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[[File:Romilarad.jpg|thumb|left|200px|Romilar 1968 Ad]]


== About DXM ==
'''Dextromethorphan''' (also known as 'DXM', 'DM' or 'robo') is an over-the-counter antitussive (cough medicine) which, when taken at doses exceeding the recommended therapeutic range, becomes a powerful [[Dissociatives|dissociative]] drug with psychedelic properties.


DXM is a dissociative drug with psychedelic properties.  
While DXM can be used safely it is not an inherently safe drug. Repeated use within a short period of time, combination with certain types of drugs, certain genetic factors and the prevalence of other active ingredients which become harmful at doses needed for disassociation make for a drug which must be used with caution.


DXM is not for everyone; it is said it follows the rule of thirds: one third hates it, one third doesnt care, and one third like it.
The high is not for everyone; it is said to loosely follow the rule of thirds: one third hates it, one third doesn't care, and one third like it. It should not be underestimated as a hallucinogenic, at higher dosages it mimics high doses of ketamine but with more psychedelic properties.  


The lower doses are fun to do with friends, especially just chilling out and listening to music and talking.
DXM manifests its effects in a series of plateaus, with dose determining which plateau (and consequently which effects) one will experience. Lower dose plateaus can be well suited to relaxation, light social interaction and listening to music, while higher doses result in a more encompassing dissociative experience which does not lend itself to attentive social attention. At high doses it's common to have strong hallucinations, experiences of detachment, depersonalisation, and out-of-body experiences. These all-encompassing states can be startling and uncomfortable for some.


High doses are very psychedellic and powerful.
Its mechanisms of action are multiple, including action as a nonselective serotonin reuptake inhibitor and a sigma-1 receptor agonist. DXM and it's major metabolite, dextrorphan, also acts as an NMDA receptor antagonist at high doses, which produces effects similar to, yet distinct from, the dissociative states caused by other dissociative anaesthetics such as [[Ketamine]] and [[PCP]].


Your mind is just as big as the universe, and encountering that space when you're unprepared for it is startling to some.
DXM does not typically show up in normal drug tests, however it can produce false positive results for PCP and/or opioids in extended or specialized drug tests. Occasional use should not produce these false-positive results after a couple days have passed.


DXM does not show up under normal drug tests; However, in extended drug tests it does show a false-positive for PCP (personal experience actually).
== History ==


Generally it's out of your system in a day or two.
The racemic parent compound racemorphan was first described in a Swiss and US patent application from Hoffmann-La Roche in 1946 and 1947, respectively; a patent was granted in 1950. A resolution of the two isomers of racemorphan with tartaric acid was published in 1952, and DXM was successfully tested in 1954 as part of US Navy and CIA-funded research on nonaddictive substitutes for codeine.  


The FDA approved DXM in 1958 after research supported its legitimacy and effectiveness as a cough suppressant. After its approval, it was introduced as an OTC medication under the name Romilar, which was introduced as a replacement for codeine containing cough remedies in an effort to cut down on abuse. In early 1960s Beat poets Allen Ginsberg and Peter Orlovsky, musicians such as Daevid Allen Soft Machine, and alternative authors such as Jack Kerouac known to have used DXM in the form of Romilar.  In 1973, Romilar was taken off the shelves after a burst in sales because of frequent misuse, and was replaced by cough syrup in an attempt to cut down on abuse. In 1975, the popularity and extensive abuse of DXM was recognized, and Romilar was removed from the OTC market. However, DXM was specifically excluded from the Controlled Substances Act (CSA) of 1970, therefore, it was still legal to produce and use.
A few years after its removal from OTC, companies began introducing refined DXM products (e.g., Robitussin, Vicks-44, Dextrotussion) that were designed to limit recreational use by creating an unpleasant taste if consumed in large quantities. Within a short time those same manufactures began to produce forms of DXM with "some appealing flavoring," which led at least one researcher to suggest that the cycle of recreational abuse may be repeated. In 1996, DXM HBr powder could be purchased in bulk from online retailers, allowing users to avoid consuming DXM in syrup preparations.


== Different Forms ==
== Different Forms ==


Different Forms
DXM is widely available in over-the-counter cough treatments which appear in different forms including gelcaps, lozenges and syrups. DXM is also less commonly found in a more pure powder form, either extracted or bought directly from a chemical manufacturer.
Extracted
 
Your best best is to do an extraction, but that takes time/effort that most people arent willing to do. It's super easy though so its worth taking a look into Agent Lemon extraction.
While there are some products available which contain only DXM as active medical ingredients it is common to find products which contain DXM but also contain enough of another active ingredient to pose a serious risk to the user's health.
Online vendor
 
You're on your own for this. Send me a PM if you find one ;)
=== Pure/Extractions ===
Syrup
 
The syrup is very downer-ish. I feel sluggish while on it, but it gives a more 'solid' trip.
The ideal source of DXM would be the purest. The safest way to use dxm is with pure powder (and at least 5-10ml propylene glycol to aid digestion) or an extraction. However, for most this form will prove impractical due to obtaining the pure powder.
Gell Caps
 
The cough gells are amazing. Its very much a clear-headed feeling.
Extractions from OTC sources requires time and a chemical procedure which most people are not equipped to do safely. If you are properly equipped, there is some detailed information on this page: https://erowid.org/chemicals/dxm/faq/dxm_chemistry.shtml
CCC*
 
There's also the corcedin cough and cold pills (triple c's). These things are really small but contain 30mg per pill. Most of the corcedin comes with other additives that mess with your heart rate or give you a high dose of antihistame. As always, make sure the only active ingredient is DXM.
===Gel Caps===
Delsym
 
Delsym is another product which contains Dextromethorphan Polistrex.
DXM Gelcaps such as Robitussin Gelcaps or other products containing only DXM encased in a gelcap are often the preferred source for DXM users. For most users, gelcaps which contain only DXM produce a more clear headed high in lower doses (slower digestion, see . Most users experience fewer side effects from gelcaps than from syrup, however some users report an upset stomach, indicating that some users may have a sensitivity to the edible plastics used to make the gelcaps.
This is an analoge of DXM that is much more mild, gives a gentler trip and it's a slow release (read: longer trip), but it is IMPOSSIBLE to get to the third on it, which is good for begininers.
 
if you're looking for a mildly psychedellic trip to get introduced to DXM and dissociatives, then try Delsym.
Some brands such as '''Cordicin Cough and Cold''' (also known as '''CCC''') have a variety of products, most of which contain other active ingredients such as antihistamines or CPM (Chlorpheniramine Maleate) and may have one or two products which contain only DXM.
Lozenges
 
No personal exprience.
'''WARNING''': Cordicin Cough & Cold is one of the most commonly used sources of DXM, and also one of the most dangerous. Nearly every single CCC product contains other active ingredients such as CPM, which can cause severe and life-threatening symptoms including seizures, shortness of breath or troubled breathing, weakness, loss of consciousness, severe dryness of the mouth, nose or throat, bleeding from the skin, mouth, eyes, rectum and vagina, and possibly death. CCC also is additionally  harmful to your kidneys, liver and heart. Avoid it.
 
===Lozenges===
 
There are also sore-throat and cough medications containing DXM which exist in the form of a hard-candy like lozenge. These sometimes contain only DXM, however most brands of DXM lozenges also contain analgesics such as acetaminophen or benzocaine.  
 
Always choose a product which only has Dextromethorphan in the active ingredients!
 
=== Syrup ===
 
Cough syrup is the most common source for DXM users. While there are many brand name and no-name syrups which only contain DXM as an active ingredient there are many active and "inactive" ingredients commonly found in cough syrups which can cause negative effects ranging in severity. See [[DXM#Adulteration|Adulteration]] for more information.
 
Some have reported the high produced from syrup is mostly sedating. You may feel sluggish when using it to get high on DXM, possibly as a result of other ingredients found in syrup however because of the even dispersion of DXM throughout the syrup it is said to produce a more 'solid' trip.
 
===Delsym===
 
Delsym is brand with many formulations which contain Dextromethorphan Polistrex.
 
