Nagai Yasuhito, Tajima Yuko, Miyakawa Koichi
Department of Psychiatry Juntendo University Graduate School of Medicine Tokyo Japan.
Department of Psychiatry Juntendo University Urayasu Hospital Urayasu Japan.
PCN Rep. 2024 Oct 4;3(4):e70011. doi: 10.1002/pcn5.70011. eCollection 2024 Dec.
Dextromethorphan (DXM) is an over-the-counter drug that is commonly abused by teenagers. Its main pharmacological property is a low-affinity -methyl-d-aspartate (NMDA) receptor antagonist.
We report acute psychotic dissociation induced by DXM and alcohol in a patient with alcohol dependence, which made it difficult to distinguish alcohol withdrawal symptoms with limited information. The psychotic symptoms were ameliorated by haloperidol; however, in cases of DXM abuse, haloperidol treatment should be avoided.
In the consultation of patients with addiction, the possibility of various addictive drugs must be kept in mind. The concomitant use of DXM and alcohol causes easy dissociation and high-dose usage of DXM and alcohol withdrawal symptoms are difficult to distinguish.
右美沙芬（DXM）是一种非处方药，常被青少年滥用。其主要药理特性是一种低亲和力的N-甲基-D-天冬氨酸（NMDA）受体拮抗剂。
我们报告了1例酒精依赖患者因右美沙芬和酒精诱发急性精神病性分离，在信息有限的情况下难以区分酒精戒断症状。使用氟哌啶醇后精神病性症状得到改善；然而，在右美沙芬滥用的情况下，应避免使用氟哌啶醇治疗。
在对成瘾患者进行会诊时，必须考虑到各种成瘾药物的可能性。右美沙芬和酒精同时使用易导致分离，且右美沙芬高剂量使用及酒精戒断症状难以区分。
