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Conservative treatment of jimsonweed ingestion.

The use of physostigmine for the treatment of jimsonweed ingestion remains controversial. We have reviewed the records of 29 cases reported to the Kentucky Regional Poison Center (KRPC) over a 7-y period during which time physostigmine was not recommended by the Center to assess the results of conservative therapy. 28/29 cases represented intentional abuse; 26/29 were males and the mean age for the group was 18.9 y (range 16 mo to 39 y). The reported ingested amounts ranged from a few to 1/2-cup of seeds. Typical mild anticholinergic symptoms including mydriasis, tachycardia, flushing, hallucinations, and both agitated behavior and lethargy were observed. No patient had life-threatening symptoms. All cases were referred to the Emergency Department, although only 20 complied. Of these, 17 were admitted for stays of 1-3 d (mean 1.8). Seventeen patients received activated charcoal on recommendation of the KRPC. Three patients with hallucinations received 1 or more doses of valium or haloperidol for sedation. All patients recovered uneventfully. We conclude that conservative treatment of jimsonweed ingestion is safe and adequate.

Adolescent↗

Accidental ingestion of jimsonweed by an adolescent.

Ingestion of jimsonweed can result in hallucinations. Despite this side effect, the differential diagnosis of jimsonweed toxicity can be difficult, in part, because routine drug screens do not detect this agent. Such a delay in diagnosis not only postpones treatment but may also result in the patient's death. Treatment involves gastric lavage, followed by supportive care. Life-threatening cases entail the cautious use of physostigmine salicylate.

Adolescent↗

Mass ingestion of Jimson Weed by eleven teenagers.

Jimson Weed is a naturally occurring plant which is commonly ingested for its hallucinogenic properties. This paper is a case report summarizing 11 cases of patients, ages 13-21 years, who presented to our emergency department following oral ingestion of large quantities of Jimson Weed pods and seeds. Toxicity following ingestion is due to an atropine-containing alkaloid contained throughout the plant and concentrated in the seeds. Signs and symptoms ranged from asymptomatic mydriasis and tachycardia to severe agitation, disorientation, and hallucinations. Nine of the eleven patients were admitted for observation. There were no deaths associated with these ingestions and none of the patients required physostigmine for reversal of severe anticholinergic symptoms. This paper also includes an historical overview of Jimson Weed, its physiologic effects, the epidemiological data, and a treatment summary.

Adolescent↗