorsnerve endings that sense changes in the body More, it is also an alpha3/beta4 nicotinic receptor antagonist and targets the serotonin reuptake pump. Dextromethorphan is rapidly absorbed from the gastrointestinal tract, where it enters the bloodstream and crosses the blood-brain barrier. The first-pass through the hepatic portal vein results in some of the drug being metabolised into an active metabolite of dextromethorphan, dextrorphan, the 3-hydroxy derivative of dextromethorphan ³.

• changes in felt bodily form,
• gustatory hallucinationswhere someone sees, hears, smells, tastes or feels things that don't exist outside of their mind,
• physical autonomybest described as the experience of one's own body performing simple or complex actions entirely of its own accord More,
• physical euphoriaan intense feeling of pleasure and well-being More,
• spatial disorientationbest described as the inability to orient oneself in 3-dimensional space. In this state, one cannot distinguish up from down, right from left, or any two different directions from another. One might also perceive the world as being flipped sideways or even upside down. More,
• appetite suppression,
• cough suppression,
• pain relief,
• perception of bodily lightness,
• sedationthe state of being relaxed or sleepy because of a drug More,
• tactile suppression,
• dizziness,
• increased blood pressure,
• increased heart rate,
• increased perspiration,
• itchiness,
• muscle spasms,
• nausea,
• optical slidingdescribed as a physical effect which inhibits the coordination and control of one's eyes by suppressing their ability to keep them still. This results in the orientation of one's eyes continuously moving in a variety of directions and the sensation of not being able to stare motionless at any particular point becoming present More,
• temperature regulation suppression ¹.

• cognitive euphoriastate of intense well-being, happiness, and excitement More,
• conceptual thinking,
• depersonalisationfeeling detached from yourself, observing yourself and your feelings and thoughts as if they belong to someone else More,
• derealisationan alteration in the perception or experience of the external world so that it seems unreal. More,
• déjà vu,
• time distortion,
• creativity enhancement,
• dream potentiationcan be described as a cognitive component which increases the intensity, vividness and frequency of sleeping dream states. This effect also creates higher detail and definition within dreams alongside of an increase in the likelihood of one's dreams becoming lucid. More,
• emotionality enhancement,
• immersion enhancementThis is an effect which can be described as a pronounced increase in one's ability to become fully engulfed within external visual or auditory stimuli such as music, movies, video games and various other forms of media. More,
• increased libido,
• increased music appreciation,
• novelty enhancement,
• personal meaning enhancement,
• amnesiainability to remember,
• cognitive fatiguethe decline in the ability to think effectively and maintain focus. More,
• decreased libido,
• disinhibition,
• information processing suppressioncan be described as a partial to complete suppression of a person's ability to process information and logically analyse a situation in an understandable and linear fashion. This is something which can result in states of stupor, indecisiveness, confusion and even irrational behaviour or delirium. More,
• memory suppression,
• personal bias suppression,
• thought deceleration,
• unity and interconnectedness ¹.

• after images,
• environmental cubisma distortion characterised by a visual segmenting or partitioning of the external environment into squares and cubes of varying amounts and sizes. Once established, these partitions begin to slowly drift away from their original location and often change in size leading to gaps that are formed in between them. More,
• environmental orbisma visual distortion characterised by a partitioning of the environment a person is currently in. This is manifested in the form of spherical 3-dimensional "orbs" that retain most of the detail and identity of the space they're distorting. More,
• perspective distortions,
• scenery slicingbest described as an effect which only occurs spontaneously and rarely sustains itself for more than several seconds. The experience of this effect splits the visual field into separate sections. These individual slices then proceed to drift slowly away from their original position before disappearing and resetting to normality. More,
• tracers,
• visual haze,
• acuity suppression,
• double vision,
• frame rate suppressiona visual suppression where one's FPS (frames per second) are significantly reduced or slowed down. While under the influence of this effect, one might feel like their vision is lagging and frame-like (similar to a strobe light) More,
• pattern recognition suppressionbest defined as the experience of a partial to complete inability to process currently perceivable visual information regardless of the clarity, detail and clearness of its visual acuity. For example, although one may be able to see what is in front of them with perfect detail, they will not be able to register or label what is in front of them. This can render even the most common of everyday objects as unrecognisable. More,
• visual disconnection,
• geometrybest described as the experience of a person's field of vision being partially or completely encompassed by fast-moving, colourful and indescribably complex geometric patterns, form constants, phosphenes, shapes, fractals, structures and colour. These geometric forms can also become structured and organised in a way that presents genuine information to the person experiencing it far beyond the perception of meaningless, although complex, shapes and colours. This happens through the experience of innately understood geometric representations that feel as though they depict specific concepts and neurological components that exist within the brain in a manner that is extremely detailed. More,
• autonomous entities,
• external hallucinationsbest described as the experience of perceiving imagined visual concepts and occurrences which display themselves seamlessly into the external environment as if they were actually happening. More,
• internal hallucinationsbest described as the perception of imagery and scenes which are experienced exclusively within a layer in front of one's open or closed eye vision and not seamlessly within the external environment around oneself. At lower levels, internal hallucinations begin with imagery which does not take up the entirety of one's visual field and is distinctively separate from its background. These can be described as spontaneous moving or still images of scenes, concepts, places, and anything one could imagine. They are manifested in varying levels of detail, ranging from ill-defined and cartoon-like in nature to completely realistic and beyond realism through seemingly impossible, non-euclidean geometric forms. They rarely hold their form for more than a few seconds before fading or shifting into another image. More,
• perspective alterations,
• scenarios and plots,
• settings, sceneries, and landscapes ¹.

