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dimenhydrinate (recreational/abuse/toxicity) refs
Can Med Assoc J 1969; 101:49–50.
 * 104. Brown JH, Sigmundson HK. Delirium from misuse of dimenhydrinate.

Can J Psychiatry 1993; 38:113–116.
 * 105. Gardner DM, Kutcher S. Dimenhydrinate abuse among adolescents.

experiences with a proprietary antihistamine. Am J Psychiatry 1972; 128:1012–3.
 * 106. Malcolm R, Miller WC. Dimenhydrinate (Dramamine) abuse: hallucinogenic

of an old problem. J Adolesc Health 1997; 21:47–49.
 * 108. Rowe C, Verjee Z, Koren G. Adolescent dimenhydrinate abuse: resurgence

dimenhydrinate. Ann Emerg Med 1993; 22:1481–1484.
 * 109. Winn RE, McDonnell KP. Fatality secondary to massive overdose of

'''Dimenhydrinate: Acute Exposures in Patients 6 Years of Age and Older''' The therapeutic dosage is 50 to 100 mg every 4 to 6 hours to a maximum of 400 mg per day (3). There were no level 1, 2, or 3 studies specifically investigating a toxic threshold dose for dimenhydrinate in patients 6 years of age and older. There were 16 cases (level 4) that involved ingestion of dimenhydrinate alone reported in six level 4 or 6 articles (104–109). The only case that was unintentional was a 42-year-old who developed anticholinergic toxicity from postoperative administration of dimenhydrinate; no dose information was provided (107). Malcolm and Miller (106) reported that two adults who ingested dimenhydrinate for recreational purposes developed euphoria and hallucinations. One of the adults ingested 16 50-mg tablets (800 mg) and one ingested 16 tablets of unknown strength. The two never sought treatment and the description of symptoms was based on selfreports. Brown and Sigmundson (104) described an 18-year-old who had “disappointing” results with 500 mg dimenhydrinate so he ingested 900–1250 mg. He developed marked anticholinergic symptoms, hallucinations, difficulty speaking and swallowing, and he became violent. In one case series, five girls ingested 500–750 mg and three girls ingested 750 mg to get high. The girls were aged 14 to 17 years. They developed mild tachycardia, ataxia, and feelings of being “spaced out.” One of the girls who ingested 750 mg reported hallucinations (108). In a case series of three teenagers who regularly abused dimenhy- drinate, a 17-year-old stated that he ingested 500–750 mg at a time (an unknown number of times) to get high over a 2-year period. In the second case, another 17-year-old reported that “many times” she ingested 250–350 mg at a time for a “cheap high”. The dose was not specified for the 18-year-old in the third case (105). There is one published death following an intentional overdose with 5000 mg (109). In the case reported by Winn and McDonnell (109), symptoms began within 30 minutes of the ingestion. Time to onset of symptoms was not reported in the other published cases.