title: Dextromethorphan: An update on its utility for neurological and neuropsychiatric disorders.
abstract: Dextromethorphan (DM) is a commonly used antitussive and is currently the only FDA-approved pharmaceutical treatment for pseudobulbar affect. Its safety profile and diverse pharmacologic actions in the central nervous system have stimulated new interest for repurposing it. Numerous preclinical investigations and many open-label or blinded clinical studies have demonstrated its beneficial effects across a variety of neurological and psychiatric disorders. However, the optimal dose and safety of chronic dosing are not fully known. This review summarizes the preclinical and clinical effects of DM and its putative mechanisms of action, focusing on depression, stroke, traumatic brain injury, seizure, pain, methotrexate neurotoxicity, Parkinson's disease and autism. Moreover, we offer suggestions for future research with DM to advance the treatment for these and other neurological and psychiatric disorders.
authors.affiliation: Department of Behavioral Medicine and Psychiatry, School of Medicine, West Virginia University, Morgantown, WV 26506, USA; Department of Pharmaceutical Sciences, School of Pharmacy, West Virginia University, Morgantown, WV 26506, USA.
authors.forename: Linda
authors.initials: L
authors.lastname: Nguyen
authors.affiliation: College of Pharmacy, Touro University California, Vallejo, CA 94592, USA.
authors.forename: Kelan L
authors.initials: KL
authors.lastname: Thomas
authors.affiliation: Graduate Program in Neuroscience, School of Medicine, West Virginia University, Morgantown, WV 26506, USA.
authors.forename: Brandon P
authors.initials: BP
authors.lastname: Lucke-Wold
authors.affiliation: Graduate Program in Neuroscience, School of Medicine, West Virginia University, Morgantown, WV 26506, USA.
authors.forename: John Z
authors.initials: JZ
authors.lastname: Cavendish
authors.affiliation: Department of Psychology, West Virginia University, Morgantown, WV 26506, USA.
authors.forename: Molly S
authors.initials: MS
authors.lastname: Crowe
authors.affiliation: Department of Behavioral Medicine and Psychiatry, School of Medicine, West Virginia University, Morgantown, WV 26506, USA; College of Pharmacy, Touro University California, Vallejo, CA 94592, USA. Electronic address: rae.matsumoto@tu.edu.
authors.forename: Rae R
authors.initials: RR
authors.lastname: Matsumoto
mesh_terms: D000818:Animals; D000996:Antitussive Agents / Q000493:pharmacokinetics / Q000494:pharmacology / Q000627:therapeutic use; D003915:Dextromethorphan / Q000493:pharmacokinetics / Q000494:pharmacology / Q000627:therapeutic use; D006801:Humans
chemical_list: D000996:Antitussive Agents; D003915:Dextromethorphan
keywords: Depression; Neurotoxicity; Pain; Seizure; Stroke; Traumatic brain injury