Final Diagnosis -- Jimson Weed Toxicity (Confusion, Agitation and Unresponsiveness)


Contributor's Note:

Jimson Weed (Datura stramonium) is also known as Stink Weed, Jamestown Weed, Angel's Trumpet, Thornapple and Loco Weed. It is a large annual herb 3-5 feet high with green to purple stems, simple oval-shaped leaves with coarsely toothed margins, and 2-5 inch long funnel-shaped white or violet flowers. Both the flower and the plant produce a foul odor giving it the name Stink Weed. The fruit (thorny pod) is ovoid with spiny capsules that are 2 inches long at full maturity. This contains the black-brown kidney-shaped seeds which are released from the pod in the fall. The plant is native to North America and is naturalized throughout the world. The three main toxic agents produced by the plant are atropine, scopolamine and hyoscyamine. These are found in all parts of the plant including the roots, stems, leaves, flowers and seeds. The highest alkaloid content in the plant is found in the seeds (0.4%). Jimson Weed is ingested in a variety of ways. It is boiled to form a drinkable tea, the seeds or portions of the plant are ingested directly, or a paste is ingested that is made from the roots and leaves. All have been found to produce symptoms of anticholinergic overdose that include xerostomia, mydriasis, flushing, tachycardia, tachypnea, restlessness, ataxia, psychological disturbances including psychoses, coma, seizures and death. Treatment is with physostigmine and supportive case. Most patients survive with no sequelae except for an amnestic period immediately after ingestion that lasts until consciousness is regained.

Laboratory data of those who have ingested Jimson Weed have been reported to show an elevation of aspartate aminotransferase and lactate dehydrogenase. There may also be a prolongation of the prothrombin time. Urine comprehensive drug screen by gas- chromatography-mass spectrometry can reveal scopolamine and atropine. Because atropine and hyoscyamine are optical isomers they can not be distinguished from one another by their mass spectra.


Milkolich JR, Paulson GW, Cross CJ. Acute Anticholinergic Syndrome Due to Jimson Seed Ingestion. Ann Intern Med 1975;83:321-5.

Klein-Schwartz W, Oderda GM. Jimsonweed Intoxication in Adolescents and Young Adults. Am J Dis Child 1984;138:737-9.

Hanna JP, Schmidley JW, Braselton Jr. WE. Datura Delirium. Clin Neuropharmacol 1992;15(2):109-13.

Contributed by Patricia Aronica, MD, Charles A. Richert, MD, and KN Rao, PhD

Case IndexCME Case StudiesFeedbackHome