Management overview for anticholinergic alkaloid poisoning from plants

Anticholinergic alkaloid plant poisoning is rare and usually due to recreational ingestion for hallucinogenic effects. Plants that contain anticholinergic alkaloids include angel’s trumpet (Brugmansia species), deadly nightshade (Atropa belladonna) and other plants from the Datura and Duboisia species (see Common plant-derived toxins for common plant-derived toxins). In Australia, flowers of the angel’s trumpet are often brewed and taken as a tea.

It is difficult to ingest enough of the active agent to cause hallucinations without developing an anticholinergic delirium. Management focuses on supportive care and sedation for agitation. If deliberate ingestion of a toxic plant is suspected, seek advice from a clinical toxicologist or poisons information centre (13 11 26). All patients who present with deliberate self-poisoning from plants require psychiatric assessment before discharge.