Datura, a genus of flowering plants known as Jimson Weed, Devil’s Trumpet, or Thornapple, is found worldwide in temperate and tropical regions. Every part of the Datura plant contains dangerous compounds that can cause severe illness or death if ingested. The risk of a fatal overdose is high due to its extreme toxicity, meaning Datura ingestion constitutes a medical emergency requiring immediate professional intervention.
Toxic Compounds and Mechanism of Action
The plant’s toxicity stems from potent natural chemicals known as tropane alkaloids, primarily atropine, scopolamine (hyoscine), and hyoscyamine. These substances are classified as anticholinergics because they interfere with the nervous system’s signaling pathways by binding to and blocking muscarinic acetylcholine receptors.
Acetylcholine is a neurotransmitter that controls involuntary body functions like digestion, salivation, and heart rate via the parasympathetic nervous system. By blocking these receptors, Datura alkaloids paralyze the parasympathetic system, leading to a massive over-activation of the opposing sympathetic system. This disruption produces the widespread and life-threatening symptoms known as anticholinergic syndrome.
Signs and Symptoms of Datura Poisoning
The effects of Datura poisoning result directly from systemic anticholinergic blockade across multiple organ systems. The classic presentation is described by the mnemonic: “hot as a hare, blind as a bat, dry as a bone, red as a beet, and mad as a hatter.” Symptoms begin within 30 to 60 minutes after ingestion but may be delayed if the plant material slows gastric emptying.
The neurological effects are the most dramatic, involving profound central nervous system dysfunction. Patients experience severe agitation, delirium, confusion, and vivid, disorienting hallucinations. This altered mental state can lead to bizarre or violent behavior, and amnesia for the entire event is common.
Physical symptoms include severe mydriasis (widely dilated pupils), causing painful light sensitivity and blurred vision. Inhibition of sweating and salivation results in extremely dry skin and mouth, often accompanied by a flushed, red face due to peripheral vasodilation. The heart rate becomes abnormally fast (tachycardia), and bladder muscles relax, leading to urinary retention. Symptoms can persist for 24 to 48 hours, or up to two weeks in severe cases.
Factors Determining Lethal Outcome
The lethality of Datura poisoning depends on plant-related variables and patient factors. The concentration of toxic alkaloids can vary by as much as 20-fold between individual plants, depending on the species, the part ingested, the season, and growing conditions. This unpredictability means the toxic dose is extremely narrow and impossible to calculate.
Fatal outcomes occur through specific physiological complications. Intense agitation combined with the inability to sweat causes body temperature to rise dangerously (severe hyperthermia). Uncontrolled hyperthermia quickly results in brain damage and multi-organ failure.
Dangerous cardiac arrhythmias are a serious risk due to massive sympathetic overstimulation of the heart. At very high doses, the alkaloids can cause profound central nervous system depression, leading to respiratory failure and coma. Underlying health conditions, especially heart or kidney issues, and delays in medical care significantly increase the probability of a fatal result.
Emergency Response and Medical Treatment
Datura ingestion must be treated as a life-threatening medical emergency requiring immediate action. The first step is to call emergency services or a Poison Control Center. Responders need to know what was ingested, how much, and the approximate time it was consumed.
In the hospital, management focuses on aggressive supportive care to stabilize the patient. This includes continuous monitoring of cardiac function and ensuring the airway and breathing are maintained. Hyperthermia is managed with cooling measures to prevent organ damage.
For severe symptoms like dangerous heart rhythms, life-threatening delirium, or seizures, an antidote called physostigmine may be administered. Physostigmine is a cholinesterase inhibitor that temporarily reverses toxic effects by increasing acetylcholine available to compete with the Datura alkaloids. Activated charcoal may also be given early after ingestion to reduce the absorption of remaining toxins.