Cough Cough

January 18, 2005 1:49 PM

Are there any dangerous effects to long-term heavy robotussin use? [MI]

A friend of mine lost her health insurance and was then unable to afford her antidepressants. She began taking Robitussin daily -- I'm not sure how much a day, but quite a bit -- and says it does the same thing as the antidepressants did. She's waiting for medicare to kick in so she can afford antidepressants again, but in the meantime, I am concerned. Is this dangerous?

posted by jennyjenny to health & fitness (22 comments total)

PUT SOME TUSSIN ON IT
posted by Steve_at_Linnwood at 1:52 PM on January 18, 2005

You could ask MC Chris, who raps about his robitussin addiction. (I realize this isn't very helpful, but someone had to post it.)
posted by goatdog at 1:54 PM on January 18, 2005

She should read up on Olney's Lesions (a.k.a. NMDA Antagonist Neurotoxicity), which are brain lesions caused (in rats, at least) by heavy usage of disassociatives such as DXM (the active ingredient in Robotussin), ketamine, and PCP.
posted by Asparagirl at 1:59 PM on January 18, 2005

And note this part from that file: IMPORTANT NOTE: Olney's lesions are WORSE in female animals than males, probably because females have different limbic connections. This may apply to humans.
posted by Asparagirl at 2:00 PM on January 18, 2005

Robotussin's active ingrediant is dextromethorphan (DXM), a disassociative that's often used for recreational purposes, sometimes called "robo-ing." Definitely pass along Erowid's page on dextromethorphan. According to thid document, disassociatives like DXM are addictive.
posted by arielmeadow at 2:02 PM on January 18, 2005

Your friend should read this immediately.

If she thinks Robitussin can help her depression, she is mistaken! She's getting stoned on DXM. (She might be feeling better because of a placebo effect, however.)

In addition, when taken in conjunction with antidepressants, dextromethorphan can cause serotonin syndrome.
posted by Specklet at 2:02 PM on January 18, 2005

I just "did" two spoons of Robitussin last night for a cough. This is serious stuff - not too far removed from some narcotics I have tried. I don't think I was imagining the slightly hallucinogenic/ opiate vibe.

I don't want to be too alarmist but I wouldn't recommend anyone takes this every day. It seems way too powerful. Or maybe I'm just a lightweight.
posted by skylar at 2:09 PM on January 18, 2005

Okay, yikes. Brain lesions?
posted by jennyjenny at 2:22 PM on January 18, 2005

jennyjenny, Olney's Lesions have never been witnessed in a human brain. Furthermore, the author of Asparagirl's article (William E. White) has posted a retraction to said article, as it was debunked.

The more you know!
posted by Jairus at 2:26 PM on January 18, 2005

I know this isn't answering your question, but are you sure your friend is using it for antidepressive purposes or is she fooling herself and/or you? Like others have said, DXM is not exactly a pick-me-up.

I'd be more worried about the potential kidney and liver damage it could cause when she goes on antidepressents. You say she's using it heavy, antidepressents with DXM is really, really bad. In fact, I hate to say it, it's probably better she'd be doping on opiates or weed -- at least as far as long-term health consequences are concerned.

Basically, no matter what the long-term consequences are, she needs to get off of it now so when she goes back to the antidepressents she doesn't die from any linguring DXM. I don't know the retention of DXM in habitual users, but my guess is she's not going to clean up for a few weeks before Prozac, but use both conqurently until she believes the prescribed medicine should start working. This is really, really dangerous.

I hate to be reactionary, as I have a mostly pro-drug stance, but some recreational drugs really are bad.
posted by geoff. at 2:29 PM on January 18, 2005

Yeah, I wouldn't fool around with Tussin. I knew a kid who used drink alot of Sizzurp (a bottle of Tussin mixed with Kool-Aid, I believe), and he's never been quite the same.
posted by SweetJesus at 2:36 PM on January 18, 2005

Perhaps she's onto something.

