Syrian rue tea: A recipe for disaster

Yürüktümen, Aslıhan; Karaduman, Sevilay; Bengi, Fecri; Fowler, John

doi:10.1080/15563650701323205

Cited by 24 publications

(18 citation statements)

References 11 publications

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“…Liver injury already noted [13] was observed in our case; it was moderate and reversible. Kidney lesion was also reported in the literature [13, 15]; in our case, we noted a severe renal failure that needed initially hemodialysis and was reversible later.…”

Section: Discussionsupporting

confidence: 75%

Peganum harmalaL. Intoxication in a Pregnant Woman

Berdaï

Labib

Harandou

2014

Case Reports in Emergency Medicine

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Peganum harmala L. is a plant widely distributed in the Mediterranean region. It is commonly used in traditional medicine in Morocco as sedative and abortifacient but exposes users to the risk of overdose and poisoning. The pharmacologically active compounds of this plant include a number of β-carboline and quinazoline alkaloids responsible of its pharmacological and toxicological effects. We report the case of a 24-year-old woman, 22 weeks pregnant, intoxicated with the seeds of Peganum harmala L. On admission, she had disturbance of consciousness, uterine contraction, and oliguria. Laboratory tests revealed renal failure and liver injury, and she benefited then from hemodialysis. During hospitalization, she was intubated after deterioration of consciousness and presented a spontaneous expulsion of the fetus. After extubation, she kept unusual sequelae: cerebellar ataxia and peripheral polyneuropathy. Physicians in regions using Peganum harmala L. as traditional medicine must be able to detect symptoms of its toxicity, in order to establish early gastrointestinal decontamination. The prognosis of this intoxication is variable; most cases can be managed successfully; but in high doses of intoxication, evolution can be fatal.

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Section: Discussionsupporting

confidence: 75%

Peganum harmalaL. Intoxication in a Pregnant Woman

Berdaï

Labib

Harandou

2014

Case Reports in Emergency Medicine

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“…2, A and B, and 3, A and B). Given the fact that the lowest dose (2 mg/kg) of harmaline tested in this study is actually lower than the human equivalent dose (5 mg/kg) (Ott, 2001;Riba et al, 2003;Yuruktumen et al, 2008), a complete inhibition of MAO-A by harmaline might occur and it is expected to alter the PK of 5-MeO-DMT or other MAO-A substrate drugs in humans. The complete blockage of MAO-A activity in mice treated with various doses of harmaline (e.g., 2, 5, and 15 mg/kg) plus the same dose of 5-MeO-DMT (e.g., 2 mg/kg) is also supported by the observation of similar blood 5-MeO-DMT C max values (e.g., about 1.9 mM; Table 2).…”

Section: Discussionmentioning

confidence: 99%

Pharmacokinetic Interactions between Monoamine Oxidase A Inhibitor Harmaline and 5-Methoxy-N,N-Dimethyltryptamine, and the Impact of CYP2D6 Status

et al. 2013

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5-Methoxy-N,N-dimethyltryptamine (5-MeO-DMT or street name "5-MEO") is a newer designer drug belonging to a group of naturally occurring indolealkylamines. Our recent study has demonstrated that coadministration of monoamine oxidase A (MAO-A) inhibitor harmaline (5 mg/kg) increases systemic exposure to 5-MeO-DMT (2 mg/kg) and active metabolite bufotenine. This study is aimed at delineating harmaline and 5-MeO-DMT pharmacokinetic (PK) interactions at multiple dose levels, as well as the impact of CYP2D6 that affects harmaline PK and determines 5-MeO-DMT Odemethylation to produce bufotenine. Our data revealed that inhibition of MAO-A-mediated metabolic elimination by harmaline (2, 5, and 15 mg/kg) led to a sharp increase in systemic and cerebral exposure to 5-MeO-DMT (2 and 10 mg/kg) at all dose combinations. A more pronounced effect on 5-MeO-DMT PK was associated with greater exposure to harmaline in wild-type mice than CYP2D6-humanized (Tg-CYP2D6) mice. Harmaline (5 mg/kg) also increased blood and brain bufotenine concentrations that were generally higher in Tg-CYP2D6 mice. Surprisingly, greater harmaline dose (15 mg/kg) reduced bufotenine levels. The in vivo inhibitory effect of harmaline on CYP2D6-catalyzed bufotenine formation was confirmed by in vitro study using purified CYP2D6. Given these findings, a unified PK model including the inhibition of MAO-A-and CYP2D6-catalyzed 5-MeO-DMT metabolism by harmaline was developed to describe blood harmaline, 5-MeO-DMT, and bufotenine PK profiles in both wild-type and Tg-CYP2D6 mouse models. This PK model may be further employed to predict harmaline and 5-MeO-DMT PK interactions at various doses, define the impact of CYP2D6 status, and drive harmaline-5-MeO-DMT pharmacodynamics.

