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Comment by tptacek | Hacker News Reader

Are you sure you posted the right paper? That paper appears to present a clinically insignificant outcome for DXM in children.

I think it's perfectly reasonable to contest the research summary this article is providing. All science-based articles on interesting topics are going to be like that. But you're writing your comment as if they took a flyer on DXM, and the research consensus is in fact that DXM is not effective. It's not as bad as phenylephrine (it has detectable, if immaterial, impact in adults), but it's pretty bad.

The point of the article, of course, isn't that Dayquil should be illegal because it's dangerous; it's that it doesn't work. Having spent an unreasonable amount of time in HN pseudoephedrine threads, I think the broad consensus of this site is that phenylephrine should be taken off the shelves.

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I don't know if OP changed their link but the one currently in their post (https://pubmed.ncbi.nlm.nih.gov/37232330/) did find DXM to be effective:

"Using objective and subject assessment tools validated in pediatric populations, this study provided evidence of the antitussive efficacy of DXM in children, aged 6–11 years, at the current OTC monograph dose and labeled indication. Compared with placebo, DXM treatment reduced cough rates 21.0% over 24 h (primary endpoint) and 25.5% during daytime/awake hours. In addition, children treated with DXM reported greater reductions in cough severity and frequency in the mornings and afternoons over 3 days than children treated with placebo. These treatment effects were statistically significant despite the study not reaching its planned sample size and are medically relevant."

Also as I mentioned in another comment, the author of original article misrepresents the findings of their own citation. DXM was found to be effective in adults, just not children.

Phenylephrine was the replacement that doesn't really work but is non (or less) stimulating right ?

From what I remember it was actually quite effective topically but not through pill form. Could be wrong.

Also makes me wonder if there's an alternative function to DXM for people with colds (maybe it makes them feel better in other ways). Or it's just good marketing and associated with NyQuil having other drugs and people assuming DayQuil works

It's not that it's less stimulating, it's that pseudoephedrine basically is methamphetamine (the chemistry to reduce it to meth is truck-stop straightforward). But oral phenylephrine doesn't work at all.

The case against DXM is nowhere nearly as good as the case against phenylephrine; phenylephrine is a scam, and DXM is a drug everyone thought was the gold standard cough suppressant, but then serious studies knocked down its effectiveness.

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