Of course you vomit. No body likes Suiciden {its slow suicide}. Buy some product with only DXM as the active ingredient. If you live anywhere near snivelization, finding a toxin-free DXM preparation should be trivial. I never vomited or even felt queasy and took many 500mg doses of syrup - free of nasty toxic additives. Read Erowid's
Guide to DXM in Non-Prescription Drugs to find out the other nasties to avoid as well.
I have read many DXM reports with CPM included in the dose [Erowid is so concerned about this that they explicitly post CPM at the top of any DXM reports that include it]. Those who have used only a few times are usually positive, but virtually all the long-term users are either dead or survived by stopping their CPM ingestion. The correlation is just so tight that it's remarkable the product hasn't been pulled from the market decades ago. Or rather, its a remarkable testament to the power of corporate lobbying dollars over medical research and clinical reports.
The 'net is chock-full of evidence that this compound is leaving a trail of brain damage and death wherever it is used in overdosage, in particular among those taking Coriciden and other CPM-containing preparations for the DXM content.
One of
Chlorpheniramine Maleate's classic characteristics is it causes nausea and vomiting in overdosage: "Symptoms Of Overdose In Children May Include Dizziness,
Nausea/vomiting..."
A post on this very forum indicates what so many others have experienced:
Other Coriciden long-term effects noted by various forum users: stomach pain, permanent gastrointestinal damage, permanent vision damage (bright/black spots). The permanent nature of these physical damages even outside the brain is particularly concerning. Vision, for example, never recovers from permanent damage because the retina doesn't regenerate.
Furthermore, antihistamines including CPM cause drowsiness and loss of recall (amnesia) in overdosage. So don't expect to remember your trips. Your body will soon remember the taste though.
Chlorpheniramine Maleate in particular, especially combined with DXM and taken repeatedly, seems to cause a progressively worsening health condition and often results in death. Former users often report intense nausea at just the sight/smell/taste of their formerly-used CPM-containing preparation.
Overdosage of CPM can also cause
Serotonin Syndrome: "
chlorpheniramine has been shown to work as a Serotonin-norepinephrine reuptake inhibitor".
Serotonin syndrome in dextromethorphan ingestion responsive to propofol therapy:
"An 18-year-old male developed a severe serotonin syndrome after recreational ingestion of Coricidin HBP (chlorpheniramine 4 mg and dextromethorphan hydrobromide 30 mg). Propofol infusion rapidly normalized his agitation, neuromuscular hyperactivity, and autonomic instability. Confirmatory analysis demonstrated a dextromethorphan serum concentration of 930 ng/mL. Dextromethorphan can produce serotonin syndrome in the absence of another serotonergic drug."
The abstract claims, contrary to the evidence it produces and showing no other, that 'Dextromethorphan can produce serotonin syndrome in the absence of another serotonergic drug.'
Having offered not a single case to support the statement, I'll do one better than the authors of the above case report and demonstrate the opposite: that such cases are nonexistent, or so exceedingly rare that careful searching does not turn them up. Not being able to find a single DXM-only case of Serotonin Syndrome after extensive Google searching, all that can be found are cases of combination with CPM or other serotonin agonists or reuptake inhibitors. If anyone can find a DXM-only Serotonin Syndrome report please post or PM.
This forum thread reports lots of nasty experiences combining DXM with serotonergic agents:
DXM+Prozac=serotonin syndrome
The title of this thread on the Drugs and Booze forum speaks loudly:
DXM + Diphenhydramine, IS NOT SAFE!
Diphenhydramine (as too Dimenhydrinate) are both, like Chlorpheniramine Maleate, antihistamines and quite toxic in overdosage. In addition, and unlike CPM, Diphen and Dimen are also potent anticholinergics, which raises another danger of toxicity. Anticholinergic toxicity produces a psychosis of its own, often long-lasting as a perusal of Erowid reports indicates.
It can be expected that overdosing on both DXM and either Dimen or Diphen would produce two distinct toxic effects: Anticholinergic toxicity and Serotonin Syndrome. Indeed, a quick Google and there we have it folks:
SEROTONIN REUPTAKE INHIBITION BY DIPHENHYDRAMINE AND CONCOMITANT LINEZOLID USE CAN RESULT IN SEROTONIN SYNDROME
In the case concommitant Linezolid enhanced the serotonin syndrome by inhibition of both MAO functional variants. Though the case does not involve DXM, it demonstrates the potency of both Dimen and Diphen as serotonin-syndrome co-inducers when combined with a secondary agent.
Together, the case report with previously linked forum threads which contain substantial use reports on DXM with serotonin reuptake inhibitors or agonists paints a clear picture of an unwise, and sometimes deadly combination.
Beyond all this, one might indulge in a little speculation. Why does it seem Coriciden is somewhat more addictive than DXM-only preparations? It doesn't seem that the acquisition demographic is sufficiently different to account for the observation.
A suspicious thread of addictivity runs through the many hundreds of Coriciden reports thus far reviewed. Something more than DXM alone. It seems another actor, or perhaps a pair of them, is playing a tune behind the mainline. Or was it a masquerade?
DXM itself has a mild SSRI effect when taken alone. When taken with an overdose of CPM, serotonin receptor activation can easily surpass damaging levels. Regardless of serotonin syndrome damage, one or both of reception and production within the serotonin system is adaptively re-regulated. ie. receptor downregulation/destruction, and ligand production decrease.
Thus the unique combination of DXM with CPM can produce a single or double effect on the serotonin system, depending on dose. Re-regulation at low doses, receptor/cell death at higher doses. As two agents acting simultaneously via differing molecular mechanisms, they can together achieve more than either apart. That is called synergy.
A second synergy amplifies the first - both DXM and CPM share a single breakdown enzyme, and together saturate it leading to multiplicative potentiation:
Because CPM is far more toxic on a weight basis than DXM, the effect in a combined formulation is that DXM enhances CPM's effects and toxicity by inhibiting its breakdown metabolism via the shared isoenzyme.
Either or both of these paths leads to a chronically depressed state post-trip. One that worsens with each trip {somewhat like the post-MDMA binge depression}, yet is only relieved while intoxicated with the unique, and uniquely destructive, combination of high-dose DXM and high-dose Chlorpheniramine Maleate.
In short,
Coriciden is uniquely pleasureable - often addictively so - because of the way that both DXM and CPM mutualistically multiply by co-potentiation their individual effects to increase serotonin receptor activation. That happy, almost MDMA-like song of joy quickly leads to a drain of sorrow for the repeat user. For that unfortunate individual, both the pleasure and pain are together sinking in an ocean of tolerance:
... and with repeated use the water level rises, often leading to dose elevation and enhanced serotonergic destruction in a futile, repetitive spiral. As the dose is raised, psychosis from CPM and DXM becomes ever stronger.
With repeated dosing, it leads to ever-worsening chronic depression due to one or both of downregulation and toxicity in the serotonergic system, often followed by
psychosis, hospitalization, and death, as so many reports testify.
At first the glad master, the frequent user becomes a damaged slave to this toxic combination. Often continued knowing the nausea and vomiting to come, the evils of dosing show by their weight the counterweight of pleasure hanging like fruit from this miserable concoction.
Luckily, it is a simple matter to avoid such dangerous combinations: the careful shopper can have his cake and eat it too, with a little ingredients label reading.
