SynthesisBritish journal of clinical pharmacology2010
Dextromethorphan, chlorphenamine and serotonin toxicity: case report and systematic literature review.
Synthesis in British journal of clinical pharmacology, 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
21 citing papers in PubMed, 1 synthesis or guideline pooled it, 56 citations in OpenAlex.
- Focus on Over-the-Counter Drugs' Misuse: A Systematic Review on Antihistamines, Cough Medicines, and Decongestants.Frontiers in psychiatry · 2021Pooled it
- Serotonergic Toxicity and Hyponatremia Associated with Antidepressant Therapy: The Pivotal Role of SIADH.Clinical drug investigation · 2026Review
- Rhabdomyolysis secondary to chlorpheniramine maleate toxicity: a case report.Frontiers in pharmacology · 2026Article
- The interplay between serotonin syndrome and syndrome of inappropriate antidiuresis: a fatal case of acute hyponatremia during treatment with duloxetine, chlorphenamine, amitriptyline, and L-tryptophan.Therapeutic advances in psychopharmacology · 2026Article
- Time Course of Serum Dextromethorphan Concentrations in a Case of Serotonin Syndrome After Massive Overdose.The American journal of case reports · 2025Article
- Histamine regulates the activity and the expression of the NaInflammation research : official journal of the European Histamine Research Society ... [et al.] · 2025Article
- Dextromethorphan Overdose with Refractory Status Epilepticus and Reversible Cranial Nerve Reflex Loss: A Case Report.The American journal of case reports · 2025Article
- Serotonin syndrome induced by Bromfed DM in a patient on sertraline.SAGE open medical case reports · 2025Article
- Overzealous over-the-counter cough syrup ingestion leading to serious manifestation in a child - A case report.Journal of family medicine and primary care · 2024Article
- Dextromethorphan moderates reward deficiency associated with central serotonin transporter availability in 3,4-methylenedioxy-methamphetamine-treated animals.Journal of the Chinese Medical Association : JCMA · 2024Article
- Multi-faceted Anti-obesity Effects of N-Methyl-D-Aspartate (NMDA) Receptor Modulators: Central-Peripheral Crosstalk.Journal of molecular neuroscience : MN · 2024Article
- High doses of dextromethorphan induced shock and convulsions in a 19-year-old female: A case report.World journal of clinical cases · 2023Article
- A Rare Presentation of Anticholinergic Toxicity in a Young Patient Due to Over-The-Counter Cold Medicines.Cureus · 2021Article
- Pharmacological Aspects of Over-the-Counter Opioid Drugs Misuse.Molecules (Basel, Switzerland) · 2020Review
- Management of severe arterial hypertension associated with serotonin syndrome: a case report analysis based on systematic review techniques.Therapeutic advances in psychopharmacology · 2019Article
- Opioid-induced inhibition of the human 5-HT and noradrenaline transporters in vitro: link to clinical reports of serotonin syndrome.British journal of pharmacology · 2018Article
- Therapeutic modification of arterial stiffness: An update and comprehensive review.World journal of cardiology · 2015Review
- Neuronal Dysregulation in Stroke-Associated Pseudobulbar Affect (PBA): Diagnostic Scales and Current Treatment Options.Journal of neurology & neurophysiology · 2015Article
- "Robo-tripping": dextromethorphan abuse and its anesthetic implications.Anesthesiology and pain medicine · 2014Article
- Serotonin Syndrome in a Sertraline-Treated Man Taking NyQuil Containing Dextromethorphan for Cold.The primary care companion for CNS disorders · 2012Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The aim of this review was to describe a patient with serotonin toxicity after an overdose of dextromethorphan and chlorphenamine and to perform a systematic literature review exploring whether dextromethorphan and chlorphenamine may be equally contributory in the development of serotonin toxicity in overdose. A Medline literature review was undertaken to identify cases of serotonin toxicity due to dextromethorphan and/or chlorphenamine. Case reports were included if they included information on the ingested dose or plasma concentrations of dextromethorphan and/or chlorphenamine, information about co-ingestions and detailed clinical information to evaluate for serotonin toxicity. Cases were reviewed by two toxicologists and serotonin toxicity, defined by the Hunter criteria, was diagnosed when appropriate. The literature was then reviewed to evaluate whether chlorphenamine may be a serotonergic agent. One hundred and fifty-five articles of dextromethorphan or chlorphenamine poisoning were identified. There were 23 case reports of dextromethorphan, of which 18 were excluded for lack of serotonin toxicity. No cases were identified in which serotonin toxicity could be solely attributed to chlorphenamine. This left six cases of dextrometorphane and/or chlorphenamine overdose, including our own, in which serotonin toxicity could be diagnosed based on the presented clinical information. In three of the six eligible cases dextromethorphan and chlorphenamine were the only overdosed drugs. There is substantial evidence from the literature that chlorphenamine is a similarly potent serotonin re-uptake inhibitor when compared with dextrometorphan. Chlorphenamine is a serotonergic medication and combinations of chlorphenamine and dextromethorphan may be dangerous in overdose due to an increased risk of serotonin toxicity.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.