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Dextromethorphan, sold under the brand name Robitussin among others, is a cough suppressant used in many cough and cold medicines. [6] In 2022, the US Food and Drug Administration (FDA) approved the combination dextromethorphan/bupropion to serve as a rapid-acting antidepressant in people with major depressive disorder.
Concerns with polypharmacy and elderly groups are reduced medication adherence, increased fall risk, cognitive function impairment, and adverse drug reaction. [11] Almost 75% of clinic visits result in people obtaining a written prescription. [12] [13] More careful prescribing practices could increase medication adherence in elderly people.
Dextromethorphan's effects have been divided into four plateaus. [14] The first plateau (1.5 to 2.5 mg per kg body weight) is described as having euphoria, auditory changes, mild stimulation, and change in perception of gravity. The second plateau (2.5 to 7.5 mg/kg) causes intense euphoria, vivid imagination, and closed-eye hallucinations.
The provider of a dextromethorphan containing product must acquire proof of age if they believe that the potential purchaser is below the age of 18. Any person found to possess more than one gram of pure dextromethorphan without the required credentials is subject to a $1000 fine for the first offense and a $2500 fine for each subsequent offense.
The Beers Criteria are intended to serve as a guide for clinicians and not as a substitute for professional judgment in prescribing decisions. The criteria may be used in conjunction with other information to guide clinicians about safe prescribing in older adults. [5] [non-primary source needed] [6] [non-primary source needed].
Patients who stayed on the medication had an average of 11% greater reduction in depressive symptoms than placebo in an FDA approval trial. [2] [3] It is taken as a tablet by mouth. [1] Side effects of dextromethorphan/bupropion include dizziness, headache, diarrhea, somnolence, dry mouth, sexual dysfunction, and hyperhidrosis, among others. [1]
Dextromethorphan – An over-the-counter cough suppressant, as well as dissociative hallucinogen. Levomethorphan – A potent opioid analgesic that was never clinically developed; a prodrug of the powerful opioid agonist analgesic levorphanol (Levo-Dromoran). Racemethorphan is the racemic mixture of both of these stereoisomers! [2]
Meclofenoxate is considered to be safe and high in tolerability.However, possible side effects may include, rarely, insomnia, dizziness, restlessness, muscle tremor, depression, nausea, muscle tension, and headache; these side effects may be due to overdosage and may indicate the need for the dosage to be reduced.
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