PubMed · 10693726
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R B McFee, H C Mofenson, T R Caraccio. 2000. Dextromethorphan: another "ecstasy"?. https://doi.org/10.1001/archfami.9.2.123
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Practicing movements results in improvement in performance and in plasticity of the motor cortex. To identify the underlying mechanisms, we studied use-dependent plasticity in human subjects premedicated with drugs that influence synaptic plasticity. Use-dependent plasticity was reduced substantially by dextromethorphan (an N-methyl-d-aspartate receptor blocker) and by lorazepam [a gamma-aminobutyric acid (GABA) type A receptor-positive allosteric modulator]. These results identify N-methyl-d-aspartate receptor activation and GABAergic inhibition as mechanisms operating in use-dependent plasticity in intact human motor cortex and point to similarities in the mechanisms underlying this form of plasticity and long-term potentiation.
OBJECTIVE: To review the use of dextromethorphan for the treatment of painful diabetic neuropathy. DATA SOURCES: MEDLINE and EMBASE searches for studies using dextromethorphan to manage diabetic neuropathy were conducted from 1966 to 1999 and 1980 to 1999, respectively. DATA SYNTHESIS: Peripheral neuropathy is a common manifestation of diabetic patients. Many classes of medications have been investigated to treat this condition, including N-methyl-D-aspartate inhibitors. A review of studies using dextromethorphan to manage diabetic neuropathy was performed. CONCLUSIONS: There are insufficient safety and efficacy data to justify the use of dextromethorphan for treating painful diabetic neuropathy. Further clinical trials are needed.