This is an extended release form of DXM which produces a longer lasting trip with weaker, more physical effects. It is somewhat more difficult to reach the third plateau using polistrex preparations, which may be preferable to beginners or users who would prefer these effects. Since it is an extended release dxm product, this means your enzyme is more able to keep up with the conversion of DXM to DXO, meaning more of a body high and less of the psychedelic DXM high. It is for this reason why it is difficult to reach 3rd plateau with polistrex. Generally, a 3rd plateau experience has a Higher percentage of DXM than DXO.
 
See Dosage information below
 
== Dosage ==
 
The dosage below refers to an "average" 180lbs / 80kg person taking DXM HBR. Before dosing it's important to note a few things:
 
* HBR and Polistirex doses vary significantly due to polistirex slow absorbsion rate.
**Dextromethorphan Polistrex, being extended release, means that your enzyme is more able to convert dxm into dxo. DXO being a more physical, less trippy drug, leads to this preparation of dxm feeling much less intense, and in many cases, very subtle. It is therefor recommended by some to predose with grapefruit juice to fully enjoy polistrex because it slows down the conversion of dxm to dxo, effectively making polistrex "more trippy" because of a higher amount of dxm that didn't get converted. <u>It should be noted that inhibiting digestive enzymes with grapefruit juice is risky and can interact with several medications and drugs and not be taken lightly.</u> For more information look up "CYP3A4 Inhibition drug interactions".
 
* '''DXM doses are affected by weight'''. For more accurate dosage information, see the following resources:
 
* For a graphical chart of the dosage ranges [http://taimapedia.org/images/4/46/DXMDosingChart.png this chart] is helpful.
 
* For an easy calculator that does the math for you, [http://dxm.tripsit.me this page] can be helpful.
 
'''Before dosing, be sure to read the Plateaus section to know which level you want to dose for.'''
 
{| class="wikitable"
 
|+ Plateau range dosage for a 80kg (180lb) person.
 
|-
 
| First || 122-200mg
 
|-
 
| Second || 200-600mg
 
|-
 
| Third || 600-1200mg
 
|-
 
| Fourth || 1200-1600mg
 
|-
 
| Risk of death || 2.2g+
 
|}
 
== Duration ==
 
{| class="wikitable"
 
|+ Oral HBR
 
|-
 
| High of 6-8 hours || Afterglow effect of 8-16 hours after dose, depending on dose
 
|}
 
{| class="wikitable"
 
|+ Oral Polistirex
 
|-
 
| High of 8-12 hours || Afterglow effect of 16-36 hours after dose, depending on dose
 
|}
 
=== Redosing ===
 
Redosing is not advised because of potential risk of risk of sigma. For more information, see [[DXM#Plateau Sigma|Plateau Sigma]]
 
It's better to know how much you've taken at the start of the trip, rather than guesstimate how much you're on as you keep dosing. The effects will start to come in waves and may not be pleasant. If you feel the need, it's recommended to take a high initial dose and a lower dose 1-2 hours in. As the duration of the trip is extended with dose boosting or redosing, the dysphoric aspects of the experience increase, until eventually most people report feeling like the walking dead. Not to mention by extending the duration of the trip you are increasing the chance for adverse effects and brain damage.
 
=== Predosing ===
 
Grapefruit juice effects dxm due to interactions with cytochrome P450-2D6. Essentially, it inhibits the enzyme that converts dxm to dxo, making a higher DXM:DXO ratio, meaning a higher, more psychedelic high, and less of a body high. With 1st and 2nd plateau, it can make it much more "trippy" and less of a physical high.<ref>http://medicine.iupui.edu/clinpharm/ddis/2d6references/#dextromethorphanSub</ref> <ref>https://en.wikipedia.org/wiki/CYP2D6</ref>
 
In order to properly predose, drink around 16oz (500mL) of grapefruit juice 1-2 hours prior to the point where you dose the dxm itself.
 
== Effects ==
 
As previously stated, the effects of this drug vary wildly from plateau to plateau, this list is in general from ALL plateaus.
 
=== Positive ===
 
* Euphoria, mood lift
 
* Increased giggling and laughing
 
* Dissociation of mind from body (positive when sought)
 
* Creative dream-like experiences
 
* Increased tactile sensation
 
* Some users report empathy and forgiveness towards other people
 
=== Neutral ===
 
* Pupil dilation
 
* Visual stop motion effect (flanging or strobing)
 
* Visual and aural (auditory) hallucinations
 
* Decreased sexual functioning (difficulty achieving orgasm)
 
* Confusion, disorientation
 
* Skin sensitivity, alters tactile (touch) and skin sensations
 
* Robotic, zombie-like walking, "robo-walk"
 
* Dis-coordination, reduced agility
 
* Loss of appetite
 
* Involuntary flexing of muscles
 
* Feelings of merging with adjacent objects like a couch or bed (with higher doses)
 
* Some users report feeling disconnected, isolated from others, (positive when sought)
 
=== Negative ===


* Vomiting


== After Effects ==
* Dizziness


It can be psychologically addictive, but only in extreme cases.
* Body itching
I did a lot and was able to quit when i wanted to.
There's a good chance you wont like it though, just because dissociation are a mental adventure not physical.
Health wise, DXM is very safe.
The only possible side effect is something called Olneys Lesions (which is essentially brain damage).
This only occurs after very heavy usage very frequently, and its NOT EVEN PROVEN to be related to DXM.
I advise against doing it every day.
I got into that habit and it's a slippery slope.
I wouldnt say i was addicted, but i had a huge compulsion to do it.
It was more like i was on the brink of a huge discovery and needed to finish the thought before it slipped away.
Habbitual abuse has the potential to lead to Olney's Lesions.
Although the evidence is spotty, its possible.
These lesions are pretty much dead spots in your brain that come from heavy dissociation use.
DXM itself is very not-dangerous, but we dont have nearly enough research into recreational drugs to say that it's 100% safe.
The problems with your jaw should go away with time.
Muscle stiffness is also a problem with serotonin syndrome.
Dude, the day after is the best thing ever.
It's like its a brand new world.
Sadly that goes away in time, but ill never forget it.


* Rash, red blotchy skin (similar to a niacin rush)


== Psychedelics VS dissociatives VS deliriants ==
* Diarrhea


There are mainly three types of hallucinogens: psychedelics, dissociatives, and deliriants.
* Fever
Psychedelics like psybocillin and LSD will expand your awareness of your surroundings and change your perspective on reality.
Dissociatives like DXM, PCP and Ketamine remove you from your surroundings to expand your consciousness.
Deliriants have their time and place but i dont recommend them.
A lot of drugs share the same attributes and things aren't nearly black and white as im making them seem to be, but this is for simplicity.
In short: Psychedelics = external. Dissociation = internal.


* Tachycardia (racing, pounding heart)


== Tripping ==
=== After-Effects ===


There are two kinds of trip: sub third and beyond second.
The after-effects of DXM are referred to as the afterglow.  
If you take a first or second plateau dose, it's totally possible to socialize.
Lower plateau doses are reletivally easy to hide compared with higher plat doses.
Since youre a dissociating yourself, you can remove yourself from awkward social situations or chaotic events.
It would also be fun to chill in your room and play a video game and listen to music.
The music will get better and you'll get more spacey.
If you take a third or fourth plateau dose, i recommend doing tripping alone.
It's not a social drug at the third plateau.
The best way to enjoy it is to lay back and listen to music with your eyes closed.
If you've ever meditated, you know how your mind can wander without your control.
On DXM, you have a tendancy to 'unlock' hidden memories.
So really the best thing is to let your mind take you where it wants to go.
It usually knows whats best.


The afterglow is almost non-existent on the First Plateau.


== Advanced/third ==
For a Second Plateau dose, the afterglow can be quite pleasurable, although some feel depressed/hungover afterwards for up to 14-16 hours after the initial dose. Expect to feel lazy and fairly tired the next day, easily remediable with caffeine and/or nootropics.


