Belladonna Alkaloid Intoxication: The 10-Year Experience of a Large Tertiary Care Pediatric Hospital.

The belladonna alkaloids can be isolated from a number of plants, which contain hallucinogens that represent a serious danger to infants, children, and adolescents. Roots, leaves, and fruits of the plant contain the alkaloids atropine, hyoscyamine, and scopolamine, which can lead to an anticholinergic toxidrome; however, not all characteristics of the toxidrome are necessarily present in each case of poisoning. A retrospective chart review of all children seen following anticholinergic ingestions, between April 2001 and November 2010, at the Hospital for Sick Children in Toronto. Ten children, with a mean age of 15.5 years (range, 15-18 years), were identified; 5 had used jimsonweed and the others had a variety of tablets containing atropine. All 10 presented with severe anticholinergic symptoms and 2 with suicide attempts. Treatments included charcoal, benzodiazepines, haloperidol, and physostigmine, and 2 patients were intubated. Ingestion and subsequent severe anticholinergic toxidrome occurred exclusively in adolescents. It is important to educate this age group regarding the toxicity and potential risks associated with the recreational use of these plants and substances. Physostigmine can help in both the diagnosis and management of patients intoxicated with these substances.

[Scopolica carniolica Jacq. tea]. / Hexentee.

We report a case of plant-poisoning of a young man following the consumption of a self-brewed infusion made of a solanaceous plant, to which he was seduced by his friends. He developed anticholinergic symptoms such as optical hallucinations, confusion, mydriasis and tachycardia. 14 hours after admission the patient was discharged from hospital in good health. With regard to this case we portray the mentioned plant (Scopolica carniolica Jacq.) and discuss the symptoms of belladonna-alkaloid-poisoning and its therapy. Further on, in a short literature survey, we depict the meaning of collective drug experiences with plants containing atropine-like substances in ancient and modern times.

[Atropa belladonna poisoning suggesting severe post-traumatic brain damage]. / Zatrucie wilcza jagoda (Atropa belladonna) sugerujace ciezkie pourazowe uszkodzenie mózgu.

In the paper I have described a case of a student of the University of Technology who has suffered a severe Atropa belladonna intoxication. Originally the student has been sent to the Surgery Department by the ambulance service doctor who had recognized the symptoms of the post-traumatic brain damage. The diagnosis of the post-traumatic brain damage has been excluded during the following diagnostic investigation, the symptoms represented by the patient and his bad general condition, however, has still reminded the same. As the next step the patient has been transferred to the Toxicology Ward according to our suggestion of Atropa belladonna intoxication, where the diagnosis has been confirmed. The patient has regained consciousness after 10 hours of the therapy (with the use of the respirator) and has been discharged from the hospital in a good general condition after 11 days. This case of intoxication has been an example of an experiment done by a very inquiring student on himself.

[Mydriasis, tachycardia]. / Mydriasis, Tachykardie.

We report a case of plant poisoning with atropa belladonna. A student took the berries because of the hallucinogen effects. In this case report we describe the symptoms and the therapy of poisoning with atropa belladonna. Another part informs about the historic and cultural importance of this nightshade. Since antiquity, the lethal as well as the hallucinogenic effects of poisoning with atropa belladonna are well known; therefore, they are an important part of orgies and rituals.

Anticholinergic poisoning associated with herbal tea.

An outbreak of cholinergic poisoning occurred in New York City during a 3-day period. Seven individuals from three families of South American origin were affected. Signs and symptoms of illness included dry skin, hyperthermia, tachycardia, dilated pupils, agitation, and hallucinations. Onset of illness in all cases was temporally associated with consumption of a tea that was labeled "Paraguay Tea" and was purchased from a grocery store specializing in South American foods. Paraguay tea, made from the leaves of the holly, Ilex paraguariensis, contains caffeine and theophylline and is a popular beverage in South America. Samples of the tea analyzed with gas chromatography contained belladonna alkaloids but neither caffeine nor theophylline. An investigation by the New York City Department of Health personnel determined that the tea was from a single lot, imported by one distributor, and sold at one grocery store. Unsold inventories of the tea were quarantined, and no further cases of anticholinergic poisoning were reported.

Anticholinergic poisoning associated with an herbal tea--New York City, 1994.

Inadvertent anticholinergic poisoning can result from consumption of foods contaminated with plants that contain belladonna alkaloids. During March 1994, the New York City Department of Health (NYCDOH) investigated seven cases of anticholinergic poisoning in members of three families; three of the seven ill persons required emergency treatment for characteristic manifestations. For all cases, manifestations occurred within 2 hours after drinking tea made from leaves purchased commercially and labeled as Paraguay tea--an herbal tea derived from the plant llex paraguariensis, which is native to South America. This report summarizes the investigation of these cases.

[Group poisoning by belladonna]. / Gruppenvergiftung mit Tollkirschentee.

A case is reported of collective intoxication in nine youths through self-brewed belladonna tea. Apart from peripheral anticholinergic symptoms, some of them had delirious states with visual hallucinations. The self-made tea was re-brewed in the laboratory and from the measured concentration of atropine the ingested total dose of atropine was estimated at up to 3 mg or more per person. In delirious states of unclear origin in young people, especially drug abusers, the possibility of intentional intoxication with atropine-containing plants should be considered. Intravenous physostigmine is the antidote of choice.

Delirium induced by poisoning with anticholinergic agents.

The authors report that anticholinergic poisoning may be increasing in frequency and present two such cases. They recommend the use of the physostigmine test and special laboratory requests for toxicologic screens as aids to the diagnosis.

Delayed fatal outcome after possible Ru-Tuss overdose.

Death resulted from the delayed onset of the acute respiratory distress syndrome and disseminated intravascular coagulation with left ventricular mural thrombus formation and nonbacterial thrombotic endocarditis approximately five days after an alleged attempted suicide by the ingestion of ten to twelve prolonged-action Ru-Tuss tablets. Although these lesions are thought to be similar in pathogenesis, this combination has not been previously reported in association with a drug overdose. The delay in onset is also of interest because of its clinical implications.

Anticholinergic poisoning from Jimson weed.

Jimson weed (Datura stramonium), is a wild growing herb that contains belladonna alkaloids. Recently there have been reports of intentional ingestion of Jimson weed by adolescents for psychedelic purposes. When seen in emergency department, these patients appear with physical signs of atropine-like poisoning, disturbances of thought and hallucinations. Diagnosis depends on a positive history, if available, and recognition of anticholinergic effects. Differentiation from lysergic acid diethylamide (LSD) ingestion and schizophrenia is important. Physostigmine, an anticholinergic agent, can reverse both central and peripheral manifestations of Jimson weed intoxication.