Bad Combinations

**void**

DXM should never be taken while on medications such as MAOIs and SSRIs, this may interact with DXM to cause serotonin syndrome. This condition, although rarely fatal, is not terribly pleasant. Some of the symptoms of serotonin syndrome include muscle rigidity, confusion, diarrhea, incoordination, low-grade fever, sweating, muscle tremor, mania, agitation, exaggerated reflexes, and nausea. Some drugs to avoid taking while on DXM are:

• phentermine, fenfluramine, phen-fen (diet drugs)

• fluoxetine (Prozac®, an SSRI), tricyclics and lithium (antidepressants)

• terfenadine (SeldaneTM - prescription antihistamine), and possibly other non-drowsy antihistamines, such as ClaritinTM and HisminalTM (these can cause heart irregularities)

• antidepressants Desyrel (trazodone) & Serzone (nefazodone) (Possible liver damage)

• some SNRIs such as bupropion (WellbutrinTM) can give a prolonged (3+ day) hangover.

• also, cigarette smoke might be considered an MAOI, which may increase unwanted side-effects

• MDMA (extacy), while it isn't a MAOI, it should be avoided with DXM (possible heart problems, serotonin syndrome and saturation of the liver enzyme CYP2D6)

• opiates and cocaine can cause a fatal overdose when mixed with DXM.

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