title: [Clinical study of BRON-L syrup (cough suppressant) abuse].
abstract: In 1980s, abuse and dependence of BRON-W syrup (cough suppressant), which contains methylephedrine, dihydrocodeine, chlorpheniramine and caffeine, were prevalent in Japan. Pharmacological and clinical studies suggest that methylephedrine and dihydrocodeine cause dependence. Although BRON-L syrup, newly modified cough suppressant contains only chlorpheniramine and caffeine, there still are abuse and dependence of this drug. In this report, three cases of BRON-L syrup abuse are demonstrated. All cases started using BRON-L syrup in the late teens in their peer groups, and dropped out from school. Case 1 misused only BRON-L syrup, but case 2 and 3 were multi-drug abusers (case 2: amphetamine, cocaine, and marijuana, case 3: solvent, alcohol, bromovalerylurea), and had kept in tough with the peer groups. Case 2 and 3 hospitalized more than 2 times. Withdrawal symptoms, such as headache, insomnia, and irritability were mild and improved in a few weeks after drug use was stopped. These findings suggest that 1) psychosocial backgrounds of these cases are in common with those of BRON-W syrup abusers, but 2) the clinical course and prognosis of multi-drug abusers are different from the BRON single abuser, 3) chlorpheniramine and caffeine possibly cause dependence, 4) abusers are likely to choose BRON brand although two main dependence-producing constituents are removed from it now. Therefore, prevention and care of BRON-L abusers requires both psychosocial and pharmacological aspects.
authors.affiliation: Department of Neuropsychiatry, Faculty of Medicine, Kagawa Medical University, 1750-1 Ikenobe, Miki-cho, Kita-gun, Kagawa 761-0793, Japan.
authors.forename: Ryosuke
authors.initials: R
authors.lastname: Miyatake
authors.forename: Tomoko
authors.initials: T
authors.lastname: Doi
authors.forename: Kenji
authors.initials: K
authors.lastname: Date
authors.forename: Tomomichi
authors.initials: T
authors.lastname: Naitoh
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Suwaki
mesh_terms: D000328:Adult; D000996:Antitussive Agents / Q000009:adverse effects*; D002110:Caffeine / Q000009:adverse effects; D002744:Chlorpheniramine / Q000009:adverse effects; D004338:Drug Combinations; D005260:Female; D006801:Humans; D008297:Male; D004366:Nonprescription Drugs / Q000009:adverse effects*; D019966:Substance-Related Disorders / Q000523:psychology*
chemical_list: D000996:Antitussive Agents; D004338:Drug Combinations; D004366:Nonprescription Drugs; D002110:Caffeine; D002744:Chlorpheniramine