DXM, short for dextromethorphan, is an over-the-counter (OTC) cough suppressant that’s found in some cough syrups and cold meds.

Robotripping, dexing, skittling — whatever you want to call it — refers to using DXM to experience a range of psychological and physical effects.

Sounds harmless enough, given that DXM is legal and readily available, right? Nope. Robotripping usually involves higher than recommended doses, which can be harmful. Plus, a lot of DXM-containing products have other active ingredients that can also be harmful in higher doses.

Healthline does not endorse the illegal use of any substances. However, we believe in providing accessible and accurate information to reduce the harm that can occur when using.

It depends on your dose.

The effects of robotripping can vary a lot depending on how much you take. DXM causes different stages of intoxication (often referred to as plateaus) that vary with dosage.

1st plateau

A 100- to 200-milligram (mg) dose of DXM produces effects that some say are similar to those of ecstasy.

It causes mild stimulation and has an uplifting effect. People also describe feeling more energetic, social, and talkative.

2nd plateau

The second stage happens with 200 to 400 mg of DXM. It’s compared with alcohol intoxication, except with a more noticeable decrease in motor and cognitive functioning.

Euphoria and hallucinations are also likely with this dose.

3rd plateau

Things can get pretty hectic at this level, which produces effects similar to those of ketamine.

This plateau happens with 400 to 600 mg of DXM. That’s enough to leave you almost incapacitated.

The effects include:

4th plateau

This involves an extremely high dose of DXM that’s anywhere from 500 to 1,500 mg. At this stage, the effects are similar to taking a hallucinogen like PCP.

The effects of this dose are hard to shake off and last longer than the effects of other plateaus. Some people have experienced the effects for 2 weeks after stopping DXM, though this is very rare.

Taking this much DXM causes a trance-like state and sensations similar to out-of-body experiences. Delirium and hallucinations often lead to aggressive or violent behavior. People also experience reduced pain perception.

DXM produces several physical effects that vary from person to person and by dose. The product you take also matters. DXM products often contain other active ingredients that produce their own effects.

Potential side effects include:

The effects start to kick in around 30 to 60 minutes after taking DXM and reach their peak at 2 to 4 hours.

Your dose, other ingredients, and your body mass index (BMI) can affect how quickly you begin to feel it.

The effects usually wear off within 6 hours or so, but there are a lot of factors that influence how long you’ll feel the effects.

These include:

  • the dosage
  • other active ingredients in the product
  • how much food is in your stomach
  • your body size

Nope. Once you’ve taken it, you pretty much need to let it run its course.

Your best bet is to try to sleep it off. If you’re feeling really out of it and nauseous, sit upright in a comfortable chair instead of lying down in case you throw up.

Here are some other things that can help you ride out your trip:

  • Take some ginger or drink ginger tea if you’re feeling sick to your stomach.
  • Put on some music or a movie to distract you and help you unwind.
  • Drink water to keep from getting dehydrated.
  • Remind yourself that all of this will be over eventually (we promise).

Again, DXM is legal, but that doesn’t mean the dosage used for robotripping is safe.

Here’s a look at some of the risks.

Heatstroke

DXM interferes with your body’s ability to regulate temperature and can cause your body temperature to spike dangerously high.

It’s been linked to heat emergencies, including heatstroke. This is also sometimes called rave-related heatstroke because it’s more likely to happen with physical exertion, like dancing.

Higher risk of toxicity and overdose in some people

According to the Drug Enforcement Administration (DEA), roughly 5 to 10 percent of Caucasians aren’t able to metabolize DXM effectively.

In these folks, the substance takes longer to clear from the body, increasing the risk of overdose and death.

Respiratory depression

DXM depresses the central nervous system (CNS), which controls your breathing. This can stop your lungs from exchanging oxygen and carbon dioxide, which is medically known as respiratory depression.

This results in slow and shallow breathing. Left untreated, it could lead to respiratory arrest and death.

Dangerous behavior

High doses of DXM have been linked to dangerous behavior that stems from effects like hallucinations, psychosis, and agitation.

It can cause you to lose touch with reality, making you more likely to do things you wouldn’t normally do, like run across a busy highway (true story).

