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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 6 of 6. This is the beginning of the thread.
Posted by Benjamin on January 27, 2001, at 19:54:13
I have been on both Paxil and Remeron at various times. Until recently I had been obtaining these drugs at CVS. The warning sheet lists numerous medications that interact with both Remeron and Paxil.
Recently I refilled the Paxil at a NYC local pharmacist. This sheet specifically warned against any use of DXM/dextromethorphan (cough suppressant found in all OTC cough medications)In my younger years I had experimented with the use of DXM for recreational purposes so this warning interested me. DXM is the most potent of the otc pychoactive drugs, but it has not been studied in depth until recently.
The warning against its use with Paxil is due to a risk of Serotonin Syndrome. This is induced because DXM is a potent serotonin reuptake inhibitor
The issue with use of Remeron is due to Remerons unique status as a alpha 2 adrenergic antagonist. These drugs greatly increase the risks of damage called Olney's lesions. They will not cause the problem on their own but DXM and other dissociatives (yes cough syrup is a dissociative) bring about Olney's lesions via a different and possibly synergistic mechanisms.
Olney's lesions are a form of permanent brain damage in which large sections of brain cells die and waste away. FOr a discussion of the syndrome follow this link http://www.frognet.net/dxm/side_effects.html#toc.6.5Note I am posting this warning because the doses of cough syrup required to cause interactions are easily within therapuetic levels.
Posted by PatJ. on January 27, 2001, at 20:29:25
In reply to Warning - Remeron, SSRIs, and DXM *(Robitussin), posted by Benjamin on January 27, 2001, at 19:54:13
> I have been on both Paxil and Remeron at various times. Until recently I had been obtaining these drugs at CVS. The warning sheet lists numerous medications that interact with both Remeron and Paxil.
> Recently I refilled the Paxil at a NYC local pharmacist. This sheet specifically warned against any use of DXM/dextromethorphan (cough suppressant found in all OTC cough medications)
>
> In my younger years I had experimented with the use of DXM for recreational purposes so this warning interested me. DXM is the most potent of the otc pychoactive drugs, but it has not been studied in depth until recently.
>
> The warning against its use with Paxil is due to a risk of Serotonin Syndrome. This is induced because DXM is a potent serotonin reuptake inhibitor
>
> The issue with use of Remeron is due to Remerons unique status as a alpha 2 adrenergic antagonist. These drugs greatly increase the risks of damage called Olney's lesions. They will not cause the problem on their own but DXM and other dissociatives (yes cough syrup is a dissociative) bring about Olney's lesions via a different and possibly synergistic mechanisms.
> Olney's lesions are a form of permanent brain damage in which large sections of brain cells die and waste away. FOr a discussion of the syndrome follow this link http://www.frognet.net/dxm/side_effects.html#toc.6.5
>
> Note I am posting this warning because the doses of cough syrup required to cause interactions are easily within therapuetic levels.Hi Benjamin,
Is DM a problem with SSRIs, too? I take an occasional swig of it for a cough I have. I am taking an SSRI and noticed that after I take a swig of DM (mine is labeled DM not dmx but it is dextromethorphan Hydrobromide 10 mg. and Guaifesin 100 mg.-a generic brand-much cheaper!)I usually fall asleep very quickly. I haven't had to take DM on a daily basis recently but I your post concerns me if I would need to. Maybe there are other cough medicines that would work as well. I'll have to check and see. Thanks for the warning and your concern. pat
Posted by stjames on January 28, 2001, at 23:04:59
In reply to Warning - Remeron, SSRIs, and DXM *(Robitussin), posted by Benjamin on January 27, 2001, at 19:54:13
> Recently I refilled the Paxil at a NYC local pharmacist. This sheet specifically warned against any use of DXM/dextromethorphan (cough suppressant found in all OTC cough medications)
>James here....
DXM is related to the opiates and the research I did indicates SS could happen with opiates. However, from what I read, the danger is if one is on some AD(s) and takes DXM or opiates to get high (ie a high dose) and not at a dose for legit reasons. I have read a case that was the exception
to this. SS is not well understood, partly because it is very uncommon. I have read a report
of SS from DXM (at abuse dosages)James
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.
Posted by Christina on January 30, 2001, at 22:05:29
In reply to Warning - Remeron, SSRIs, and DXM *(Robitussin), posted by Benjamin on January 27, 2001, at 19:54:13
> > Olney's lesions are a form of permanent brain damage in which large sections of brain cells die and waste away
Well.. that explains part of my problems!
Posted by nicole tracy on March 15, 2005, at 15:13:36
In reply to Warning - Remeron, SSRIs, and DXM *(Robitussin), posted by Benjamin on January 27, 2001, at 19:54:13
This is true, I was on Prozac at 40mg daily and took robotussin, DXM or dextromethorphan makes you feel high if you are on an SSI. especially coricidan cough and cold
> I have been on both Paxil and Remeron at various times. Until recently I had been obtaining these drugs at CVS. The warning sheet lists numerous medications that interact with both Remeron and Paxil.
> Recently I refilled the Paxil at a NYC local pharmacist. This sheet specifically warned against any use of DXM/dextromethorphan (cough suppressant found in all OTC cough medications)
>
> In my younger years I had experimented with the use of DXM for recreational purposes so this warning interested me. DXM is the most potent of the otc pychoactive drugs, but it has not been studied in depth until recently.
>
> The warning against its use with Paxil is due to a risk of Serotonin Syndrome. This is induced because DXM is a potent serotonin reuptake inhibitor
>
> The issue with use of Remeron is due to Remerons unique status as a alpha 2 adrenergic antagonist. These drugs greatly increase the risks of damage called Olney's lesions. They will not cause the problem on their own but DXM and other dissociatives (yes cough syrup is a dissociative) bring about Olney's lesions via a different and possibly synergistic mechanisms.
> Olney's lesions are a form of permanent brain damage in which large sections of brain cells die and waste away. FOr a discussion of the syndrome follow this link http://www.frognet.net/dxm/side_effects.html#toc.6.5
>
> Note I am posting this warning because the doses of cough syrup required to cause interactions are easily within therapuetic levels.
This is the end of the thread.
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