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Journal of Medical Toxicology

, Volume 10, Issue 2, pp 148–151 | Cite as

Nutmeg Poisonings: A Retrospective Review of 10 Years Experience from the Illinois Poison Center, 2001–2011

  • Jamie E. EhrenpreisEmail author
  • Carol DesLauriers
  • Patrick Lank
  • P. Keelan Armstrong
  • Jerrold B. Leikin
Toxicology Investigation

Abstract

Nutmeg is a commonly consumed spice. The toxic effects of nutmeg have been purported to be due mainly to myristicin oil. Prior poison center series of nutmeg exposures show very few unintentional exposures of nutmeg to children younger than 13. Case series from these centers did not record drug exposures combined with nutmeg. This study is a review of Illinois Poison Center (IPC) data regarding nutmeg exposures from January of 2001 to December 2011. The goal of this study was to compare the Illinois data to the literature as well as look for current trends in nutmeg poisonings. The data were extracted using the code for hallucinogenic plants in the IPC database, and poisonings unrelated to nutmeg exposure were eliminated. Medical outcomes were noted as recorded. Thirty-two cases of nutmeg ingestion were reported. Of the 17 (53.1 %) unintentional exposures, 10 subjects (58.8 %) were under the age of 13. Four of the exposures in children under the age of 13 were ocular exposures. Fifteen exposures (46.9 %) were intentional exposures. Of these intentional exposures, five (33.3 %) were recorded to have combined drug intoxication. All of these were between the ages of 15 and 20. One patient with polypharmaceutical exposure required ventilatory support in the hospital. Our study shows an unexpected percentage of unintentional exposures in juveniles under the age of 13, out of the total exposures to nutmeg. Mixing of nutmeg with other drugs was seen and required more intervention in adolescents. More education about these two factors, i.e., nutmeg exposures as intentional polypharmacy in adolescents and unintentional exposures in young children, is advised.

Keywords

Nutmeg Myristicin oil Polypharmacy Overdose Hallucinogen 

Notes

Acknowledgments

The authors would like to thank Dr. Eli D. Ehrenpreis for his help in manuscript preparation.

References

  1. 1.
    Quin GI, Fanning NF, Plunkett PK (1998) Nutmeg intoxication. J Accid Emerg Med 15(4):287–288PubMedCentralPubMedCrossRefGoogle Scholar
  2. 2.
    Carstairs SD, Cantrell FL (2011) The spice of life: an analysis of nutmeg exposures in California. Clin Toxicol 49:177–180CrossRefGoogle Scholar
  3. 3.
    Forrester MB (2005) Nutmeg intoxication in Texas, 1998–2004. Hum Exp Toxicol 24:563–566PubMedCrossRefGoogle Scholar
  4. 4.
    Barceloux DG (2009) Nutmeg (Myristica fragrans Houtt.). Dis Mon 55:373–379PubMedCrossRefGoogle Scholar
  5. 5.
    Stein U, Greyer H, Hentchel H (2001) Nutmeg (myristicin) poisoning-report on a fatal case and a series of cases recorded by a poison information center. Forensic Sci Int 118:87–90PubMedCrossRefGoogle Scholar
  6. 6.
    Demetriades AK, Wallman PD, McGuiness A, Gavalas MC (2005) Low cost, high risk: accidental nutmeg intoxication. Emerg Med J 22:223–225PubMedCentralPubMedCrossRefGoogle Scholar
  7. 7.
    Bronstein AC, Spyker DA, Cantilena LR Jr, Rumack BH, Dart RC (2011) 2011 Annual report of the American Association of Poison Control Centers’ National Poison Data System (NPDS): 26th annual report. Clin Toxicol 49:910–941CrossRefGoogle Scholar
  8. 8.
    Hoyt BT, Rasmussen R, Griffin S, Smilkstein MJ (2008) Poison center data accuracy: a comparison of rural hospital chart data with the TESS database. Acad Emerg Med 6(8):851–855CrossRefGoogle Scholar
  9. 9.
    Blanc PD, Kearney TE, Olson KR (1995) Underreporting of fatal cases to a regional poison control center. West J Med 162(6):505–509PubMedCentralPubMedGoogle Scholar
  10. 10.
    Hoppe-Roberts JM, Lloyd LM, Chyka PA (2000) Poisoning mortality in the United States: comparison of national mortality statistics and poison control center reports. Ann Emerg Med 35(5):440–448PubMedCrossRefGoogle Scholar
  11. 11.
    Ghosh A, Ghosh T (2010) Herbal drugs of abuse. Syst Rev Pharm 1:141–145CrossRefGoogle Scholar
  12. 12.
    Brenner N, Knight E, Frank OS (1993) Chronic nutmeg psychosis. J R Soc Med 86(3):179–180PubMedCentralPubMedGoogle Scholar
  13. 13.
    Sjo O, Hvidberg EF, Naestoft J, Lund M (1975) Pharmacokinetics and side-effects of clonazepam and its 7-amino-metabolite in man. Eur J Clin Pharmacol 8(3):249–254PubMedCrossRefGoogle Scholar
  14. 14.
    Pitsikas N (2000) Duloxetine Eli Lilly & Co. Curr Opin Investig Drugs 1:116–121PubMedGoogle Scholar
  15. 15.
    Vgontzas AN, Kales A, Bixler EO (1995) Benzodiazepine side-effects: role of pharmacokinetics and pharmacodynamics. Pharmacology 51:205–222PubMedCrossRefGoogle Scholar

Copyright information

© American College of Medical Toxicology 2014

Authors and Affiliations

  • Jamie E. Ehrenpreis
    • 1
    Email author
  • Carol DesLauriers
    • 2
  • Patrick Lank
    • 3
    • 4
  • P. Keelan Armstrong
    • 5
    • 6
  • Jerrold B. Leikin
    • 7
  1. 1.Rosalind Franklin University of Medicine and ScienceSkokieUSA
  2. 2.Illinois Poison CenterChicagoUSA
  3. 3.Northwestern University Feinberg School of MedicineChicagoUSA
  4. 4.Department of Emergency MedicineNorthwestern UniversityChicagoUSA
  5. 5.Computer Science DepartmentBrandeis UniversityBostonUSA
  6. 6.Computer Science Department MS 018Brandeis UniversityWalthamUSA
  7. 7.NorthShore University HealthSystemGlenviewUSA

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