The non-narcotic dextrorotatory morphinan, dextrorphan, as well as its levorotatory opioid enantiomer, levorphanol, and its O-methyl derivative, dextromethorphan, have recently been shown to antagonize N-methyl-D-aspartate receptor-mediated neurotoxicity. Consistent with in vivo data suggesting that this neurotoxicity contributes to the neuronal damage associated with hypoglycemia, micromolar concentrations of these morphinans markedly attenuated the injury of cultured mouse cortical neurons produced by acute glucose deprivation. These observations lend specific support to the possibility that morphinan compounds may prove to have clinical therapeutic utility in hypoglycemic encephalopathy.