Hidden dangers in cough syrup

Cough syrup is one of the most common over-the-counter medications people turn to when they’re dealing with a cold or flu. The idea of quieting a persistent cough and getting better sleep sounds appealing, but what if that medicine bottle is doing far more harm than good? Many popular cough syrups, including brands like NyQuil and Robitussin, contain dextromethorphan (DXM). While it may seem harmless on the surface, DXM is a chemical that affects the brain in a way that is far from natural. Instead of treating the root cause of a cough, it simply shuts down the brain’s ability to recognize the need to cough. This isn’t just a questionable way to suppress symptoms—it’s a method that comes with serious risks to neurological function, cardiovascular health, and overall well-being.

How Dextromethorphan Works and Why It’s Problematic

Dextromethorphan is a synthetic drug that was developed in the 1950s as a replacement for codeine in cough syrups. Unlike codeine, DXM is not classified as an opioid, but it still acts on the brain in ways that alter normal function. DXM is a dissociative hallucinogen, meaning that it works by disrupting communication between neurons in the brain.^[1] This is the same mechanism of action seen in drugs like PCP and ketamine. Instead of soothing the throat, reducing inflammation, or helping the immune system, DXM suppresses the body's ability to register the need to cough by interfering with NMDA receptors in the brain. While this can temporarily relieve symptoms, it does nothing to promote healing and comes with a range of side effects.

The Health Risks of Dextromethorphan

DXM is far from a benign substance. It affects multiple systems in the body, and its use—even at standard doses—can lead to a variety of unwanted symptoms.^[1]

• Neurological effects include dizziness, confusion, memory impairment, and in some cases, seizures. Since DXM affects neurotransmitter function, it has the potential to alter brain chemistry in ways that may be harmful, particularly for individuals with underlying neurological conditions.
• Cardiovascular risks are another major concern. DXM can increase heart rate and blood pressure, putting stress on the cardiovascular system. This can be especially dangerous for individuals with high blood pressure, heart conditions, or those taking other medications that also affect heart function.
• Gastrointestinal issues such as nausea, vomiting, and stomach pain are common side effects. The body recognizes DXM as a foreign chemical and may react by trying to expel it.
• Psychological effects range from mild agitation and anxiety to paranoia and hallucinations. Some users experience dissociation, a feeling of being disconnected from reality, which is one of the reasons DXM has been misused as a recreational drug.

Why DXM Is Still on the Market

Despite its questionable safety profile, DXM remains widely available in over-the-counter medications. It has continued to be used as a primary cough suppressant for several reasons.

• It is inexpensive to manufacture and profitable for pharmaceutical companies, making it a financially attractive option.
• It does not fall under opioid regulations, which means it faces less scrutiny despite its impact on the brain.
• Consumers generally do not question over-the-counter medications, assuming they are safe simply because they are widely available.

DXM and the Risk of Abuse

One of the lesser-known issues with DXM is its potential for abuse. Since it acts as a dissociative drug, it can produce mind-altering effects at high doses. Some individuals, particularly teenagers, have misused DXM to experience hallucinations, a practice known as "robotripping." The risks of DXM abuse include overdose, psychotic episodes, and long-term damage to brain function.^[2]

Safer Alternatives for Cough Relief

The good news is that you don’t need DXM to get through a cough. Several natural alternatives can help soothe symptoms while supporting the healing process.

• Raw honey is as effective as over-the-counter cough medicines for reducing cough frequency. It also has antibacterial properties that can help fight infections.^[3]
• Herbal teas made from ginger, thyme, or marshmallow root can help reduce irritation and support immune function.^[4]
• Saltwater gargles help break down mucus and reduce throat inflammation.^[5]
• Steam inhalation with essential oils such as eucalyptus or peppermint can open airways and provide relief without the use of synthetic chemicals.^[6]

Final Thoughts

Dextromethorphan is a prime example of how the pharmaceutical industry offers symptom suppression rather than true healing. Instead of helping the body recover, DXM forces the brain to ignore symptoms, creating the illusion of relief while exposing the body to potential harm. For those who prioritize health, understanding what goes into over-the-counter medications is just as important as reading food labels. Opting for natural remedies and avoiding synthetic chemicals can support the body’s natural healing process without unnecessary risks.

1. Journey, Jonathan D., et al. “Dextromethorphan Toxicity.” StatPearls, StatPearls Publishing, 2025.
2. Schifano, Fabrizio, et al. “Focus on Over-the-Counter Drugs’ Misuse: A Systematic Review on Antihistamines, Cough Medicines, and Decongestants.” Frontiers in Psychiatry, vol. 12, May 2021, p. 657397.
3. Abuelgasim, Hibatullah, et al. “Effectiveness of Honey for Symptomatic Relief in Upper Respiratory Tract Infections: A Systematic Review and Meta-Analysis.” BMJ Evidence-Based Medicine, vol. 26, no. 2, Apr. 2021, pp. 57–64. 
4. Bode, Ann M., and Zigang Dong. “The Amazing and Mighty Ginger.” Herbal Medicine: Biomolecular and Clinical Aspects, edited by Iris F. F. Benzie and Sissi Wachtel-Galor, 2nd ed., CRC Press/Taylor & Francis, 2011.
5. Tiong, Vunjia, et al. “The Effectiveness of Various Gargle Formulations and Salt Water against SARS-CoV-2.” Scientific Reports, vol. 11, Oct. 2021, p. 20502.
6. Köteles, Ferenc, et al. “Inhaled Peppermint, Rosemary and Eucalyptus Essential Oils Do Not Change Spirometry in Healthy Individuals.” Physiology & Behavior, vol. 194, Oct. 2018, pp. 319–23.