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Herbal and Supplement Use in Pain Management
Published in Sahar Swidan, Matthew Bennett, Advanced Therapeutics in Pain Medicine, 2020
Drug interactions: Anti-depressants, meperidine, MAOIs, pentazocine, tramadol: concurrent use might cause additive serotonergic effect and increase the risk of serotonin syndrome.90Dextromethorphan: concurrent use may cause additive serotonergic effects and increase the risk of serotonin syndrome.90Levodopa: SAMe methylates levodopa and may lead to worsening of Parkinsonian syndrome. SAMe administration may lead to a decreased effect of levodopa.91
Infectious Disease: Upper Respiratory Infections and Otitis Media
Published in Hilary McClafferty, Integrative Pediatrics, 2017
Dextromethorphan was approved by the FDA in 1958 and is a common ingredient in children’s over-the-counter medicines as a cough suppressant. It is a man-made chemical with similarities to opioids, but is non-addictive. American Academy of Pediatrics policy statements have raised concerns about dextromethorphan for decades because ultimately cough suppression is undesirable and often dangerous in children, especially in young children, who rely on their powerful gag reflex to protect their airway. Side effects include: irritability, agitation, and hallucinations (Academy of Pediatrics Committee on Drugs 1997).
Nonopioid and adjuvant analgesic agents
Published in Pamela E. Macintyre, Stephan A. Schug, Acute Pain Management, 2014
Pamela E. Macintyre, Stephan A. Schug
Dextromethorphan is widely available as an over-the-counter cough suppressant. It is not in common clinical use as an analgesic adjuvant agent and results from clinical trials in the postoperative setting have been disappointing.
Emerging drugs in the treatment of chronic cough
Published in Expert Opinion on Emerging Drugs, 2023
Danica Brister, Mustafaa Wahab, Moaaz Rashad, Nermin Diab, Martin Kolb, Imran Satia
N-methyl-d-aspartate receptors (NMDARs) are present throughout the central nervous system (CNS), are the target for the excitatory neurotransmitter glutamate and are thought to be pivotal for the initiation and maintenance of CNS plasticity in neuropathic pain [80,81]. Blocking NMDARs could therefore be a potential therapeutic target in RCC/UCC. Dextromethorphan, a weak antagonist of NMDARs, is used in many over-the-counter antitussive preparations, but compared with placebo, it reduces acute cough by no more than 17% [82]. Memantine is an approved medication for Alzheimer’s disease and is a low-affinity uncompetitive NMDAR antagonist, preferentially targeting already activated receptors. Importantly, memantine has previously been shown to block experimentally evoked coughs by inhalation of citric acid and bradykinin in conscious guinea pigs [83]. A small open-label feasibility and tolerability dose escalation study in 14 patients with RCC/UCC demonstrated that most patients could not tolerate a dose greater than 10 mg, with a median tolerated duration of only 38.5 days [84]. The most common adverse events reported were dizziness, tiredness, and drowsiness. Although this was not an efficacy study, there no significant improvement in awake cough frequency after treatment with memantine.
Combinations of dextromethorphan for the treatment of mood disorders - a review of the evidence
Published in Expert Review of Neurotherapeutics, 2023
Zamfira Parincu, Dan V. Iosifescu
Similar results were also found in the phase III, double-blind, placebo-controlled GEMINI trial (n = 327), where AXS-05 (45 mg dextromethorphan/105 mg bupropion) was compared to placebo, with dextromethorphan-bupropion showing rapid and significant antidepressant efficacy for MDD patients, not TRD [32]. The treatment significantly reduced MADRS scores compared to placebo at week 1 and week 6 (least-squares mean difference, −3.87; 95% CI, −1.39 to −6.36; p = .002), associated with an effect size (Cohen’s d) of 0.89. Dextromethorphan-bupropion was also more effective than placebo in improving MADRS starting at week 1 (least-squares mean difference, −2.23; 95% CI, −.6 to −3.86; p = .007) and continuing to week 2 (least-squares mean difference, −3.44; 95% CI, −1.4 to −5.47; p < .001) and up to week 6. At week 6, clinical response (≥ 50% reduction in MADRS from baseline) with dextromethorphan-bupropion was 54.0%, compared to 34.0% with placebo (treatment difference, 20.0%; 95% CI, 8.4 to 31.6; p < .001). The NNT for response was 5. Furthermore, at study endpoint, 39.5% of patients achieved remission (endpoint MADRS ≤ 10) with dextromethorphan-bupropion compared to 17.3% with placebo (treatment difference, 22.2; 95% CI, 11.7 to 32.7; p < .001). The NNT for remission was 5. Researchers reported dizziness, nausea, headache, somnolence, and dry mouth as the most common adverse effects; of note, dextromethorphan-bupropion was not associated with psychotomimetic effects, weight gain, or increased sexual dysfunction [32].
Premarital sex and its contributing factors in high-risk Indonesian adolescents: an observational study
Published in Journal of Social Distress and Homelessness, 2023
Hartono Gunardi, Wresti Indriatmi, Soedjatmiko Soedjatmiko, Rini Sekartini, Bernie E. Medise, Achmad Rafli, Nia Kurniati
The risk of having premarital sex was increased by 3.4 times in adolescents with NMUPD. This finding is consistent with a previous study that found alcohol consumption and NMUPD were related to HRSB (Li et al., 2013). Any medicine that may induce psychoactive effects (relaxation, sedation, intoxication, euphoria, increased energy, and hallucinations) can be abused and such effects can be produced if taken in higher doses. For example, intoxicating, hallucinogenic, and dissociative effects are produced by dextromethorphan when consumed 5–10 times the recommended dose. Trihexyphenidyl is abused for its stimulant, euphoriant, and hallucinogenic effects, and chlorpromazine for its significant anticholinergic and sedating effects (Reeves et al., 2015). Adolescents who practiced NMUPD were more likely to have multiple sex partners, have sex after drinking or using drugs, and engage in unprotected sex (Benotsch et al., 2011).