Belladonna, one of the most famous poisonous plants in history, went from centuries of use in medicine and cosmetics to the center of a major FDA safety controversy in 2016. The plant itself still grows across Europe and parts of Asia, and compounds derived from it remain in clinical use today. But the name became headline news when homeopathic teething products containing belladonna were linked to serious adverse events in infants, prompting recalls and federal warnings.
Belladonna’s Long History of Use
Atropa belladonna, commonly called deadly nightshade, has been used for centuries in ways that seem alarming by modern standards. In 14th-century Italy, women dropped belladonna extract into their eyes to dilate their pupils, creating a glassy, wide-eyed look considered attractive at the time. The plant’s name literally translates to “beautiful woman” in Italian.
By the early 20th century, belladonna had a legitimate place in Western medicine. Nursing textbooks from the 1920s through the 1950s documented its uses as a pain reliever, pupil dilator, muscle relaxant, and breathing stimulant given before chloroform anesthesia. Those same textbooks also noted careful dosing parameters and the serious hazards of taking too much, because the line between a therapeutic dose and a toxic one is dangerously thin.
How Belladonna Affects the Body
Belladonna contains compounds that block a key chemical messenger in the nervous system, essentially shutting down certain automatic body functions. It paralyzes nerve endings, which causes breathing rate to increase while simultaneously halting the production of body fluids like mucus, gastric juices, and breast milk.
At low doses, these effects can be medically useful. At higher doses, they produce what toxicologists call anticholinergic syndrome: a predictable and dangerous cascade of symptoms. The body overheats because it can’t sweat. The heart races. The mouth goes completely dry. The pupils dilate so wide that light becomes painful. The digestive system and bladder stop working normally.
The central nervous system effects are even more alarming and get worse as the dose increases. They range from agitation and short-term memory loss to vivid hallucinations (both visual and auditory), seizures, and eventually cardiovascular collapse and coma. The classic medical mnemonic for belladonna poisoning describes the patient as “hot as a hare, blind as a bat, dry as a bone, red as a beet, mad as a hatter.”
How Toxic the Plant Actually Is
Belladonna berries look like small, dark, glossy cherries, which makes them particularly dangerous around children. Ingesting just two to three berries can be toxic to a child. For an adult, the threshold is roughly 10 berries. Every part of the plant is poisonous, but the berries and roots contain the highest concentrations of toxic compounds.
The Teething Tablet Controversy
The event that put belladonna back in the news was an FDA warning issued in September 2016. The agency warned consumers that homeopathic teething tablets and gels containing belladonna posed an unnecessary risk to infants and children, urging parents to stop using the products immediately and throw away any they had at home.
The products in question were marketed by Hyland’s Inc. and CVS, among others. Homeopathic products are supposed to contain only extremely diluted amounts of their active ingredients, so diluted that little to no original substance remains. But FDA testing revealed something different: the levels of belladonna-derived compounds in some of the CVS tablets and some of the Hyland’s tablets far exceeded the amounts stated on the labels. In other words, infants were getting unpredictable and potentially dangerous doses of a potent toxin.
The fallout was swift. In April 2017, Standard Homeopathic Company issued a nationwide voluntary recall of Hyland’s teething tablets. Over the following months, the FDA issued warning letters to multiple other manufacturers, including Raritan Pharmaceuticals, Homeolab USA, and Nova Homeopathic Therapeutics. The episode raised broader questions about the regulation of homeopathic products, which have historically faced less federal oversight than conventional drugs.
Where Belladonna Stands Today
Despite the teething tablet scandal, belladonna hasn’t disappeared from medicine. Two compounds originally isolated from the plant, atropine and scopolamine, are still widely used in conventional healthcare. Atropine is a standard treatment for dangerously slow heart rate and is used in emergency medicine worldwide. Ophthalmologists and optometrists still use atropine drops to dilate patients’ eyes during exams, a direct descendant of the practice Italian women used centuries ago. In herbal medicine, belladonna preparations are still sometimes used to manage muscle spasms, nerve pain, and excessive secretions, though with far greater caution than in earlier eras.
Several prescription products still combine belladonna alkaloids with phenobarbital for gastrointestinal conditions. These are regulated as prescription medications with controlled dosing, a very different situation from the inconsistently manufactured homeopathic products that triggered the 2016 crisis.
The plant itself remains widespread. It grows naturally across Europe and has not been evaluated for conservation concern by the IUCN. It is neither endangered nor particularly rare in its native range. Belladonna’s story is less about a plant that vanished and more about a substance that modern regulation struggled to keep safe, particularly when it was marketed in products for the most vulnerable patients.