This is a difficult question to answer, because DXM’s effects tend to vary
widely depending on the person, their set and setting, other drugs, their
physiology, and so on. DXM, probably more than most drugs, tends to exert
its (recreational) effects in separate stages or “plateaus”, rather than
being linearly dose-dependent. Within a given plateau, a given set of
effects will occur (at a roughly dose-dependent strength). On the other
hand, once the next plateau is reached, the feeling may change entirely. A
reasonable analogy is water - it exists in three states (solid, liquid, and
gas) which all can exist at varying temperatures (e.g., hot water and cold
water), but which have different characteristics.

DXM and its metabolite, dextrorphan (DXO), produce different sets of
effects. Normally, DXM is converted mostly or entirely into DXO, but with
recreational doses, the conversion enzyme (P450-2D6) may saturate, leaving
a mixture of DXM and DXO. Furthermore, another of DXM’s metabolites -
3-methoxymorphinan - can also block this enzyme, so that taking divided
doses leads to more DXM and less DXO than taking a combined dose of the
same amount.

DXM’s effects are in some ways much more subtle than DXO’s. Whereas DXO
produces a heavy “stoning” or intoxicating effect, DXM by itself is only
lightly intoxicating. DXM, however, can alter the thought processes,
leading to highly abnormal, psychosis-like mental states. It is possible
that DXM, via sigma activation, may induce a mental state similar to that
of schizophrenia. Whether or not this is fun to you is, of course, up to

DXM seems to exhibit at least four definable plateaus based solely on
dosage, and an additional plateau is notable from a specific dosing regimen
(see below, Section 5.9). I previously listed three plateaus; then four;
now I’m listing five (although “Plateau Sigma” doesn’t occur at dosages
higher than the fourth plateau). Evidently, dosages above the fourth
plateau lead to full anaesthesia, psychosis, coma, and/or death.

Not everyone notes distinction between the first and second plateaus, or
between the third and fourth plateaus. Others suggest that each effect of
DXM has a dosage level at which it starts, and (in some cases) a dosage
level at which its effects are no longer noticeable (being overpowered by
other effects). Some people will disagree with this classification method,
but I think this is the best way to represent DXM’s effects. Both the third
and fourth plateaus have significant dissociative characteristics, much
like ketamine.

The most important thing to keep in mind is that the effects in different
plateaus are often very different. For example, on the first plateau, DXM
tends to have a stimulant effect. Upon reaching the second plateau,
however, the stimulant effect may no longer be present.

The beginning of the comedown off of a DXM trip can come abruptly. Often,
the user will know when it’s starting to end by noticing the return of
normal sensory processing. Coming down from there may take a significant
amount of time. A second DXM trip too soon after coming down is not a good
idea due to the potential for side effects and psychotic episodes (227).
Wait at least three days and preferrably two weeks between each DXM trip.

The following table can be used as a general guideline for the plateaus.
For convenience I give example dosages in gelcaps and 3mg/ml syrup for 75kg
and 150lb adults; adjust up or down by the amounts indicated per 10kg or
25lb. Calculating with the mg/kg is more accurate, but it’s easy to make
mistakes when using non-metric measures. These dosages are as DXM

Dosage will vary considerably from person to person, by as much as 5 times!
Also, these mg/kg figures should evidently be adjusted down for higher mass
(e.g., maybe 6mg/kg to 13mg/kg third plateau for a 150kg adult). Note that
kg = pounds * 0.45.

I have included a new category in this table: “Usenet Suggestions”. This is
a combination of suggested dosage guidelines from Usenet, and may more
accurately represent the plateau dosage of DXM in regular users (the
original plateau levels were based mostly on occasional users).

Table 1: DXM Plateaus and Dosages

Plateau First Second Third Fourth
Dosage Range
(mg/kg) 1.5-2.5 mg/kg 2.5-7.5 mg/kg 7.5-15 mg/kg >15mg/kg
Usenet Suggestions
(mg/kg) 2.7 mg/kg 6.4 mg/kg 9.4 mg/kg 18mg/kg
Gelcaps (30mg) for 4 to 6 6 to 18 18 to 37
75kg adult gelcaps gelcaps gelcaps >37 gelcaps

Adjust per 10kg 1/2 to 1 1 to 2.5 2.5 to 5 5 gelcaps
gelcap gelcaps gelcaps
Gelcaps (30mg) for 3 to 5 5 to 17 17 to 34
150lb adult gelcaps gelcaps gelcaps >34 gelcaps

Adjust per 25lb 1/2 to 1 1 to 2.5 2.5 to 5.5 5.5 gelcaps
gelcaps gelcaps gelcaps
Syrup (3mg/ml) for
75kg adult 37 to 62 ml 62 to 187 ml 187 to 375 ml >375 ml
Adjust per 10kg 5 to 8 ml 8 to 25 ml 25 to 50 ml 50 ml
Syrup (3mg/ml) for 2 tbsp to 2 2 oz to 5.5 5.5 oz to 11
150lb adult oz (1/4 cup) oz (2/3 cup) oz (1 1/3 cup) >11oz

Adjust per 25lb 1 tsp to 2 2 tsp to 1 oz 2 tbsp to 2oz 2 oz
tsp (1/8 cup) (1/4 cup)

The specific effects at each plateau will be listed according to the
following categories: Sensory, Cognitive/Emotional, Motor, and Memory.
Additionally, the lower two plateaus are considered together, as are the
upper two plateaus.

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