Three cases of angel's trumpet tea-induced psychosis in adolescent substance abusers

Abstract

An increase of intoxications in persons using alkaloid-containing ornamental plants (mainly angel's trumpet) for their hallucinogenic effects and easy and cheap availability is registered. It is mainly adolescents who are experimenting with these plants. In addition to severe vegetative anticholinergic symptoms, the clinical picture is often dominated by a toxic psychosis with hallucinations, disturbances of orientation, and psychomotoric agitation, aggression, or anxiety. Three cases of severe psychotic pictures with only mild or completely missing vegetative symptoms after ingestion of angel's trumpet tea are reported. Caused by the increasing spreading of angel's trumpet shrubberies in Europe and North America, intoxications with large numbers of fatalities have to be expected in the future. The taxonomical, pharmacological, and clinical aspects of angel's trumpet-induced disorders are discussed. Knowledge of the clinical picture is important for correct diagnosis and treatment. Prevention by mass media should mainly focus on the medical fatalities of abuse and not emphasize the hallucinogenic effects, presumably increasing unwanted interest for these plants among youths.

Towards an animal model of an antipsychotic drug-resistant cognitive impairment in schizophrenia: scopolamine induces abnormally persistent latent inhibition, which can be reversed by cognitive enhancers but not by antipsychotic drugs

“…We showed (Barak and Weiner, 2007) that low doses of scopolamine (0.15, 0.5 mg/kg) led to LI disruption, and this was reversed by both typical and atypical APDs and by the acetylcholinesterase (AChE) inhibitor physostigmine, as found with muscarinic antagonist-induced pro-psychotic effects in humans (Brown et al, 2004 ;Gopel et al, 2002 ;Granacher and Baldessarini, 1975) and animals (Hohnadel et al, 2007 ;Jones et al, 2005). Based on this behavioural and pharmacological profile, we suggested that scopolamine-induced LI disruption might model the positive spectrum of the antimuscarinic syndrome.…”

The muscarinic system, cognition and schizophrenia

“…Anti-muscarinic psychosis is characterized by a number of schizophrenia-like symptoms, including attention and executive function difficulties, memory loss, multi-sensory hallucinations and delusions (see Barak, 2009, for a review). This drug-induced psychotic state can be treated with antipsychotic medications or acetylcholinesterase inhibitors, in addition to discontinuing the anti-muscarinic treatment that trigged the state (Göpel et al, 2002;Granacher and Baldessarini, 1975;Nogué et al, 1991). Similarly, acute administration of anti-muscarinic agents can also produce cognitive impairments amongst otherwise healthy human subjects that mimic the deficits documented amongst schizophrenia patients (e.g.…”

Neuropsychiatric Effects of Prescription Drug Abuse

“…Case reports exist of anticholinergic intoxication from moonflower seeds (Datura inoxia) (DeFrates et al 2005), nutmeg (Abernethy and Becker 1992), and angels trumpet (Brugmansia) (Isbister et al 2003;Gopel et al 2002).…”