DXM vs. Ketamine, PCP, Codeine, Acid And Other Drugs

Last Updated: December 18, 2019

In recent years DXM recreational use has risen because of high effects of the medicine in exaggerated doses, which are often compared to other drugs. Mosty dextromethorphan is compared to PCP, LSD, Weed, Ketamine, Acid, etc. due to similar psychoactive effects. However, when it comes to DXM comparison with other drugs, there are many significant differences. It has a different mode of action, dosage, side effects, and risks.

DXM vs. Ketamine

Dextromethorphan medication is often compared to ketamine as both are dissociative anesthetics. DXM and ketamine are part of a family of drugs known as Glutamate Blockers, which slow down the activity of the Neurotransmitter Glutamate. Another similarity is the potential of both drugs to act as antidepressants by slowing down glutamate activity. Ketamine is well known as pain-relieving medication, and dextromethorphan also may attenuate acute pain sensations.

DXM has the next similarities of side effects with ketamine:

  • numbness
  • dizziness
  • hallucinations
  • changes in sensory perception, etc

Ketamine also produces more intense high in general at a lower dose. To achieve a similar high with Dextromethorphan, one would have to take a much larger dose. Dextromethorphan also lasts a lot longer, about 6 to 8 hours, while ketamine wears off fairly quickly.

Both drugs are often abused; however, although ketamine is classified as a controlled substance, dextromethorphan is still available over-the-counter in the form of cough medication, which is the main DXM difference from ketamine.


How does PCP compare to DXM? Phencyclidine (PCP) is similar to dextromethorphan as it is also a dissociative drug, which acts as a glutamate blocker. Compared to dextromethorphan, it produces more unpredictable reactions. DXM is like PCP in the sense that dextromethorphan was also used medically, as an anesthetic, but it was discontinued for use later.

How close is DXM to PCP in effects? Both of these drugs can cause hallucinations, dizziness, drowsiness, changes in sensory perception, nausea, etc.,

dxm causes aggressive behavior like PCP

Is DXM the same as PCP? No, unlike dextromethorphan, PCP can cause aggressive and violent behavior at high doses. This aggressive behavior combined with an inability to feel pain makes a person danger not only for themselves but for others too, an effect not mimicked by dextromethorphan. The general reactions of both typically last for around 6 hours; however, with PCP, it can take up to 24 hours to completely come back to normal. It also has more long term psychoactive side effects which can last for up to a year. DXM can test positive for PCP, and it happens very often.

Although the drugs have similar side effects, the PCP may cause more adverse reactions, lead to more potent addiction and has a higher death rate.

DXM vs. Codeine

DXM and codeine both are used as cough medicines; thus, it is easy to wonder whether DXM is the same as codeine. Codeine, like dextromethorphan, is classified as an opioid, but their modes of action are different. Dextromethorphan lowers glutamate activity while codeine works by stopping pain signals from reaching the brain. Because both DXM and codeine are used to treat cough, both are widely abused by teenagers who can get drugs from any local pharmacy without a prescription. This has changed for codeine, which can no longer be sold over the counter after it was found out that it is highly addictive like other narcotics. Some of the physical side effects are similar:

  • nausea,
  • dizziness
  • drowsiness.

Is a DXM high similar to codeine high? Both dextromethorphan and codeine create a euphoric high, which is why both are addictive; however, most of the major side effects are quite different. Psychoactive reactions of codeine are milder compared to dextromethorphan.

Unlike codeine, dextromethorphan is not physically addictive, but the body still can develop psychological dependence and tolerance to dextromethorphan.


LSD is similar to dextromethorphan in the sense that both produce psychedelic reactions such as visual and auditory hallucinations and a distorted sense of perception. However, LSD is primarily a psychedelic drug while dextromethorphan just has dissociative effects, typically causing out of body experiences at high doses. Since both cause hallucinations, it is common to wonder how DXM visuals are compared to LSD visuals. Hallucinations caused by LSD are typically more vivid and heighten the senses while those caused by dextromethorphan dull the senses.

dxm causes visuals like lsd

Compared to high doses of dextromethorphan, LSD has less severe physical consequences, and overdosing is significantly harder. Is DXM like acid? Dextromethorphan is typically taken recreationally only to get euphoria and visuals, and in high doses, DXM can feel like acid. However, some LSD users take it for spiritual and religious reasons. Users believe it clears the mind and offers a sort of spiritual awakening.

