What are the risks?

DXM causes physical and psychological effects that might be frightening or at least unpleasant. Vomiting, nausea, and diarrhea are among the most common ones. Psychological effects could be manifested in grave disorientation, depression, sense of disintegration of one’s personality or of sense of “unreality” and “switching off” that can last for days. Chronic usage may cause depression, psychological dependence and, very likely, brain damages. Extremely high doses could be blamed for causing psychotic paroxysms.
In addition to the risks related to the usage of DXM itself, many of the pharmaceutical products that contain DXM have other active ingredients, thus creating a possibly hazardous combination (for example, Acetaminophen (widely known as Paracetamol) and Chlorpheniramine Maleate).

•    The use of pharmaceutical products that contain active ingredients other than DXM should be prohibited because:
-    When taken in high doses, Acetaminophen (Paracetamol) could cause liver damages, liver insufficiency and even death. Many of the products whose active ingredient is DXM contain also Acetaminophen.
-    High doses of Chlorpheniramine Maleate may lead to such severe and even life-threatening symptoms as convulsions, loss of consciousness, bleeding from the skin, mouth and rectum, and even to death. Many of the DXM-containing products use also Chlorpheniramine Maleate.
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•    Do not use DXM if you take MAOIs (Monoamine oxidase inhibitors) or if you have taken such over the last two weeks. MAOIs are some kinds of antidepressants that are sold under prescription. Ayahuasca, also contains MAOIs (harmine and harmaline). The combination between DXM and MAOIs is hazardous since it may cause the so-called “serotonin syndrome” including fever, high blood pressure and arrhythmia.

•    Operating machines and driving should not be allowed after taking DXM.

•    Expectant mothers, too, should not take DXM since its dissociative compounds could severely affect the fetus’ brain development.
•    Taking DXM together with alcohol should be avoided.

•    Do not use DXM if you take or if you have taken SSRIs (Selective Serotonin Reuptake Inhibitors) over the last two weeks. SSRIs are some kinds of antidepressants sold on prescription. The combination between DXM and SSRIs, too, may cause the above-mentioned “serotonin syndrome” manifested by fever, high blood pressure and arrhythmia.

•    Nausea, vomiting, diarrhea and stomach spasms are among the common effects and may last for several days after the intake.

•    Itches and other skin reactions are also possible to occur.

•    The high quantity of glucose, thickening agents and other ingredients commonly used in cough suppressants burden the kidney and pancreatic functions.

•    Chronic or frequent use of DXM may lead to strong desire for experiencing again the same feeling or even to psychological dependency. Although that it is not the common case, some users take DXM everyday and can hardly quit.

•    Despite the scarce data on correlations between DXM usage and physiological dependency with abstinent syndromes, some users report for “hangovers” that last one to two weeks after they have quit. This may be referred to as light abstinent syndrome. However, there are no data proving that DXM causes life-threatening abstinent syndromes.

•    Chronic DXM usage leads to increased tolerance and thus higher doses are needed for the initial effect to be experienced again.

•     Some scientists assume that the use of DXM, as well as of other dissociative compounds, causes small brain holes. This syndrome is known as Olney’s Lesions. However, there are no enough researches to prove this assumption.

Information Source:  http://www.erowid.org/chemicals/dxm/dxm.shtml