In my experience, animals love it when im on dxm.
For a Third Plateau dose, the afterglow may additionally add a headache, feel more like an alcohol hangover, and almost like a 1st plateau trip for most of the day after. The effects of this may last for up to 16-20 hours, with some people feeling the "brain-dead", tired and lazy effects up to 72 hours! The tired and "brain-dead" effects can be remedied with caffeine and/or nootropics.
It's hard to explain, but my pets gather around me and we chitchat.
When you look at a drawing, you could say that it's a shadow of a 3D object.
There is something 'behind' the object that you see, and if you have the right tools you can see what it is.
For example, someone looks at your shadow and can know that it's just a projection of what you really look like.
Reality is a shadow of something bigger.
Everything we come into contact with and experience is just the face of a massive being.
Nothing in reality is actually there: it's an image of the idea of what that thing is.
IE: The sandwich your about to eat is just a representation of the idea of nurisment.
Humans are projections of higher beings who choose to visit 3D.
When we 'die' on earth, it's just getting rid of a shell.
Our consciousness is tied to something much larger and uncomprehendable.
It's like a biological internet.
We are all connected to eachother and pass information to eachother without knowing it.
When i got to the third, i disconnected from my body.
The little voice in your mind that's aware that you're alive and need to keep breathing in order to live stopped talking.
Once i was able to let go, i became god.
It's hard to describe, but it felt like i was apart of a family who was happy to see me again.
I could create universes, worlds, anything.
Reality doesnt mean much to me anymore.
I'm convinced im here to watch the show.
The show is the world.
I know it's all going to the shitter, and im fine with it, because it's going to be entertaining.
I chose to experience this portion of history for a reason.


For a Fourth Plateau dose, don't plan anything for the day after, because you will be very "out of it" for a good 24-32 hours after dosing, with some people feeling the sedation/"brain-dead"/lazy effects up to 72 hours!. Definitely plan a Fourth Plateau dose at least a good 2 days away from social events, work, school, ect. (IE, do it Friday night/Saturday Morning if you have to work Monday). Eating becomes a difficult task during a Fourth Plateau afterglow. The best things to eat during this period are soft foods like yogurt, mashed potatoes, soups, and nutritional milkshakes like SlimFast or ENU Total Nutrition Meal Replacement Shakes. This afterglow may be fairly painful like an alcohol hangover, but can be slightly remedied with Ibuprofen/Acetaminophen, a multivitamin and the aforementioned supplements/food, caffeine and/or nootropics. . You will also appear to be extremely high from an outward appearance. Expect to feel very tired, lethargic and "brain-dead" for up to 72 hours.


== Interactions ==
=== Robo-Walk ===


Are you on any medication, especially SSRI's?
The robo-walk feels like all of the muscles in your body are activated at once and while strange to the observer is not painful to the user. You can still walk but detailed coordination such as running, jumping, or maneuvering around furniture becomes much harder if not impossible. However, when you you start getting the effects of robo-walk, you really wouldn't want to be moving around anyway. The best thing to do is get a good pair of headphones, turn off the lights, close your eyes and let your mind wander.
Anti-depression meds interact with DXM in a not-so-good way.
DXM effects the serotonin receptors, and have the potential to give you something called Serotonin Syndrome.
Basically this means that you have a shit-ton more serotonin in your system than you should.
It causes you to feel uncomfortable, wired, irritable, and worst of all: you can't sleep.
Most commonly, SS can only be treated with time. If you've mixed chems, then it can be potentially life threatening as serotonin is responsible for a lot of bodily functions you wouldnt normally think (digestion).
If you're taking any anti-depressant or otherwise psychoative medicine, then please be careful or do NOT take DXM at all.
Guaif will make you want to die, and acetominophen will make you die.


It's similar to being overly aware that you are walking incorrectly and overcompensating because of it. Not much you can do about it except to minimize your walking by having everything ready before you start (food, water, triptoys, grapefruit juice, dxm in whatever preparation, ect).


== Plateaus ==
== Plateaus ==


There are various 'stages' to DXM trips called ''plateaus''. Traditionally, there are only four plateaus that someone should try to aim for. All of them share general feelings of dissociation, but the strength and effects of these feelings are more pronounced in the later two plateaus.
The first two plateaus are commonly associated with a mix of being high on THC and drunk on alcohol. If you take a First Plateau dose, it's totally possible to socialize. At second, it becomes harder, but not impossible. Lower plateau doses are relatively easy to hide compared to higher plateau doses and talking with others becomes a lot easier while under the influence of DXM. It would also be fun to chill in your room alone and do whatever you normally do for fun, but it's suggested to try something that will take up most of your attention but allow your mind to wander at the same time. Something like playing a casual video game, or drawing whatever comes to mind.
If you take a Third or Fourth plateau dose, it is recommend to trip alone or with a close friend, as it is not a social drug at this dose. The best way to enjoy it is to lay back and listen to music with your eyes closed.
Choosing your destination plateau will depend a lot on what other drugs you've done and how comfortable you are with your own mind. People who have never tried any hallucinogen other than marijuana and/or alcohol should start with a First Plateau dose, while people with mushrooms or [[LSD]] experience could start at a Second Plateau dose. '''It is not advised to start at the Third or Fourth plateau''' unless you have extensive experience with other dissociatives.
=== First Plateau ===
The First Plateau is the lightest in effect. It feels a bit 'off', and is often likened to something of a cross between the effects of [[MDA]] and Alcohol. First plateau is usually slightly stimulating. The First plateau has also been described as "basically like a hit or two of good weed and 2-3 beers with 10 minutes of a 'trip' about 2 hours in."
Effects commonly experienced at the first plateau level
* A shift in thinking perspective; things look and feel 'different'
* Increased tactile sensation
* Increased appreciation of music
* Feeling heavy, sensation of increased body weight
* Enhanced emotional response & sensitivity
* Some dizziness or vertigo
'''First Plateau dose: 1.5-2.5mg/kg.'''


**NOTE: I AM LOOKING FOR MORE INPUT IN THIS SECTION. i would love to hear your input on what the different plats feel like.**
=== Second Plateau ===


Choosing your destination plateau will depend a lot on what other drugs you've done and how comfortable you are with your mind.  
This plateau is a bit more intense. You may feel like you are stoned and movement may become difficult. The second plateau can be fun yet disorienting. Music sounds much deeper, clearer, almost like you are there at the concert. Walking/Moving your body becomes slightly difficult at this point. Some may experience some closed eye visuals at this point. You can socialize with ''close'' friends and you could say you're slightly drunk. A slight warning, DXM is almost like a truth serum and you may share embarrassing or "secret" things you wouldn't normally share. You may start to get a bit of disassociation, and the high starts to get somewhat intense in the second plateau.  


DXM’s potency is based off of how many mg you take, per your body weight in kilograms (mg/kg).  
'''Second Plateau dose: 2.5-7.5mg/kg.'''


For example: Joe's mass is 100 kilograms. He wants to hit the second plateau (2.5mg/kg to 7.5mg/kg). Therefore, Joe has to ingest 250 to 750mg of DXM. Sally's mass is half of Joe's (50kg), so it would only take her 175 to 375mg of DXM to get to the same plateau.
'''Transitional'''


There are four 'stages' to DXM trips called plateaus.  
Most people stop their DXM journey here, as the higher two plateaus are not really '''fun''' but ''introspective'' and ''enlightening''. We don't recommend crossing this threshold until you're ready to move on from a lighter, happier experience to a sometimes darker and definitely more introspective full blown trip. Enjoy the 2nd plateau as long as you can because it's more of a fun experience and one tends to enjoy second plateau less after visiting the third plateau. "Once you see what's behind the curtain, you can't enjoy the show" so they say.


The first two are very similar, and the last two are similar.  
Additionally, approximate at 7.5mg/kg there is an elusive "Eiffel Tower" dose where you may experience the effects of both the Second and Third plateaus in waves.


