Abstract
Introduction: Dextromethorphan is a commonly used antitussive agent that can be purchased over the counter. It is metabolized primarily by the cytochrome P450 (CYP) 2D6 isozyme. Methadone has been found to inhibit CYP2 D6, indicating a potential for interaction with dextromethorphan. Case summary: An 83-year-old woman was evaluated for delirium, hypersomnia, confusion, lethargy, impaired concentration, and poor food intake. Symptoms resolved soon after discontinuing dextrometh orphan. Discussion: Vulnerability to delirium was potentially caused by coadministration of methadone, which can inhibit the CYP2D6 isozyme. Conclusion: Evaluation of delirium should include close investigation of the patient's medications for potential interactions with dextromethorphan.
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