DXM vs. Shrooms

Shrooms are psychedelics, which cause visual and auditory hallucinations while Dextromethorphan causes dissociative out of body experiences along with hallucinations. Unlike Dextromethorphan, shrooms are classified as a schedule 1 drug in the US, which means there is no approved medical use.

Does DXM act like mushrooms? Some of the most common side effects of dextromethorphan are similar to those of mushrooms, such as hallucinations, nausea, dizziness, etc.. Shrooms compared to DXM have less severe side effects. Most physical reactions are relatively the same, including nausea, diarrhea, and cramps. Anxiety is another common side effect of the two drugs, but mushrooms can also cause paranoia as well as psychosis. In a controlled setting, however, both dextromethorphan and shrooms are thought to help with depression, although more research is needed. Shrooms are also significantly less addictive than dextromethorphan.

DXM vs. Weed

Consuming a low dose of dextromethorphan vs. consuming marijuana has similar reactions, such as a feeling of euphoria, relaxation, and drowsiness. Both can cause hallucinations and other psychological symptoms such as anxiety, panic attacks, and paranoia. In rare cases, marijuana can cause psychosis too.

Both dextromethorphan and marijuana have medicinal uses. Dextromethorphan is used in treating cough while cannabis (CBD) has been unofficially used to treat epilepsy. Just recently, the FDA has approved the first cannabis-based drug for the treatment of certain types of epilepsy.


MDMA (also known as Ecstasy, a well-known party drug) causes an increase in energy, a euphoric high, and a more extroverted personality. However, both MDMA and DXM increase Serotonin production raise blood pressure and heart rate, so DXM feels like MDMA in this respect.

There is a noticeable difference between DXM and MDMA side effects, as the second has potentially lethal ones, which are rarer compared to DXM. MDMA stays in the system longer, being detectable in urine for up to 3 days, while DXM exits the system quickly and is no longer detectable after 12 hours.

Getting Help

In a nutshell, DXM has side effects being more severe on average compared to other drugs such as weed, magic mushrooms, ketamine, etc. Drug addiction treatment options are widely available for dextromethorphan addicts since it has dramatically risen in popularity in recent decades. If the addiction is more severe and other efforts to quit the drug have failed, the addict ought to be checked into drug rehab centers. DXM, PCP, and Codeine are initially treated by a medical detox. Dextromethorphan addiction is also relatively easier to treat compared to other major drugs since it is not physically addictive. While ketamine and MDMA treatment requires strictly monitored rehab, dextromethorphan treatment can be both residential or outpatient.

Page Sources

  1. Weinbroum AA, Rudick V, Paret G, Ben-Abraham R. The role of dextromethorphan in pain control. 2000. https://www.ncbi.nlm.nih.gov/pubmed/10875724
  2. Roland R Griffiths, Matthew W Johnson, Michael A Carducci, Annie Umbricht, William A Richards, Brian D Richards, Mary P Cosimano, Margaret A Klinedinst. Psilocybin produces substantial and sustained decreases in depression and anxiety in patients with life-threatening cancer: A randomized double-blind trial. 2016. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5367557/
  3. FDA Food & Drug Administration NEWS RELEASE. FDA approves first drug comprised of an active ingredient derived from marijuana to treat rare, severe forms of epilepsy. 2018. https://www.fda.gov/news-events/press-announcements/fda-approves-first-drug-comprised-active-ingredient-derived-marijuana-treat-rare-severe-forms
  4. Paediatr Child Health Journal. A fatal case of Ecstasy poisoning. 2001. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2807764/#

Published on: August 6th, 2019

Updated on: December 18th, 2019

About Author

Peter J. Grinspoon, MD

Dr. Peter Grinspoon is an experienced physician with long-term clinical practice experience. As a former analgesic addict, Dr. Grinspoon knows precisely how important it is to provide patients with effective treatment and support. Medical writing for him is the way to communicate with people and inform them about their health.


Leave a comment