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Dextromethorphan + risperidone is an investigational drug combination studied for the treatment of schizophrenia. Dextromethorphan, a small molecule traditionally used as an over-the-counter antitussive, acts as a non-competitive N-methyl-D-aspartate (NMDA) receptor antagonist and sigma-1 receptor agonist with anti-inflammatory and neuroprotective properties. In a clinical trial conducted by National Cheng-Kung University Hospital in collaboration with the National Defense Medical Center, dextromethorphan was evaluated as an adjunctive (add-on) therapy to risperidone, an atypical antipsychotic that targets dopamine D2 and serotonin 5-HT2A receptors. The therapeutic rationale for this combination involves dextromethorphan's potential to protect dopamine neurons from inflammation-mediated degeneration and provide neurotrophic support to monoamine neurons, potentially addressing both positive and negative symptoms of schizophrenia more effectively than antipsychotic monotherapy.
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