Compared to other OTC drugs, dextromethorphan has a relatively benign safety profile. Your friend may be exploring the fringes of medicine, but there is some solid science behind her experimentation. I'd still be concerned for her health--but a makeshift antidepressant is probably far better than none at all. As long as she's taking a reasonably low-level dose (~60 mg/day), I wouldn't worry too much. If she's pounding a whole bottle every day... that's a different story.

Mixing SSRIs and DXM is most certainly bad news, though.

on preview: SweetJesus, "szzurp" usually is referring to codeine cough syrup with promethazine, a narcotic. that's a whole different bag, yo.
posted by LimePi at 3:03 PM on January 18, 2005

I had a room mate and friend in college who would drink a bottle of robitussin before going out to drink. I am glad I had the better sense to not do that. Crazy.
posted by jasonspaceman at 3:45 PM on January 18, 2005

does said friend yearn to become a ninja warrior?

clarence... come to korea...
posted by mdpc98 at 4:04 PM on January 18, 2005

LimePi: Really? I could have sworn it was Robitussin, or whatever generic knock-off had the most DXM, mixed with koolaid. He used to try and trip out off the stuff.

Maybe he was fucking up the name, and didn't know what he was taking about, but he used to listen to a lot of Lil' Flip, so I assumed he knew what he was talking about ;-)
posted by SweetJesus at 4:06 PM on January 18, 2005

If your friend really can't pay for prescription, she should look into respected guides. Medline Plus (www.medlineplus.org) has some great information about living with mental illness, and about where to get treatment. Medicine is just one step.

I am not a pharmacist, pharmacologist, or even a good chemist, but self-medicating is a bad road to go down, even for doctors. The least she should do is look into clinical trials for holistic treatments. I know there are a few trials exploring the benefits of vitamin D, though once again, it's a good idea to research dosage carefully. exercise and good nutrition are very hard for many depressed people, but they too have been shown to be helpful. I hope her depression is manageable.

Has she tried looking into treatment at a nearby medical school? I have had a few un-insured friends who have received free treatment and therapy from residents and medical students under the guidance of licensed physicians.
posted by gesamtkunstwerk at 4:32 PM on January 18, 2005

antidepressants have a momentum effect, by which i mean it takes time for them to start and stop. hence she is probably feeling the residual effects of the antidepressants.

i would suggest that she contact her psychiatrist, explain the situation, and ask for some samples to tide her over. doctors generally have more drug samples than they know what to do with.
posted by hendrixson at 4:42 PM on January 18, 2005

Aaaaaaaaaaaagh!

I have to strongly strongly strongly recommend that your friend stop.

#1 - DXM is a dissociative, related to PCP. That shit will make you do strange things and just generally fuck up your brain.
#2 - I am not sure if it is addictive (I'll second checking out Erowid for more info), but it seems likely it could be. Once a tolerance is developed, chances of overdosing and having a quasi-psychotic episode are increased.
#3 - I had an acquaintance in middle school who used Robitussin heavily as a narcotic. He called it "Robo-tripping." Soon after he started, he ran away from home and was not heard from again until he was arrested for his involvement in the death of another boy. He is in jail now for second degree murder. I believe there were other factors that led to his breakdown, but the Robitussin played a big part.
posted by mai at 6:02 PM on January 18, 2005

DMT (what the "good" Robo is labeled: "Robotussin DMT") is NOT good for the brain. I have an old friend who lived in a squat in NYC and did a lot of Robo. Although now reformed, he is not in his right mind.
posted by maniactown at 7:30 PM on January 18, 2005

What actually is in szzurp is open to debate.
posted by sad_otter at 8:28 PM on January 18, 2005

Maniactown, I think perhaps you mean Robotussin-DM, which is a very different beast from DMT.
posted by arielmeadow at 9:42 PM on January 18, 2005

Thanks, all. I have since talked to her, and I should clarify. She's taking not more than 100 mg a day, an amount that doesn't get her high at all. Not that that will necessarily make side effects not happen, but it's not "heavy use."

Anybody here able to speak with any authority on the serotonigenic effect of this stuff? Limepi, where do you get the ~60 mg number from? I'm giving her the link to this conversation. Thanks, all.
posted by jennyjenny at 10:19 AM on January 19, 2005