=== Third Plateau ===


**First Plateau**
Third Plateau is a full on dissociative experience. At this point it is no longer a social drug and should be done alone or with a tripsitter. The third plateau is considerably more sedating and movement becomes a bit harder. Closed eye visuals are more prominent at this level. You will lose track of time quit easily as it becomes meaningless quite quickly. Large amounts of dissociation happens at this level, and the internal thoughts can be quite interesting. To explain further, you may start to feel like you don't belong in your own body, or that your mind and body are two separate beings. Additionally, thoughts may be similar to "My body is only what everyone else sees but not really me, because I am just my mind, not my body."


Feels a bit 'off'. Perhaps like you're a bit buzzed from alcohol or a big hit off a bong.
There is a little bit of post-trip amnesia starting at 3rd Plateau. As stated previously, 3rd Plateau is quite intense. It's not the full comatose stage that the 4th Plateau is, but it can be pretty overwhelming nonetheless.


**Second Plateau**
'''Third Plateau dose:  7.5-15 mg/kg.'''


You feel like your stoned.
=== Fourth Plateau ===


Your consciousness feels like it's distancing itself from reality, like it's taking a 'step back' into yourself.  
This is the deep meditative state. This is most akin to a "k-hole" that people experience after taking large amounts of ketamine. Few people enjoy going this far, as all one can really do (or really wants to do) is sit, listen to music, close your eyes, and experience a full blown dissociative trip. You can create universes in your mind just by thinking of them. DXM users have been known to have extremely vivid, controllable hallucinations and out of body experiences at this level.  Full blown disassociation from everything and full on ego death is very common at this level. Other very common hallucinations at this level are people visiting aliens, meeting god (sometimes the two being the same entity) and becoming god.
One explanation of the fourth plateau "It's kind of like the top of your skull pops off and all the knowledge of the universe is poured into your head, but by the end of the trip it's all seeped out again and you are left with the realization that you really don't much of anything at all."
Another explanation is : "A total detachment from the body. The ego is pulled inside. Everything is very distant. Walking, talking, moving is not possible. Thinking is however. Left free to observe the self from a dark quiet immobility. A strange taste in the mouth. Like the numb of the dentist in every tissue. Loss of emotion, loss of anything earthly. "


The second is supposed to be fun, it's introducing you to the idea that reality is a dream.  
It is quite difficult to recall these very powerful hallucinations as post-trip amnesia is very common.  


Music is awesome to listen to and you can walk outside and perhaps hallucinate a small-mild amount.
'''Fourth Plateau dose: 15mg/kg-20mg/kg. Higher is possible, but not advised, because risk of death around 25mg/kg, but varies slightly from person to person'''


You can socialize with friends and they might take you for sober, or you could say you're slightly drunk.
=== Plateau Sigma ===


There is another level that DXM can take you to, but it is not higher in dosage than 4th plateau, it is more of an extension of 2nd and 3rd plateaus. In order to get to this state, you must binge. For this reason '''WE HIGHLY RECOMMEND AGAINST IT!''' For example, a user has said "I took a 3rd plateau dose, then when it was starting to wear off, I took a 2nd plateau dose, when that was finally coming down, I took a 3rd plateau dose again, and when that came down, I did ANOTHER 2nd plateau dose. When that final dose hit, I was stuck in Plateau Sigma."


Many people refer to this level as "plateau sigma" because when you get to this state, your sigma receptors are hit on, and HARD. This completely changes the trip. This mind state is generally referred to as dysphoric, dark, confusing and "a hellish introspective nightmare". As one user put it "it's a dark and confusing dream-like state where everything you think you know is insanely hard to grasp while all of your wildest, most bizarre fantasies are merely common, boring every day events that feel as normal as waking up and drinking coffee."


**Hold on!**
As with 4th plateau, it's hard to describe as amnesia is quite common and information about this state is quite rare as it is. That being said, this state has VERY RARELY been reported as being pleasurable '''AT ALL'''.  Most people describe it as dark and confusing, like a living nightmare.


Most people stop their DXM journey here, as the final two are not really 'fun' but 'enlightening'.  
For more information, the William White FAQ has a section on Plateau Sigma at [https://www.erowid.org/chemicals/dxm/faq/dxm_experience.shtml#toc.5.9 This Page]


I dont recommend crossing this threshold until you're ready to move on from games of the mind to excersizes of the consciousness.
== Harm Reduction ==


Enjoy the 2nd plat as long as you can because right now it's more of a fun experience and there is no going back once youve been here.
There is only three '''MAJOR''' rules about dxm use, and they are as follows :


It's like once you see what's behind the curtain, you cant enjoy the show.  
*'''NEVER''' use any preparation of DXM that has '''ANY''' other active ingredients, as they can make you sick and/or dead. See [[DXM#Adulteration|Adulteration]]
*Keep in mind this general rule of thumb for DXM : 1 plateau/week.
**In other words, If you take a Third Plateau Dose, wait 3 weeks before using again. If you use a Second Plateau dose, wait 2 weeks before using again.
*Watch out what you are mixing DXM with, as mixing with certain drugs can cause serotonin syndrome, or Ataxia, see [[DXM#Interactions|Interactions]]


Not to say that its not enjoyable, but it looses it's fun charm.
See [[Dissociatives#Harm_Reduction|Dissociative Harm Reduction]] for general information.


**Robowalk**
=== Adulteration ===


You get something called the robo-walk, cuz you walk like a robot.
Many products which contain DXM also contain other medication or otherwise non-medically-active ingredients that can cause serious harm in the doses found in DXM containing products. If a user intends to use an OTC cough medication in order to get high on DXM they almost always will have to consume a dangerous quantity of other dangerous ingredients if they are present in the medication. For this reason it is strongly recommended to find a source which contains '''''DXM''''' as the '''ONLY''' ''active'' ingredient


It feels like all of the muscles in your body are activated at once.


You can still walk but forget about running or balance.  
The following is a summary of other ingredients commonly found in DXM products.  


Imagine the large muscles in your body all tensing up at once, so to walk you dont try to move your leg, you try and relax it in the way you want to go.  
{| class="wikitable"
|+ Adulterant Table
|-
| Name
| Description
| Common Brands
| Danger
|-
| Acetaminophen/Paracetamol/APAP
| a painkiller found in headache/flu medicine
| Tylenol, Vicks (NyQuil), TheraFlu, Triaminic
| APAP is Hepatoxic in high doses. This means it will damage your liver if taken in high doses. Your body can only process a certain amount of APAP at once before it the normal pathways become saturated. Once the regular pathways used for metabolizing APAP have been saturated, the remaining APAP gets broken down in the liver by an enzyme called ''cytochrome P450'' '''When forced to break down APAP this enzyme produces toxic metabolites!'''
|-
| Guaifenesin
| Guaifenesin is an expectorant.
| Robitussin DM, Mucinex, Robefen
| Guaifenesin overdoses cause severe nausea and vomiting in most users. Guaifenesin can also cause kidney stones with chronic use.<ref>https://pubmed.ncbi.nlm.nih.gov/15673990/</ref>
|-
| Antihistamines
| Found in Allergy/Sleep/Nighttime medications
| Coricidin Cough and Cold, Zicam, Dimetapp, Chloraseptic
| When taken in high doses antihistamines can cause dizzyness, nausea, a strong dysphoria, paranoia, delirium and hallucinations. Many antihistamines can also have a dangerous synergy with DXM which can lead to liver, kidney and heart complications.
|-
| PPA, pseudoephedrine, and phenyleprine
| Decongestant agents
| Sudafed, Vescadril, Curedex, Watkins, Hardex
| Vasoconstriction (constriction of blood vessels) and decreased nasal secretions , and ''with larger doses'' insomnia, hypertension, heart rhythm abnormalities, hemorrhaging, stroke, or death. Note that these are extreme reactions, and that individual tolerance to sympathomimetics tends to vary considerably. Tolerance can build quickly, and a fatal dose for one person may have only a mild effect on another person.
|}
{| class="wikitable"
|+ Inactive Ingredients Adulterant Table
|-
| Name
| Description
| Common Brands
| Danger
|-
| Food Coloring/Dyes
| Dyes added for color
| Almost ALL brands except Zarbee's Naturals and Chestal Naturals
| Usually these dyes are not harmful in low doses however in doses which may be required for DXM's effects they can become problematic. '''Tartrazine (FD&C Yellow #5)''' is one of the most notable coloring ingredients to cause reactions. Not necessarily dangerous unless you are allergic to certain dyes. Check out the ingredients list if you are.
|-
| Glucose, sucrose, fructose, invert sugar
| Cough syrups usually contain one or more chemicals used to make them taste sweet.
| Pretty much all brands except Prospan, Diabetic Tussin and Scot-Tussin
| These sweeteners pose an obvious risk to people with blood sugar conditions such as diabetes or hypoglycemia. If you have diabetes or hypoglycemia, make sure you get a diabetic brand, gel-caps, or even an extraction instead of syrup. In rare cases, excessive, chronic use of cough syrup '''HAS''' led to people getting diabetes.
|-
| Propylene glycol or Polyethylene glycol
| Thickening agents
| Pretty much all brands of syrup
| These are not toxic nor inherently dangerous but may cause an upset stomach when consumed in large doses.
|}


