A case of beta-carboline alkaloid intoxication following ingestion of Peganum harmala seed extract.
Beta-carboline alkaloids harmine, harmaline, and tetrahydroharmine can stimulate the central nervous system by inhibiting the metabolism of amine neurotransmitters, or by direct interaction with specific receptors; they are found in numerous plants, including Peganum harmala, Passiflora incarnata and Banisteriopsis caapi, and in the entheogen preparation Ayahuasca, which is traditionally brewed using B. caapi to enhance the activity of amine hallucinogenic drugs. The ingestion of plant preparations containing beta-carboline alkaloids may result in toxic effects, namely visual and auditory hallucinations, locomotor ataxia, nausea, vomiting, confusion and agitation. We report a case of intoxication following intentional ingestion of P. harmala seed infusion; P. harmala seeds were bought over the Internet. The harmala alkaloids were identified by gas chromatography-mass spectrometry in the seed extract and the patient's urine. This is, to our knowledge, the first case of P. harmala intoxication corroborated by toxicological findings.
Frison
Giampietro
G
Forensic Toxicology and Antidoping Unit, University Hospital of Padova, Via Falloppio 50, I-35121 Padova, Italy.
Favretto
Donata
D
Zancanaro
Flavio
F
Fazzin
Giorgio
G
Ferrara
Santo Davide
SD
D000328:Adult; D000470:Alkaloids / Q000009:adverse effects* / Q000652:urine; D001259:Ataxia / Q000139:chemically induced; D002243:Carbolines / Q000009:adverse effects* / Q000652:urine; D053593:Forensic Toxicology; D008401:Gas Chromatography-Mass Spectrometry; D006212:Hallucinations / Q000139:chemically induced; D006801:Humans; D008297:Male; D032443:Peganum / Q000009:adverse effects*; D010936:Plant Extracts / Q000009:adverse effects*; D011595:Psychomotor Agitation / Q000209:etiology; D012639:Seeds / Q000009:adverse effects*; D014202:Tremor / Q000139:chemically induced; D014839:Vomiting / Q000139:chemically induced
D000470:Alkaloids; D002243:Carbolines; D010936:Plant Extracts