Dextromethorphan suppresses the cough reflex by acting on the brain's cough center in the medulla oblongata. It also functions as a sigma-1 receptor agonist and NMDA receptor antagonist, mechanisms being explored for potential neuroprotective and antidepressant effects, though its relevance to general healthspan is currently speculative and unproven in humans.
Verdict
An unproven healthspan agent; use only for its intended purpose (cough).
HEALTHSPAN IMPACT
Negligible
RISK LEVEL
Moderate
EVIDENCE GRADE
C
MONTHLY COST
$5 - $20
Protocol
- For cough suppression, 10-20 mg every 4 hours or 30 mg every 6-8 hours as needed.
- Extended-release formulations are typically dosed at 60 mg every 12 hours.
Flags
- High potential for abuse at supratherapeutic doses, causing dissociative and hallucinogenic effects.
- Risk of life-threatening serotonin syndrome when combined with MAOIs, SSRIs, or SNRIs.
- Metabolism is highly variable due to CYP2D6 genetic polymorphisms, affecting efficacy and safety.
- Common side effects include dizziness, drowsiness, nausea, and confusion.