Datura poisoning, clinical and laboratory findings. Report of five cases

Abstract

Introduction. Plants of Datura species contain belladonna alkaloids that can cause central and peripheral anticholinergic effects. Abuse of Datura plants for their hallucinogenic effects is growing among adolescents and young adults. Datura poisoning has caused a diagnostic challenge in medical emergency wards. In this article we report 5 cases of Datura toxicity at Clinical Toxicology Emergency of Baharloo Hospital, Tehran, Iran during Summer-Fall 2015, and discuss their clinical presentations and laboratory findings. Cases. All 5 cases with Datura toxicity were young males and had intentionally used the plants. Mean duration of hospitalization was 3.2 days. Three cases were multiple-drug abusers. Mydriasis, tachycardia, tachypnea and flushing alongside with psychotic-like signs and symptoms were observed in all cases. Elevation of liver enzymes was present in three of cases but without clinical significance. Raised LDH or CPK in four patients were without myoglobinuria and evidence of rhabdomyolysis and these biomarkers returned to normal levels by supportive care. All patients discharged with complete recovery and there was no need to ICU admission. Discussion. With the absence of routine laboratory diagnostic tests for alkaloids and complex and confusing presentations of Datura intoxication, diagnosis of such cases is difficult. Physicians' clinical suspicion and sufficient knowledge play the mainstay roles in appropriate and timely diagnosis and management of cases with Datura toxicity. Since regulatory legislation wouldn't be successful in halting the availability of natural plants, the best strategy to prevent Datura abuse is informing people about the adverse effects of these plants.

Effects of datumetine on hippocampal NMDAR activity

“…Despite its potential usefulness, the plant has gained psychoactive use among the adolescent especially secondary school students in Nigeria [ 9 , 10 ]. In Nigeria, D. metel accounts for 0.08% of drug abuse [ 11 ].…”

“…Widely reports indicated that abusers of the plant do not remember any event(s) during the intoxication phase, and as such characterized as mind-altering and date rape drug [ 10 , 17 ]. A report showed that thieves used this plant to dispossess their victims of their belongings as they do not remember anything during the intoxication [ 18 ].…”

Drugs of abuse and ocular effects

“…Datura stramonium (Angel's trumpets, Jimson Weed, Loco weed, Devil's Trumpet, Moon Flower, Witch's Thimble, Devil's Apple, Thorn Apple, Stinkweed, Mad Apple, Devil's Weed, Malpitte, and Green Dragon) is a hallucinogen drug that is popular among teenagers. [117][118][119] This plant contains atropine, scopolamine, and hyoscyamine, creating an anticholinergic syndrome. This plant can be ingested, drunk in an herbal infusion or smoked.…”

“…This plant can be ingested, drunk in an herbal infusion or smoked. 118 The United Nations report 120 that in 2013, in Canada, adolescent prevalence for use of Datura was 2.6%.…”

“…Ocular effects of this drug are presumably related to its toxicity and anticholinergic action, which is thought to block of the central and peripheral muscarinic receptors. 121 Recurrent reports exist on Datura causing mydriasis with reduced or absent pupillary reaction, visual hallucinations, [118][119][120] and occasional reports on accommodation dysfunction, anisocoria, photophobia, diplopia, and blurry vision. [117][118][119][122][123][124][125]…”