Chemical Abstracts Service Registry Number 125735 Type Depressant opioid class See page 24 Federal Schedule Listing Unlisted

Uses. This substance is closely related to levorphanol and can produce a false positive for levorphanol in drug screen tests. The human body will transform part of a dextromethorphan dose into dextrorphan. The same transformation occurs in rats; when comparing results in males and females, researchers found that a given amount of dextrorphan lasts twice as long in female rats.

Dextrorphan can fight coughs and reduce epileptic seizures, although test results differ about how well it diminishes seizures. Mice research has found that the drug helps mice recover from strokes, and in humans the drug appears useful for treating minor strokes. Some research indicates that the substance has potential for treating various human neurological afflictions, but such potential has yet to be fulfilled. A rat experiment found dextrorphan ineffective in preventing brain damage caused by the chemical warfare agent soman. A rat study testing dextrorphan's potential as an antidote for meth-cathinone poisoning had limited success.

Drawbacks. Unwanted side effects may include nausea, vomiting, sleepiness, high or low blood pressure, uncontrollable eye movement, and hallucinations. Rat experiments show that high enough does can impair memory and learning. When one group of researchers tested dextrorphan's ability to prevent some types of brain damage, the scientists found instead that dextror-phan caused damage in rats.

Abuse factors. At one time dextrorphan was a Schedule I substance, but eventually it was removed from any schedule of controlled substances. Such a journey is most unusual; assorted drugs have been moved from one schedule to another over the years, but the direction is almost always to put the drugs under more controls rather than fewer. Scientists describe dextrorphan as producing effects similar to PCP. At sufficiently high levels, dextrorphan can make people feel as if they are intoxicated with alcohol.

Drug interactions. Dextrorphan has reduced cocaine effects in mice.

Cancer. Not enough scientific information to report.

Pregnancy. After male mice received dextrorphan in an experiment, they produced offspring having lower weight, delays in maturation, and abnormal swimming behavior. Whether the drug passes into a human fetus or the milk supply of a nursing mother is unknown.

Additional scientific information may be found in:

Aylward, M., et al. "Dextromethorphan and Codeine: Comparison of Plasma Kinetics and Antitussive Effects." European Journal of Respiratory Diseases 65 (1984): 283-91.

Dematteis, M., G. Lallement, and M. Mallaret. "Dextromethorphan and Dextrorphan in Rats: Common Antitussives—Different Behavioural Profiles." Fundamental and Clinical Pharmacology 12 (1998): 526-37. "Safety, Tolerability and Pharmacokinetics of the N-Methyl-D-Asparate Antagonist Ro-01-6794/706 in Patients with Acute Ischemic Stroke." Annals of the New York Academy of Sciences 765 (1995): 249-61, 298. Schutz, C.G., and M. Soyka. "Dextromethorphan Challenge in Alcohol-Dependent Patients and Controls." With reply by Drystal and Petrakis. Archives of General Psychiatry 57 (2000): 291-92. Szekely, J.I., L.G. Sharpe, and J.H. Jaffe. "Induction of Phencyclidine-Like Behavior in Rats by Dextrorphan But Not Dextromethorphan." Pharmacology, Biochemistry, and Behavior 40 (1991): 381-86.

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