According to various reports, DXM misuse has also been linked to assault, suicide, and homicide.

Liver damage

Many OTC cough and cold medications that contain DXM also contain acetaminophen.

Acetaminophen can cause serious liver damage when you take more than directed.

DXM can cause serious interactions when combined with other substances and OTC or prescription meds.

Taking it with other CNS depressants can intensify or prolong the effects of both and significantly increase your risk for respiratory arrest, overdose, and death.

Other substances

Mixing substances is never a good idea, but the following make for a particularly risky combo with DXM:

OTC meds

DXM shouldn’t be mixed with certain OTC meds, including some herbal remedies and supplements.

These include:

Prescription medication

There are quite a few prescription medications that shouldn’t be combined with DXM. They include:

Serotonin syndrome warning

Avoid DXM if you’re on antidepressants, especially monoamine oxidase inhibitors (MAOIs). This combo’s been shown to cause a serious condition called serotonin syndrome.

Symptoms of serotonin syndrome include:

  • confusion
  • disorientation
  • irritability
  • anxiety
  • muscle spasms
  • muscle rigidity
  • tremors
  • shivering
  • overactive reflexes
  • dilated pupils

Serotonin syndrome is a medical emergency requiring immediate treatment.

Was this helpful?

Yep. People can develop a substance use disorder, including addiction, around DXM. Users can develop a tolerance as well as a psychological and physical dependence to DXM.

Some potential signs of DXM-related substance use disorder include:

  • cravings intense enough to affect your ability to think about other things
  • a need to use more DXM to experience the same effects
  • unease or discomfort if you can’t easily access DXM
  • trouble managing work, school, or household responsibilities because of your DXM use
  • friendship or relationship difficulties caused by your DXM use
  • spending less time on activities you used to enjoy
  • withdrawal symptoms when you try to stop using DXM

Taking more than the directed dose of DXM — or any medication for that matter — comes with risks.

If you’re going to do it, though, there are a few things you can do reduce some of the risk:

  • Know what you’re taking. Read labels to make sure you’re not ingesting other active ingredients, like acetaminophen, guaifenesin, and antihistamines. Same goes for DXM pills from randoms or the internet. They can be contaminated with other substances.
  • Stick with the lowest dose. Start with a very low dose. Be sure to give it time to kick in before you think of redosing.
  • Don’t mix. Most fatal overdoses are the result of mixing substances. Don’t combine DXM with alcohol or other substances.
  • Drink water. DXM can cause dehydration. Not only will this make you feel like crap, but it can also do a number on your kidneys. Drink plenty of water before and after robotripping.
  • Don’t do it alone. Robotripping by yourself isn’t a good idea. Have someone with you who can help if things go south.
  • Choose a safe setting. Make sure you’re at home or in another safe and familiar setting in case you experience hallucinations or pass out.
  • Remain seated. DXM can mess with muscle coordination and cause drowsiness, increasing your risk for falls and injury. Extreme sedation and a slowed breathing rate can increase your risk for passing out and choking if you happen to vomit. Moving around too much can also lead to overheating.

If you’re going to robotrip (or be around people who are), it’s crucial to know how to recognize an overdose.

Call 911 if you or someone else experiences any of these signs or symptoms after taking DXM:

If you’re concerned about law enforcement getting involved, you don’t need to mention the substances used over the phone. Just be sure to tell them about specific symptoms so they can send the appropriate response.

If you’re caring for someone else, get them to lay slightly on their side while you wait. Have them bend their top knee inward if they can for added support. This position will keep their airways open in case they begin to vomit.

DXM isn’t illegal, but that doesn’t mean it’s safe. In high doses, it can have serious and lasting effects, including dependence.

If you feel like your DXM use is getting out of hand, there’s help available. You can bring it up with your primary healthcare provider, if you’re comfortable with it, or try one of these free and confidential resources:

Adrienne Santos-Longhurst is a freelance writer and author who has written extensively on all things health and lifestyle for more than a decade. When she’s not holed-up in her writing shed researching an article or off interviewing health professionals, she can be found frolicking around her beach town with husband and dogs in tow or splashing about the lake trying to master the stand-up paddle board.