• auditory distortion,
• auditory enhancement,
• auditory hallucinationswhere someone sees, hears, smells, tastes or feels things that don't exist outside of their mind,
• auditory suppression ¹.

• blurred vision,
• confusiontrouble focusing, slow or disorganised thinking, poor short-term memory, unsure of time or place, or having difficulty following a conversation,
• difficulty in urination,
• drowsiness or dizziness,
• nausea or vomiting (severe),
• shakiness and unsteady walk,
• slowed breathing,
• unusual excitement, nervousness, restlessness, or irritability (severe) ¹⁷.

• αMT,
• PCP,
• MDMASee Ecstasy More,
• Alcohol – Both substances potentiate the ataxialoss of motor coordination More and sedationthe state of being relaxed or sleepy because of a drug More caused by the other and can lead to unexpected loss of consciousness at high doses. Place affected patients in the recovery position to prevent vomit aspirationvomit being inhaled into the lungs, a potentially life-threatening condition More from excess. Additionally CNSthe Central Nervous System, upon which certain drugs act depression can lead to difficulty breathing. Avoid on anything higher than 1st plateau.
• GBL / GHB – Both substances cause ataxialoss of motor coordination More and bring a risk of vomiting and unconsciousness. If the patient falls unconscious while under the influence there is a severe risk of vomit aspirationvomit being inhaled into the lungs, a potentially life-threatening condition More if they are not placed in the recovery position. This combination is hard to predict.
• Opioids – CNSthe Central Nervous System, upon which certain drugs act depression, difficult breathing, heart issues, hepatoxicrelating to or causing injury to the liver. More, just very unsafe combination all around. Additionally if one takes dxm, their tolerancethis is the process by which the receptors in your brain become habituated to the action of a drug. When tolerance is reached, more of the drug is required to achieve the same effect. With benzodiazepines, and probably with many other classes of drugs as well, tolerance is virtually always associated with some degree of physical dependence. If you find that you are experiencing tolerance, this is a clear warning sign that you may have formed a dependence. More of opiates goes down slightly, thus causing additional synergistic effectsan effect arising between two or more agents, entities, factors, or substances that produces an effect greater than the sum of their individual effects More.
• Tramadol,
• MAOIsMAOIs may be used to treat the symptoms of depression. More – High risk of serotonin syndrome.
• SSRIs – High risk of serotonin syndrome ¹¹.

• DOx – The DOx class as psychedelic stimulants have the potential to mask the effects of DXM and could lead to redosing to an unsafe level. DXM can also potentiate DOx resulting in an unpleasantly intense experience.
• NBOMes,
• 2C-T-x,
• 5-MeO-xxT – Little information exists about this combination.
• Amphetamines – Both substances raise heart rate, in extreme cases, panic attacks caused by these drugs have led to more serious heart issues.
• Cocaine – Both substances raise heart rate, in extreme cases, panic attacks caused by these drugs have led to more serious heart issues ¹¹.

• Nausea, stomach cramps, and other unpleasant gastro-intestinal effects are common and may persist for days after use.
• Itching and other skin reactions have been reported.
• The large amount of glucose, thickeners, etc., present in many cough syrups may be hard on your kidneys and pancreas ¹⁹.