Detailed coordination such as running, jumping, or manuvering around furnature becomes much harder if not impossible.
=== Interactions ===


However, when you hit the third you really wouldnt want to be moving around anyway.  
DXM has several potentially dangerous interactions with pharmaceutical and recreational drugs including analgesics (painkillers), antihistamines, antidepressants and stimulants.


The best thing to do is get a good pair of headphones, turn off the lights, close your eyes and let your mind wander.  
DXM has the potential to cause [[Wikipedia:Serotonin Syndrome|Serotonin Syndrome]] if mixed with other serotonergic drugs such as [[Antidepressants|antidepressants]] that act as SSRIs, MAOIs, empathogens which affect serotonin release such as [[MDMA]], [[MDA]], [[Mephedrone]], [[Tramadol]], 2-c-t-x drugs, [[MXE]], aMT, 5-HTP, ect.
Serotonin Syndrome causes discomfort, excitability, irritability, diarrhea, moodswings, seizures, coma and can be deadly <ref>http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2464814/</ref> if not treated.


**CEV's**
* See [[Drug_Combinations|Drug combinations]] and [[Dissociatives#Interactions|Dissociative Interactions]] for more information.


Inside your mind is an entirely new universe to explore.
== Chemistry and Pharmacology ==


You think of water and an ocean appears.  
IUPAC:(4bS,8aR,9S)-3-Methoxy-11-methyl-6,7,8,8a,9,10-hexahydro-5H-9,4b-(epiminoethano)phenanthrene.


You create universes and live lifetimes inside your mind.  
Dextromethorphan is the dextrorotartory enantiomer of levomethophan, which is the methyl ether of levophanol, both opioid analgesics.


=== Pharmacodynamics ===


**Third Plateau**
{| class="wikitable"


This is where you start tripping. you cannot ignore the feeling inside of you.
|+ Binding receptors
at this point its no longer a social drug and should be done by yourself or with a sitter.


This is most akin to an acid trip: it feels very distorted and lasts a couple hours.
|-


| NMDA - 7253


I had many trips by myself and never had a bad trip.
|-


Ive had trips that i wanted to be over, but never any horrifying hallucinations.
| SERT - 2015


The third plateau is srs bsns and isnt 'party-mode' or even 'socialize-mode'. Its more like 'alone-and-tripping-mode'.
|-


I honestly cant advocate going into a social situation on a third plat dose.
| NET - 110606


With the slurring, robo walk, bugged out eyes, sweating, concentration, and the fact that you're tripping!
|-


If you really MUST socialize on the third plat: put on a movie.
| Sigma-1 - 23


It will make the room dark, get people to sit down, and will let you space out for the 2 hours it's playing.
|-


Again, i highly reccomend not socializing on the third plateau.
| Sigma-2 - 240


Once you hit the third for the first time, you realize a lot of things.
|}


Its different for everyone, but everyone seems to have a type of rebirth.
=== Pharmacokinectics ===


Following oral dosing, DXM is rapidly absorbed from the GI tract. Where it enters the bloodstream, and crosses the blood-brain barrier.


**Fourth Plateau**
At therapeutic doses, DXM acts centrally (brain) as opposed to locally (Respiratory tract). It's rapidly absorbed from the GI tract into the active metabolite Dextrophan (DXO) in the liver by the cytochrome P450 enzyme CYP2D6.


This is the deep meditative state.  
Around 10 percent of the Caucasian population has little or no CYP2D6 enzyme activity, leading to long-lived high drug levels. ALL Caucasians should take a small test dose (1st plateau or medical levels) to feel for this ahead of time.


Few people enjoy going this far, as all you can really do (or want to do) is sit, listen to music, close your eyes, and become god.


You can create universes in your mind just by thinking of them.


== Images ==


== Redosing ==
<gallery mode="packed-hover">


I advise against redosing.
Image:Dxm1.jpg|''Robitussin brand DXM Gel Caps''
It's better to know how much you've taken at the start of the trip, rather than guestimate how much you're on as you keep dosing.
The effects will start to come in waves and may not be pleasant.
If you feel the need, i would reccomend doing a high dose in the begining, and a lower dose 1-2 hours in.


Image:Dxm_gelcap.jpg


== Predosing ==
</gallery>


You should know to make sure there's only DXM in the product you're taking.
== Links ==
A light snack would help to help with the stomach cramps.
* [http://tripsit.me/the-dexterous-world-of-dxm/ The Dexterous World of DXM from TripSit]
try freezing it. Ive never tried it but ive heard it works.
* [http://www.erowid.org/chemicals/dxm/faq/dxm_faq.shtml DXM FAQ]
There is an enzyme-inhibiting "thing" in grapfruit juice that will increase the intensity; however, it must be drank in fairly large quantities (I recommend 1L to start with) and must be drank BEFORE or DURING the drinking o your dxm. NEVER AFTER as it can cause some nausea in people.
* [https://www.erowid.org/chemicals/dxm/dxm_timeline.php DXM timeline on Erowid]
It could have something to do with the Vitamin C content, but i dont know enough about biology to say one way or another.
* [http://en.wikipedia.org/wiki/Dextromethorphan Wikipedia]
Another tip for a better trip: drink a diet pepsi (or any diet).
* [http://www.dextroverse.org Dextroverse]
Something in the sugar makes DXM break down faster or some magic.
== References ==
I dont think your stomach contents effect the trip as much as they effect your urge to vomit.


<references />


== Cosmic Coincidence Control or Syncronicity ==
[[Category:Dissociative]]


It's where the unvierse spins in just the right way to make things come together for you.
[[Category:Drugs]]
It's having coincidences happen at an alarming rate and for things that youd never expect.
It's like the universe is pushing everything to be at that exact moment.
You cant control the future, but you can impact the past to make the future out to what you want it to be.
You cant say "i want a lot of money" and get it, but you can be helping your friend move out of his apt and find a lotto ticket on the floor that happens to win.
It's hard to explain, but coincidences that are so improbable that if things had changed by a second on either side and it wouldnt have happened.

Latest revision as of 18:04, 8 April 2023

Romilar 1968 Ad

Dextromethorphan (also known as 'DXM', 'DM' or 'robo') is an over-the-counter antitussive (cough medicine) which, when taken at doses exceeding the recommended therapeutic range, becomes a powerful dissociative drug with psychedelic properties.

While DXM can be used safely it is not an inherently safe drug. Repeated use within a short period of time, combination with certain types of drugs, certain genetic factors and the prevalence of other active ingredients which become harmful at doses needed for disassociation make for a drug which must be used with caution.

The high is not for everyone; it is said to loosely follow the rule of thirds: one third hates it, one third doesn't care, and one third like it. It should not be underestimated as a hallucinogenic, at higher dosages it mimics high doses of ketamine but with more psychedelic properties.

DXM manifests its effects in a series of plateaus, with dose determining which plateau (and consequently which effects) one will experience. Lower dose plateaus can be well suited to relaxation, light social interaction and listening to music, while higher doses result in a more encompassing dissociative experience which does not lend itself to attentive social attention. At high doses it's common to have strong hallucinations, experiences of detachment, depersonalisation, and out-of-body experiences. These all-encompassing states can be startling and uncomfortable for some.

