Dextromethorphan is a commonly used cough suppressant. It is the dextrorotatory form of the racemic racemethorphan, which was patented by Hoffmann-La Roche in 1954. O. Häfliger and co-workers prepared the chiral form in 1956. Dextromethorphan is an over-the-counter drug formulated most often as the hydrobromide monohydrate.
At high doses, dextromethorphan is a dissociative hallucinogen. Its effects are similar to those of phencyclidine (“angel dust”).
Recently, the combination of dextromethorphan and quinidine was shown to alleviate the symptoms of pseudobulbar affect: laughing and crying in patients with multiple sclerosis, amyotrophic lateral sclerosis, and other neurologic diseases. The combination drug was approved for this use by the US Food and Drug Administration in 2010. It is marketed by Avanir under the trade name Nuedexta.
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