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“…The primary origin of the plant is central Asia, but nowadays, it is native to the Mediterranean region, including the Middle East, North Africa, and southern Europe. It also grows in other subtropical areas such as Australia and southwest of the United States [3][4][5]. The plant is a multi-branched shrubby raising to 60cm with short creeping roots, deeply cleft linear P leaves, white 5-petaled flowers, and rounded 3-celled seed capsules carrying more than 50 seeds [2].…”

Section: Introductionmentioning

confidence: 99%

“…Similarly, the dried capsules of the plant are hung in some houses to protect against "the evil eye" in some regions of Iran and Turkey [2]. P. harmala is recognized as "Üzerlik" or "Yüzerlik" in Turkey, "Harmel" or "Harmal" in North Africa and Arab countries, and "African Rue", "Syrian rue", "Turkish Rue", and "Mexican Rue" in the United States [1][2][3][4][5][6][7]. For centuries, it has been used to produce a red dye for Persian carpets, and in the 1920s, it was imported into the United States for this purpose [5].…”

Section: Introductionmentioning

confidence: 99%

Abortion Induced by Peganum Harmala Ingestion in a Pregnant Woman: A Case Report and Literature Review

Vahabzadeh

Mohammadi

Delirrad

2019

IJMTFM

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Background: Peganum harmala is a medicinal plant used in Iran and other countries. Many therapeutic effects have been described for this plant; it is insect repellant, disinfectant, antimicrobial, sedative, analgesic, anti-inflammatory, emetic, and abortifacient. Roots and seeds are medicinally-active parts of the plant containing some β-carboline and quinazoline alkaloids, which are responsible for its pharmacological and toxicological effects. Poisoning with high doses of Peganum harmala can be life-threatening. Case Report: We reported a 31-year old woman with an unwanted pregnancy, who ingested 1 glass of Peganum harmala seeds to induce abortion. On admission, she had severe nausea and vomiting, mild abdominal pain, and stable vital signs. Physical examination was unremarkable, and the leukocytosis was the only abnormal laboratory finding. The patient underwent nasogastric tube insertion, gastric lavage, as well as the administration of activated charcoal. Although she left the hospital on self-consent, further follow-up revealed that she had a spontaneous abortion without any complications. Conclusion: Although most cases of Peganum harmala intoxication can be managed successfully, this poisoning led to abortion in our case. Physicians working in Iran and other regions, where Peganum harmala is used as traditional medicine, must be aware of its toxicity for the early diagnosis and management.

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Syrian rue tea: A recipe for disaster

Cited by 24 publications

References 11 publications

Peganum harmalaL. Intoxication in a Pregnant Woman

Peganum harmalaL. Intoxication in a Pregnant Woman

Pharmacokinetic Interactions between Monoamine Oxidase A Inhibitor Harmaline and 5-Methoxy-N,N-Dimethyltryptamine, and the Impact of CYP2D6 Status

Abortion Induced by Peganum Harmala Ingestion in a Pregnant Woman: A Case Report and Literature Review

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