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Comment by gavinray | Hacker News Reader

I've been taking 90mg DXM with my 150mg Bupropion XR for the last few years.

Noticed a moderate improvement. I think NMDA is one of those targets that's flown under the radar, but now is being implicated with all sorts of cognitive processes.

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It causes memory and thinking problems. Some people are less sensitive to it than others, but i think that's why they haven't caught on. People online definitely experiment with using dxm and the alzheimers drug memantine. From what I've heard they're just too strong. Not sure why something weaker and not functional has never been produced though

Isn't DXM a disassociative at high doses? Moreover, don't people risk getting quite addicted to it, escalating their dose beyond even what you take? Perhaps your dose is stable, but even optimistically, it is management, not a cure. A cure is more possible with lower doses of DXM before it becomes a hard dependence.

wellbutrin+dxm is actually offered as a combination pill now (Auvelity)

The bupropion (Wellbutrin) portion of the combination mentioned above serves as a CYP2D6 inhibitor as well, actually boosting the action of the DXM in the body. Auvelity dosing starts lower with just 45mg of DXM, jumping to 90mg as the tolerance curve starts to set in.

CYP2D6 metabolizes DXM into a much more potent NMDA antagonist (dextrorphan, sometimes abbreviated to DXO). Inhibiting it boosts some action(s) of DXM but likely reduces the NMDA antagonist effect.

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