Posted by Sunnely on January 30, 2001, at 19:43:21
In reply to Warning - Remeron, SSRIs, and DXM *(Robitussin), posted by Benjamin on January 27, 2001, at 19:54:13
Serotonergic drugs such as SRIs (serotonin reuptake inhibitors) including Prozac, Paxil, Zoloft, Luvox, Celexa, Serzone, and Remeron have the potential to cause serotonin syndrome when combined with dextromethorphan. Serotonin syndrome is a serious condition that can result in death. It is usualy caused by increased serotonin stimulation.
Another potential adverse effect of dextromethorphan if used excessively is psychosis. Dextromethorphan is metabolized by the liver enzyme CYP2D6 and to some degree CYP3A4. One of its metabolites (by product), dextrorphan, is an antagonist of the NMDA (N-methyl-D-aspartate) subtype of the glutamate receptors. Phencyclidine (PCP, often referred to as "angel dust"), an NMDA receptor antagonist, has been known to induce complex psychotic states (similar to schizophrenic symptoms). At higher risk for dextromethorphan-induced psychosis are those individuals with "rapid metabolizer" phenotype (genetic make up) of the cytochrome CYP2D6. Individuals with this cytochrome genetic make up rapidly metabolize dextromethorphan to dextrorphan (high level) --- > psychotic symptoms.
poster:Sunnely
thread:52711
URL: http://www.dr-bob.org/babble/20010122/msgs/53004.html