Abuse of cough syrup one factor in dementia

began to appear after that point. He is following up with a neurologist who has performed cognitive and memory testing and said his condition is worsening. I witnessed him unable to subtract 7 from 100.

There is very little research on the effects of cough–syrup abuse, at least that I have been able to find. This may be partly due to the fact that it isn’t widely abused, and generally abusers are teenagers, not senior citizens. Can you offer any insight on the cough syrup’s effect on dementia? —

A: Dextromethorphan, one of the active ingredients in most cough syrups, is a drug of abuse. It is most commonly used by teens and young adults, and there are medical issues in your husband that make this drug dangerous for him, even potentially life-threatening.

DXM is safe and has no psychological effects when taken at the usual doses to suppress cough. However, when large amounts are taken (such as an entire bottle), the effects are dramatic and may resemble intoxication with phencyclidine (PCP or “angel dust”). These may include hallucinations and psychosis (a grossly distorted sense of reality). With chronic use, there are clear reports of progressive cognitive deterioration, exactly as you describe.

DXM itself acts on the neurotransmitter serotonin, and when combined with certain other drugs — including the duloxetine, gabapentin and trazodone — can cause serotonin syndrome, which is potentially fatal. Symptoms of serotonin syndrome include muscle stiffness or twitching, fever and mental status changes, such as anxiety, restlessness and disorientation.

The cough syrup is at least partially responsible for his dementia, and there is a significant likelihood that he will do himself severe damage with continued use. Getting off this drug is difficult, and a consultation with an addiction specialist would serve him best.