Its mechanisms of action are multiple, including action as a nonselective serotonin reuptake inhibitor and a sigma-1 receptor agonist. DXM and it's major metabolite, dextrorphan, also acts as an NMDA receptor antagonist at high doses, which produces effects similar to, yet distinct from, the dissociative states caused by other dissociative anaesthetics such as Ketamine and PCP.

DXM does not typically show up in normal drug tests, however it can produce false positive results for PCP and/or opioids in extended or specialized drug tests. Occasional use should not produce these false-positive results after a couple days have passed.

History

The racemic parent compound racemorphan was first described in a Swiss and US patent application from Hoffmann-La Roche in 1946 and 1947, respectively; a patent was granted in 1950. A resolution of the two isomers of racemorphan with tartaric acid was published in 1952, and DXM was successfully tested in 1954 as part of US Navy and CIA-funded research on nonaddictive substitutes for codeine.

The FDA approved DXM in 1958 after research supported its legitimacy and effectiveness as a cough suppressant. After its approval, it was introduced as an OTC medication under the name Romilar, which was introduced as a replacement for codeine containing cough remedies in an effort to cut down on abuse. In early 1960s Beat poets Allen Ginsberg and Peter Orlovsky, musicians such as Daevid Allen Soft Machine, and alternative authors such as Jack Kerouac known to have used DXM in the form of Romilar. In 1973, Romilar was taken off the shelves after a burst in sales because of frequent misuse, and was replaced by cough syrup in an attempt to cut down on abuse. In 1975, the popularity and extensive abuse of DXM was recognized, and Romilar was removed from the OTC market. However, DXM was specifically excluded from the Controlled Substances Act (CSA) of 1970, therefore, it was still legal to produce and use.

A few years after its removal from OTC, companies began introducing refined DXM products (e.g., Robitussin, Vicks-44, Dextrotussion) that were designed to limit recreational use by creating an unpleasant taste if consumed in large quantities. Within a short time those same manufactures began to produce forms of DXM with "some appealing flavoring," which led at least one researcher to suggest that the cycle of recreational abuse may be repeated. In 1996, DXM HBr powder could be purchased in bulk from online retailers, allowing users to avoid consuming DXM in syrup preparations.

Different Forms

DXM is widely available in over-the-counter cough treatments which appear in different forms including gelcaps, lozenges and syrups. DXM is also less commonly found in a more pure powder form, either extracted or bought directly from a chemical manufacturer.

While there are some products available which contain only DXM as active medical ingredients it is common to find products which contain DXM but also contain enough of another active ingredient to pose a serious risk to the user's health.

Pure/Extractions

The ideal source of DXM would be the purest. The safest way to use dxm is with pure powder (and at least 5-10ml propylene glycol to aid digestion) or an extraction. However, for most this form will prove impractical due to obtaining the pure powder.

Extractions from OTC sources requires time and a chemical procedure which most people are not equipped to do safely. If you are properly equipped, there is some detailed information on this page: https://erowid.org/chemicals/dxm/faq/dxm_chemistry.shtml

Gel Caps

DXM Gelcaps such as Robitussin Gelcaps or other products containing only DXM encased in a gelcap are often the preferred source for DXM users. For most users, gelcaps which contain only DXM produce a more clear headed high in lower doses (slower digestion, see . Most users experience fewer side effects from gelcaps than from syrup, however some users report an upset stomach, indicating that some users may have a sensitivity to the edible plastics used to make the gelcaps.

Some brands such as Cordicin Cough and Cold (also known as CCC) have a variety of products, most of which contain other active ingredients such as antihistamines or CPM (Chlorpheniramine Maleate) and may have one or two products which contain only DXM.

WARNING: Cordicin Cough & Cold is one of the most commonly used sources of DXM, and also one of the most dangerous. Nearly every single CCC product contains other active ingredients such as CPM, which can cause severe and life-threatening symptoms including seizures, shortness of breath or troubled breathing, weakness, loss of consciousness, severe dryness of the mouth, nose or throat, bleeding from the skin, mouth, eyes, rectum and vagina, and possibly death. CCC also is additionally harmful to your kidneys, liver and heart. Avoid it.

Lozenges

There are also sore-throat and cough medications containing DXM which exist in the form of a hard-candy like lozenge. These sometimes contain only DXM, however most brands of DXM lozenges also contain analgesics such as acetaminophen or benzocaine.

Always choose a product which only has Dextromethorphan in the active ingredients!

Syrup

Cough syrup is the most common source for DXM users. While there are many brand name and no-name syrups which only contain DXM as an active ingredient there are many active and "inactive" ingredients commonly found in cough syrups which can cause negative effects ranging in severity. See Adulteration for more information.

Some have reported the high produced from syrup is mostly sedating. You may feel sluggish when using it to get high on DXM, possibly as a result of other ingredients found in syrup however because of the even dispersion of DXM throughout the syrup it is said to produce a more 'solid' trip.

Delsym

Delsym is brand with many formulations which contain Dextromethorphan Polistrex.

This is an extended release form of DXM which produces a longer lasting trip with weaker, more physical effects. It is somewhat more difficult to reach the third plateau using polistrex preparations, which may be preferable to beginners or users who would prefer these effects. Since it is an extended release dxm product, this means your enzyme is more able to keep up with the conversion of DXM to DXO, meaning more of a body high and less of the psychedelic DXM high. It is for this reason why it is difficult to reach 3rd plateau with polistrex. Generally, a 3rd plateau experience has a Higher percentage of DXM than DXO. 

See Dosage information below

Dosage

The dosage below refers to an "average" 180lbs / 80kg person taking DXM HBR. Before dosing it's important to note a few things:

  • HBR and Polistirex doses vary significantly due to polistirex slow absorbsion rate.
    • Dextromethorphan Polistrex, being extended release, means that your enzyme is more able to convert dxm into dxo. DXO being a more physical, less trippy drug, leads to this preparation of dxm feeling much less intense, and in many cases, very subtle. It is therefor recommended by some to predose with grapefruit juice to fully enjoy polistrex because it slows down the conversion of dxm to dxo, effectively making polistrex "more trippy" because of a higher amount of dxm that didn't get converted. It should be noted that inhibiting digestive enzymes with grapefruit juice is risky and can interact with several medications and drugs and not be taken lightly. For more information look up "CYP3A4 Inhibition drug interactions".
  • DXM doses are affected by weight. For more accurate dosage information, see the following resources:
  • For a graphical chart of the dosage ranges this chart is helpful.
  • For an easy calculator that does the math for you, this page can be helpful.

Before dosing, be sure to read the Plateaus section to know which level you want to dose for.

Plateau range dosage for a 80kg (180lb) person.
First 122-200mg
Second 200-600mg
Third 600-1200mg
Fourth 1200-1600mg
Risk of death 2.2g+

Duration

Oral HBR
High of 6-8 hours Afterglow effect of 8-16 hours after dose, depending on dose
Oral Polistirex
High of 8-12 hours Afterglow effect of 16-36 hours after dose, depending on dose

Redosing

Redosing is not advised because of potential risk of risk of sigma. For more information, see Plateau Sigma

It's better to know how much you've taken at the start of the trip, rather than guesstimate how much you're on as you keep dosing. The effects will start to come in waves and may not be pleasant. If you feel the need, it's recommended to take a high initial dose and a lower dose 1-2 hours in. As the duration of the trip is extended with dose boosting or redosing, the dysphoric aspects of the experience increase, until eventually most people report feeling like the walking dead. Not to mention by extending the duration of the trip you are increasing the chance for adverse effects and brain damage.

Predosing

Grapefruit juice effects dxm due to interactions with cytochrome P450-2D6. Essentially, it inhibits the enzyme that converts dxm to dxo, making a higher DXM:DXO ratio, meaning a higher, more psychedelic high, and less of a body high. With 1st and 2nd plateau, it can make it much more "trippy" and less of a physical high.[1] [2]

In order to properly predose, drink around 16oz (500mL) of grapefruit juice 1-2 hours prior to the point where you dose the dxm itself.

