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DXM (dextromethorphan) is a cough suppressant used in over-the-counter cough medicines. In high quantities, DXM acts as a dissociative hallucinogen (trippy drug) giving effects similar to, but not the same as, ketamine.
In increased doses DXM can cause increased empathy and energy, altered visual perceptions, loss of balance, euphoria, chattiness, feelings of increased strength and slowed breathing. Other effects can include confusion, hallucinations, sweating, dilated pupils, nausea, vomiting, restlessness, itchy skin and blackouts.
There is evidence that the risk of serotonin syndrome is greatly increased if you are on anti-depressants and take DXM. DXM also interacts with grapefruit and many citrus fruits and this combination should be avoided to reduce risk. Mixing with alcohol can make you more likely to be sick and poses a great risk of slowed breathing or suddenly becoming unconsious - this is considered a highly risky combination.
Pure DXM is measured in milligrams (mg) and a small dose is considered to be 100 mg. The risk increases with higher doses and this dose should not be taken as a recommendation. The effects of DXM are also dose-specific meaning different doses create different effects. A small amount might make you giggly while increased amounts will make you hallucinate, 'dissociate' or blackout.
The effects can take 20 minutes to one hour to kick in and high doses can take longer. A dose will normally last four hours with high doses lasting up to six hours.
If you choose to take DXM
Avoid mixing DXM and other drugs (including many psychedelics, alcohol, anti-depressants and MDMA which are considered risky combinations)
Effects are dose specific and will depend on your body type and size
Avoid taking high doses of over the counter medicines that contain DXM plus other active ingredients. Some only contain DXM and so may be less risky
Start with a small dose
Take in a safe environment as you may lose balance, co-ordination and vision
DXM is not controlled in the UK but is listed as a pharmacy only medication