Cold medicine has been linked to hallucinations. But could it actually lead to violence?

In the days since a Raleigh husband told a 911 dispatcher he took excessive cold medicine, then awoke to find his wife’s bloody body, the maker of the over-the-counter drug has defended the product.

Meanwhile, a UNC pharmacy professor – and others who have taken medicines such as Coricidin – say they’ve heard of or experienced hallucinations while on the drugs.

Early Friday, Raleigh police charged Matthew James Phelps, 29, with first-degree murder after finding his wife, Lauren Ashley-Nicole Hugelmaier Phelps, mortally stabbed on the bedroom floor of their northwest Raleigh townhouse. Phelps, a Bible college graduate who had been married less than a year, could face the death penalty if he is convicted.

In a 911 recording released by police, Phelps tells a dispatcher that he took too much Coricidin Cough & Cold medicine, then went to sleep. He recalled having a dream, then waking up to see his wife’s body and a knife on the bed.

Christopher Loder, a spokesman with the Bayer Corp., which manufactures Coricidin, issued a statement this week that said there is no evidence to suggest the medication is associated with violent behavior.

But Stefanie Ferreri, a clinical professor at UNC-Chapel Hill’s Eshelman School of Pharmacy, pointed to Dextromethorphan or DXM – a cough suppressant that’s found in Coricidin and other cold medications such as Robitussin and NyQuil. She said DXM can induce closed-eye hallucinations, out-of-body experiences and even temporary psychosis.

“There have been questions about whether it should be sold over the counter,” Ferreri said this week. “The Food and Drug Administration has been considering if it should go behind the counter like they have done with other medications that contain pseudoephedrine.”

Pseudoephedrine, found in some cold medications, is a key ingredient in making methamphetamine – a powerful, highly addictive stimulant often produced illegally by “meth cooks” in makeshift laboratories in garages, homes and even motel rooms.

After reading about Phelps, James Johnston of Evanston, Ill., called The News & Observer to share his own experience 30 years ago when he said he nearly choked his wife to death after taking the cold and flu medication NyQuil at bedtime.

“I had her in a head lock,” said Johnston, a retired 68-year-old businessman. “I was really trying to choke her. She was screaming and hollering.”

In an earlier experience taking NyQuil before going to bed, Johnston said he dreamed that he was fighting someone.

“I would raise my leg as high as I could to kick somebody, but I was kicking the bed,” he said. “We realized it was the NyQuil. I have never taken it again, and I have never had a problem since.”

During Phelps’ nearly six-and-a-half-minute 911 call, he told the dispatcher about having a dream, turning on the bedroom lights and finding his wife’s body on the floor.

“There’s blood all over me, and there’s a bloody knife on the bed. I think I did it,” Phelps told the dispatcher.

“I took more medicine than I should have. I took Coricidin Cough and Cold because I know it can make you feel good and sometimes I can’t sleep at night.”

Phelps then said, “Oh my God. Oh God. She didn’t deserve this. Why?”

When he heard the recording of the 911 call, Johnston said he was immediately reminded of his experience when he awoke to find he had been trying to choke his wife.

Ferreri said cough medicines can be used by teenagers for recreational purposes. They are easily accessible and can cause feelings of euphoria. Some who abuse Coricidin Cough & Cold know it by the slang names “Triple C” or “Skittles.” The high produced by such a drug or the cough medicine Robitussin is sometimes called a “robotrip.” The high gradually increases on a series of “plateaus,” from relaxed to a full out-of-body experience.

Ferreri said a recommended dosage of medications containing DXM is 30 milligrams taken twice daily. Dosages that exceed 120 milligrams by a 29-year-old, otherwise healthy person could cause hallucinations, euphoria, agitation, an out-of-body experience and psychosis, Ferreri said.

She also noted that an older person with a slower metabolism could take a proper dose and still have detrimental side effects.

“An older person having a harder time metabolizing it might have vivid dreams they don’t normally have,” she said.

Ferreri also said that individuals who abuse DXM do not develop the kind of higher tolerance for the drug that’s associated with opioid use.

“The side effects are the same each time,” she said. “Same dose. Same high.”

Phelps’ attorney, Joseph Blount Cheshire V of Raleigh, said this week that Coricidin’s side effects would be a “subject of inquiry” during the course of his client’s trial.

Ferreri said she’s not surprised Cheshire may be considering that as a line of defense.

“For me, if I was that attorney, I would go down that route,” she said. “He has a pretty good case.”

Thomasi McDonald: 919-829-4533, @thomcdonald