Effects

As previously stated, the effects of this drug vary wildly from plateau to plateau, this list is in general from ALL plateaus.

Positive

  • Euphoria, mood lift
  • Increased giggling and laughing
  • Dissociation of mind from body (positive when sought)
  • Creative dream-like experiences
  • Increased tactile sensation
  • Some users report empathy and forgiveness towards other people

Neutral

  • Pupil dilation
  • Visual stop motion effect (flanging or strobing)
  • Visual and aural (auditory) hallucinations
  • Decreased sexual functioning (difficulty achieving orgasm)
  • Confusion, disorientation
  • Skin sensitivity, alters tactile (touch) and skin sensations
  • Robotic, zombie-like walking, "robo-walk"
  • Dis-coordination, reduced agility
  • Loss of appetite
  • Involuntary flexing of muscles
  • Feelings of merging with adjacent objects like a couch or bed (with higher doses)
  • Some users report feeling disconnected, isolated from others, (positive when sought)

Negative

  • Vomiting
  • Dizziness
  • Body itching
  • Rash, red blotchy skin (similar to a niacin rush)
  • Diarrhea
  • Fever
  • Tachycardia (racing, pounding heart)

After-Effects

The after-effects of DXM are referred to as the afterglow.

The afterglow is almost non-existent on the First Plateau.

For a Second Plateau dose, the afterglow can be quite pleasurable, although some feel depressed/hungover afterwards for up to 14-16 hours after the initial dose. Expect to feel lazy and fairly tired the next day, easily remediable with caffeine and/or nootropics.

For a Third Plateau dose, the afterglow may additionally add a headache, feel more like an alcohol hangover, and almost like a 1st plateau trip for most of the day after. The effects of this may last for up to 16-20 hours, with some people feeling the "brain-dead", tired and lazy effects up to 72 hours! The tired and "brain-dead" effects can be remedied with caffeine and/or nootropics.

For a Fourth Plateau dose, don't plan anything for the day after, because you will be very "out of it" for a good 24-32 hours after dosing, with some people feeling the sedation/"brain-dead"/lazy effects up to 72 hours!. Definitely plan a Fourth Plateau dose at least a good 2 days away from social events, work, school, ect. (IE, do it Friday night/Saturday Morning if you have to work Monday). Eating becomes a difficult task during a Fourth Plateau afterglow. The best things to eat during this period are soft foods like yogurt, mashed potatoes, soups, and nutritional milkshakes like SlimFast or ENU Total Nutrition Meal Replacement Shakes. This afterglow may be fairly painful like an alcohol hangover, but can be slightly remedied with Ibuprofen/Acetaminophen, a multivitamin and the aforementioned supplements/food, caffeine and/or nootropics. . You will also appear to be extremely high from an outward appearance. Expect to feel very tired, lethargic and "brain-dead" for up to 72 hours.

Robo-Walk

The robo-walk feels like all of the muscles in your body are activated at once and while strange to the observer is not painful to the user. You can still walk but detailed coordination such as running, jumping, or maneuvering around furniture becomes much harder if not impossible. However, when you you start getting the effects of robo-walk, you really wouldn't want to be moving around anyway. The best thing to do is get a good pair of headphones, turn off the lights, close your eyes and let your mind wander.

It's similar to being overly aware that you are walking incorrectly and overcompensating because of it. Not much you can do about it except to minimize your walking by having everything ready before you start (food, water, triptoys, grapefruit juice, dxm in whatever preparation, ect).

Plateaus

There are various 'stages' to DXM trips called plateaus. Traditionally, there are only four plateaus that someone should try to aim for. All of them share general feelings of dissociation, but the strength and effects of these feelings are more pronounced in the later two plateaus.

The first two plateaus are commonly associated with a mix of being high on THC and drunk on alcohol. If you take a First Plateau dose, it's totally possible to socialize. At second, it becomes harder, but not impossible. Lower plateau doses are relatively easy to hide compared to higher plateau doses and talking with others becomes a lot easier while under the influence of DXM. It would also be fun to chill in your room alone and do whatever you normally do for fun, but it's suggested to try something that will take up most of your attention but allow your mind to wander at the same time. Something like playing a casual video game, or drawing whatever comes to mind.

If you take a Third or Fourth plateau dose, it is recommend to trip alone or with a close friend, as it is not a social drug at this dose. The best way to enjoy it is to lay back and listen to music with your eyes closed.

Choosing your destination plateau will depend a lot on what other drugs you've done and how comfortable you are with your own mind. People who have never tried any hallucinogen other than marijuana and/or alcohol should start with a First Plateau dose, while people with mushrooms or LSD experience could start at a Second Plateau dose. It is not advised to start at the Third or Fourth plateau unless you have extensive experience with other dissociatives.

First Plateau

The First Plateau is the lightest in effect. It feels a bit 'off', and is often likened to something of a cross between the effects of MDA and Alcohol. First plateau is usually slightly stimulating. The First plateau has also been described as "basically like a hit or two of good weed and 2-3 beers with 10 minutes of a 'trip' about 2 hours in."

Effects commonly experienced at the first plateau level

  • A shift in thinking perspective; things look and feel 'different'
  • Increased tactile sensation
  • Increased appreciation of music
  • Feeling heavy, sensation of increased body weight
  • Enhanced emotional response & sensitivity
  • Some dizziness or vertigo

First Plateau dose: 1.5-2.5mg/kg.

Second Plateau

This plateau is a bit more intense. You may feel like you are stoned and movement may become difficult. The second plateau can be fun yet disorienting. Music sounds much deeper, clearer, almost like you are there at the concert. Walking/Moving your body becomes slightly difficult at this point. Some may experience some closed eye visuals at this point. You can socialize with close friends and you could say you're slightly drunk. A slight warning, DXM is almost like a truth serum and you may share embarrassing or "secret" things you wouldn't normally share. You may start to get a bit of disassociation, and the high starts to get somewhat intense in the second plateau.

Second Plateau dose: 2.5-7.5mg/kg.

Transitional

Most people stop their DXM journey here, as the higher two plateaus are not really fun but introspective and enlightening. We don't recommend crossing this threshold until you're ready to move on from a lighter, happier experience to a sometimes darker and definitely more introspective full blown trip. Enjoy the 2nd plateau as long as you can because it's more of a fun experience and one tends to enjoy second plateau less after visiting the third plateau. "Once you see what's behind the curtain, you can't enjoy the show" so they say.

Additionally, approximate at 7.5mg/kg there is an elusive "Eiffel Tower" dose where you may experience the effects of both the Second and Third plateaus in waves.

Third Plateau

Third Plateau is a full on dissociative experience. At this point it is no longer a social drug and should be done alone or with a tripsitter. The third plateau is considerably more sedating and movement becomes a bit harder. Closed eye visuals are more prominent at this level. You will lose track of time quit easily as it becomes meaningless quite quickly. Large amounts of dissociation happens at this level, and the internal thoughts can be quite interesting. To explain further, you may start to feel like you don't belong in your own body, or that your mind and body are two separate beings. Additionally, thoughts may be similar to "My body is only what everyone else sees but not really me, because I am just my mind, not my body."

There is a little bit of post-trip amnesia starting at 3rd Plateau. As stated previously, 3rd Plateau is quite intense. It's not the full comatose stage that the 4th Plateau is, but it can be pretty overwhelming nonetheless.

Third Plateau dose: 7.5-15 mg/kg.

