Abstract: Objective To investigate both the reminders of addiction in the instructions of Chinese listed drugs containing dextromethorphan and the reports of addiction cases at home and abroad so as to provide evidence for standardized use. Methods Labels of drugs containing dextromethorphan were retrieved while case reports of addiction induced by dextromethorphan in CNKI, Wan Fang and PUBMED database were searched for before statistical analysis. Results On December 16, 2021, the National Medical Products Administration changed dextromethorphan hydrobromide oral monotherapy from an over-the-counter drug to a prescription one, and revised the instructions of 11 dextromethorphan products by deleting such descriptions as “no addiction or tolerance after long-term use”. On April 30, 2024, the National Medical Products Administration, Ministry of Public Security and the National Health Commission jointly issued an announcement adjusting dextromethorphan monotherapy as the second category of psychotropic drugs. However, some dextromethorphan-containing compound preparations were still labeled as non-addictive after long-term use under the item of pharmacological actions in the instructions. A total of 21 reports about addiction to dextromethorphan after long-term use were retrieved, including 11 domestic ones and 10 foreign ones, all of which involved minors who were enticed by their peers. Obvious symptoms of withdrawal, feelings of euphoria, and even suicide were reported. Conclusion Labels of drugs containing dextromethorphan should be standardized, and clinicians ought to be better informed of the drug dependence caused by dextromethorphan to improve the public knowledge of dextromethorphan, especially among minors.

Key words: Dextromethorphan, Instructions, Addiction, Abuse, Tolerate, Juvenile