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Dextromethorphan: Another Ecstasy? Archives of Family Medicine:"The letter by Cranston and Yoast1 in the April issue of the ARCHIVES, which discusses the abuse potential of dextromethorphan (DMX), is timely because it is a readily available substance that was recently distributed in Texas at "rave" parties as the newest ecstasy.2 Rave parties are all-night dances that were originally popularized by European adolescents at which loud "techno" music is played and at which euphoriant drugs called ecstasy are usually available."
http://archfami.ama-assn.org/issues/v9n2/ffull/flt0200-1.html

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Dextromethorphan and Ecstasy Pills, Journal of The American Medical Association:"In their Research Letter, Mr Baggott and colleagues1 report that they performed a chemical analysis of 3,4-methylenedioxymethamphetamine (MDMA) tablets, also known as "ecstasy," and found that such tablets frequently contain dextromethorphan. The authors imply that findings of "lethargy or hyperexcitability, tachycardia, ataxia, and nystagmus, as well as a phencyclidine-like psychosis" can occur only in dextromethorphan toxicity."
http://jama.ama-assn.org/issues/v285n4/ffull/jlt0124-3.html

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Drugs and Chemicals of Concern, Dextromethorphan, (DXM, DM, Robo, Velvet, Rojo), Diversion Control Program, Department of Justice:"The majority of abuse occurs among teenagers and young adults. DXM alone, or mixed with other ingredients, such as ephedrine or phenylpropanolamine, has been sold as "ecstasy". It has been identified as a "filler" in confiscated samples of "bogus heroin" and as "bogus ketamine"."
http://www.deadiversion.usdoj.gov/drugs_concern/dextro_m/summary.htm

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Finding Abuse Where You Least Expect It, Parents. The Anti-Drug:"One category of products sometimes abused by teenagers that few parents know about is OTC cough and cold remedies. The OTC cough and cold medications available in your local pharmacy, supermarket or convenience store are safe and effective when used as directed. But some youth are drawn to an ingredient found in nearly half of these medications called dextromethorphan, or DXM. When taken in excessive doses, dextromethorphan can produce a high or cause psychoactive effects."
http://www.theantidrug.com/advice/articles_dmx.html

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Doctors' Answers to "Frequently Asked Questions" - Dextromethorphan:"Dextromethorphan hydrochloride is a semisynthetic narcotic. It suppresses coughs about half as effectively as codeine. However, has little addictive potential due to its low narcotic activity. It will produce the same side effects as any narcotic - constipation and occasional nausea(especially on an empty stomach). It is mainly used as an agent to suppress cough and acts in the brain and it has no analgesic activity. It is metabolized by the liver and excreted in the urine."
http://www.druginfonet.com/faq/new/DRUG_FAQ/Dextromethorphan.htm

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Dextromethorphan (DXM) - a new recreational drug?:"The overdosage - which is needed for the sought-after psychotropic effect - has generally produced, in the cases we have collected so far, moderate symptoms of the central nervous system (somnolence, confusion, uncoordinated movements, agitation, less frequently hallucinations). Quite frequently, there is also an accelerated heart rate, enlarged pupils and vomiting. In addition to these relatively mild toxic effects, severe symptoms of poisoning have also occurrred in some cases (coma, convulsions and massive hypertension). Damage to muscle tissue and psychosis have been reported one."
http://www.toxi.ch/eng/news_957184695_28669.html

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MorphiDex (MS:DM) double-blind, multiple-dose studies in chronic pain patients:"Preclinical and double-blind single-dose placebo-controlled studies demonstrated that MorphiDex (MS:DM), a 1:1 ratio of morphine sulfate (MS) to dextromethorphan hydrobromide (DM), provides significantly greater analgesia than an equal dose of immediate release MS, with a faster onset, and a duration of greater or = 8 h. The analgesic effect of MS:DM compared to MS was evaluated in 2 double-blind, multiple-dose studies in 321 patients with cancer and other chronic pain: a crossover study that consisted of two 2-wk periods and a 4-wk parallel study."
http://opioids.com/morphidex/

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Dextromethorphan (Systemic), Medline Plus:"Some commonly used brand names are: In the U.S.-- Benylin Adult Formula Cough Syrup, Benylin Pediatric Cough Suppressant, Cough-X, Creo-Terpin, Delsym Cough Formula, Diabe-TUSS DM Syrup, Hold DM, Pertussin CS Children's Strength, Pertussin DM Extra Strength, Robitussin Maximum Strength Cough Suppressant, Robitussin Pediatric Cough Suppressant, Sucrets 4 Hour Cough Suppressant, Trocal, Vicks 44 Cough Relief, In Canada-- Balminil DM, Balminil DM Children, Benylin DM, Benylin DM 12 Hour, Benylin DM for Children, Benylin DM for Children 12 Hour, Broncho-Grippol-DM, Calmylin #, 1 Delsym, Koffex DM, Novahistex DM, Novahistine DM, Robitussin Pediatric, Triaminic DM Long Lasting for Children."
U.S. National Library of Medicine
8600 Rockville Pike, Bethesda, MD 20894
custserv@nlm.nih.gov
http://www.nlm.nih.gov/medlineplus/druginfo/dextromethorphansystemic202187.html

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Dextromethorphan Hydrobromide Syrup, Rxlist.com:"Dextromethorphan is an antitussive agent and, unlike the isomeric levorphanol, it has no analgesic or addictive properties. The drug acts centrally and elevates the threshold for coughing. It is about equal to codeine in depressing the cough reflex. In therapeutic dosage dextromethorphan does not inhibit ciliary activity. Dextromethorphan is rapidly absorbed from the gastrointestinal tract and exerts its effect in 15 to 30 minutes. The duration of action after oral administration is approximately three to six hours. Dextromethorphan is metabolized primarily by liver enzymes undergoing O-demethylation, N-demethylation, and partial conjugation with glucuronic acid and sulfate. In humans, (+)-3-hydroxy-N-methyl-morphinan, (+)-3-hydroxymorphinan, and traces of unmetabolized drug were found in urine after oral administration."
http://www.rxlist.com/cgi/generic3/promdex_cp.htm

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