Fourth Plateau

This is the deep meditative state. This is most akin to a "k-hole" that people experience after taking large amounts of ketamine. Few people enjoy going this far, as all one can really do (or really wants to do) is sit, listen to music, close your eyes, and experience a full blown dissociative trip. You can create universes in your mind just by thinking of them. DXM users have been known to have extremely vivid, controllable hallucinations and out of body experiences at this level. Full blown disassociation from everything and full on ego death is very common at this level. Other very common hallucinations at this level are people visiting aliens, meeting god (sometimes the two being the same entity) and becoming god. One explanation of the fourth plateau "It's kind of like the top of your skull pops off and all the knowledge of the universe is poured into your head, but by the end of the trip it's all seeped out again and you are left with the realization that you really don't much of anything at all." Another explanation is : "A total detachment from the body. The ego is pulled inside. Everything is very distant. Walking, talking, moving is not possible. Thinking is however. Left free to observe the self from a dark quiet immobility. A strange taste in the mouth. Like the numb of the dentist in every tissue. Loss of emotion, loss of anything earthly. "

It is quite difficult to recall these very powerful hallucinations as post-trip amnesia is very common.

Fourth Plateau dose: 15mg/kg-20mg/kg. Higher is possible, but not advised, because risk of death around 25mg/kg, but varies slightly from person to person

Plateau Sigma

There is another level that DXM can take you to, but it is not higher in dosage than 4th plateau, it is more of an extension of 2nd and 3rd plateaus. In order to get to this state, you must binge. For this reason WE HIGHLY RECOMMEND AGAINST IT! For example, a user has said "I took a 3rd plateau dose, then when it was starting to wear off, I took a 2nd plateau dose, when that was finally coming down, I took a 3rd plateau dose again, and when that came down, I did ANOTHER 2nd plateau dose. When that final dose hit, I was stuck in Plateau Sigma."

Many people refer to this level as "plateau sigma" because when you get to this state, your sigma receptors are hit on, and HARD. This completely changes the trip. This mind state is generally referred to as dysphoric, dark, confusing and "a hellish introspective nightmare". As one user put it "it's a dark and confusing dream-like state where everything you think you know is insanely hard to grasp while all of your wildest, most bizarre fantasies are merely common, boring every day events that feel as normal as waking up and drinking coffee."

As with 4th plateau, it's hard to describe as amnesia is quite common and information about this state is quite rare as it is. That being said, this state has VERY RARELY been reported as being pleasurable AT ALL. Most people describe it as dark and confusing, like a living nightmare.

For more information, the William White FAQ has a section on Plateau Sigma at This Page

Harm Reduction

There is only three MAJOR rules about dxm use, and they are as follows :

  • NEVER use any preparation of DXM that has ANY other active ingredients, as they can make you sick and/or dead. See Adulteration
  • Keep in mind this general rule of thumb for DXM : 1 plateau/week.
    • In other words, If you take a Third Plateau Dose, wait 3 weeks before using again. If you use a Second Plateau dose, wait 2 weeks before using again.
  • Watch out what you are mixing DXM with, as mixing with certain drugs can cause serotonin syndrome, or Ataxia, see Interactions

See Dissociative Harm Reduction for general information.

Adulteration

Many products which contain DXM also contain other medication or otherwise non-medically-active ingredients that can cause serious harm in the doses found in DXM containing products. If a user intends to use an OTC cough medication in order to get high on DXM they almost always will have to consume a dangerous quantity of other dangerous ingredients if they are present in the medication. For this reason it is strongly recommended to find a source which contains DXM as the ONLY active ingredient


The following is a summary of other ingredients commonly found in DXM products.

Adulterant Table
Name Description Common Brands Danger
Acetaminophen/Paracetamol/APAP a painkiller found in headache/flu medicine Tylenol, Vicks (NyQuil), TheraFlu, Triaminic APAP is Hepatoxic in high doses. This means it will damage your liver if taken in high doses. Your body can only process a certain amount of APAP at once before it the normal pathways become saturated. Once the regular pathways used for metabolizing APAP have been saturated, the remaining APAP gets broken down in the liver by an enzyme called cytochrome P450 When forced to break down APAP this enzyme produces toxic metabolites!
Guaifenesin Guaifenesin is an expectorant. Robitussin DM, Mucinex, Robefen Guaifenesin overdoses cause severe nausea and vomiting in most users. Guaifenesin can also cause kidney stones with chronic use.[3]
Antihistamines Found in Allergy/Sleep/Nighttime medications Coricidin Cough and Cold, Zicam, Dimetapp, Chloraseptic When taken in high doses antihistamines can cause dizzyness, nausea, a strong dysphoria, paranoia, delirium and hallucinations. Many antihistamines can also have a dangerous synergy with DXM which can lead to liver, kidney and heart complications.
PPA, pseudoephedrine, and phenyleprine Decongestant agents Sudafed, Vescadril, Curedex, Watkins, Hardex Vasoconstriction (constriction of blood vessels) and decreased nasal secretions , and with larger doses insomnia, hypertension, heart rhythm abnormalities, hemorrhaging, stroke, or death. Note that these are extreme reactions, and that individual tolerance to sympathomimetics tends to vary considerably. Tolerance can build quickly, and a fatal dose for one person may have only a mild effect on another person.
Inactive Ingredients Adulterant Table
Name Description Common Brands Danger
Food Coloring/Dyes Dyes added for color Almost ALL brands except Zarbee's Naturals and Chestal Naturals Usually these dyes are not harmful in low doses however in doses which may be required for DXM's effects they can become problematic. Tartrazine (FD&C Yellow #5) is one of the most notable coloring ingredients to cause reactions. Not necessarily dangerous unless you are allergic to certain dyes. Check out the ingredients list if you are.
Glucose, sucrose, fructose, invert sugar Cough syrups usually contain one or more chemicals used to make them taste sweet. Pretty much all brands except Prospan, Diabetic Tussin and Scot-Tussin These sweeteners pose an obvious risk to people with blood sugar conditions such as diabetes or hypoglycemia. If you have diabetes or hypoglycemia, make sure you get a diabetic brand, gel-caps, or even an extraction instead of syrup. In rare cases, excessive, chronic use of cough syrup HAS led to people getting diabetes.
Propylene glycol or Polyethylene glycol Thickening agents Pretty much all brands of syrup These are not toxic nor inherently dangerous but may cause an upset stomach when consumed in large doses.

Interactions

DXM has several potentially dangerous interactions with pharmaceutical and recreational drugs including analgesics (painkillers), antihistamines, antidepressants and stimulants.

DXM has the potential to cause Serotonin Syndrome if mixed with other serotonergic drugs such as antidepressants that act as SSRIs, MAOIs, empathogens which affect serotonin release such as MDMA, MDA, Mephedrone, Tramadol, 2-c-t-x drugs, MXE, aMT, 5-HTP, ect. Serotonin Syndrome causes discomfort, excitability, irritability, diarrhea, moodswings, seizures, coma and can be deadly [4] if not treated.

Chemistry and Pharmacology

IUPAC:(4bS,8aR,9S)-3-Methoxy-11-methyl-6,7,8,8a,9,10-hexahydro-5H-9,4b-(epiminoethano)phenanthrene.

Dextromethorphan is the dextrorotartory enantiomer of levomethophan, which is the methyl ether of levophanol, both opioid analgesics.

Pharmacodynamics

Binding receptors
NMDA - 7253
SERT - 2015
NET - 110606
Sigma-1 - 23
Sigma-2 - 240

Pharmacokinectics

Following oral dosing, DXM is rapidly absorbed from the GI tract. Where it enters the bloodstream, and crosses the blood-brain barrier.

At therapeutic doses, DXM acts centrally (brain) as opposed to locally (Respiratory tract). It's rapidly absorbed from the GI tract into the active metabolite Dextrophan (DXO) in the liver by the cytochrome P450 enzyme CYP2D6.

Around 10 percent of the Caucasian population has little or no CYP2D6 enzyme activity, leading to long-lived high drug levels. ALL Caucasians should take a small test dose (1st plateau or medical levels) to feel for this ahead of time.


Images

  • Robitussin brand DXM Gel Caps

    Robitussin brand DXM Gel Caps

Links

References

  1. ↑ http://medicine.iupui.edu/clinpharm/ddis/2d6references/#dextromethorphanSub
  2. ↑ https://en.wikipedia.org/wiki/CYP2D6
  3. ↑ https://pubmed.ncbi.nlm.nih.gov/15673990/
  4. ↑ http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2464814/
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