Title:Dextromethorphan-Induced Altered Level of Consciousness in Children:
A Case Series
Volume: 18
Issue: 3
Author(s): Priyanka Pravinbhai Hotha, Rachna Gupta*Manish Narang
Affiliation:
- Department of Pharmacology, University College of Medical Sciences, Delhi, India
Keywords:
Adverse drug reaction, Altered level of consciousness, dextromethorphan, over the counter medicine, dose, euphoria.
Abstract:
Background: Dextromethorphan, an N-methyl-d-aspartate receptor antagonist, has been used as
cold and cough medication. Serious adverse events with therapeutic doses of dextromethorphan are rarely
observed. Here, we report three cases of altered levels of consciousness in children with a therapeutic dose
of dextromethorphan.
Case Presentation: In all three cases, children developed an altered level of consciousness after taking the
first dose of syrup dextromethorphan. Children were unresponsive to any verbal command and pain stimuli.
Medical history revealed no pre-existing comorbidities. Other systemic, cardiovascular, abdominal, respiratory
and nervous system examinations were normal. All patients were hospitalised and managed with
symptomatic and supportive care. Dextromethorphan was stopped. After adequate treatment, all of them
recovered satisfactorily. The causality assessment was done based on the World Health Organization Uppsala
Monitoring Centre causality scale, and it was probable/likely in all three cases.
Conclusion: In children, an altered level of consciousness could occur with therapeutic doses of dextromethorphan;
hence, health care professionals should prescribe dextromethorphan with extreme caution.
