Dextromethorphan-induced near-fatal suicide attempt in a slow metabolizer at cytochrome P450 2D6

Caution should be exercised in prescribing DXM to geriatric patients, as they may be more susceptible to the drug's adverse effects because of increased clearance time. It appears that dose may play a greater role in causing psychosis, rather than the rate of metabolism, as evident in our patient who, contrary to the more oftendescribed scenario, was a slow metabolizer at CYP2D6.