Understanding Belladonna (Atropa belladonna)
Belladonna, commonly known as deadly nightshade, is a plant whose leaves and berries are extremely toxic [1.8.2]. It contains potent tropane alkaloids, primarily atropine, scopolamine, and hyoscyamine, which can disrupt the body's nervous system [1.8.2]. These substances have anticholinergic properties, meaning they block the neurotransmitter acetylcholine [1.4.1]. This can affect involuntary body functions like salivation, sweating, pupil size, heart rate, and digestion [1.7.4, 1.8.4]. Historically, it was used for various purposes, from a poison on arrow tips to a cosmetic in Renaissance Italy to dilate pupils [1.3.6, 1.8.2]. Today, its alkaloids are sometimes used in prescription medications like Donnatal, a drug for irritable bowel syndrome, though even this use is not fully approved by the FDA as safe or effective [1.7.5, 1.8.2]. Despite any historical or medicinal use, all parts of the plant are poisonous, and its use as an over-the-counter supplement is widely considered unsafe [1.3.6, 1.8.4].
Specific Populations Who Must Avoid Belladonna
Due to its high toxicity and unpredictable effects, several groups of people should never use belladonna products [1.7.1]. Ingestion can lead to severe anticholinergic syndrome, with symptoms like dry mouth, blurred vision, rapid heartbeat, confusion, hallucinations, and in severe cases, convulsions, respiratory failure, and death [1.8.2, 1.8.3].
Pregnant and Breastfeeding Women
Belladonna is considered likely unsafe for use during pregnancy and while breastfeeding [1.2.5, 1.8.4]. The toxic chemicals can cross the placenta and may harm the unborn baby [1.5.4]. For breastfeeding mothers, the alkaloids can pass into breast milk, potentially harming the infant, and may also reduce milk production [1.2.5, 1.5.3].
Children and Infants
Children are particularly vulnerable to belladonna's toxic effects [1.2.5]. Ingesting even a small number of berries—as few as two—can be fatal [1.2.5]. The U.S. Food and Drug Administration (FDA) has issued multiple warnings against using homeopathic teething tablets and gels containing belladonna for infants [1.6.1, 1.6.2]. Investigations found inconsistent and sometimes dangerously high levels of belladonna in these products, leading to reports of serious adverse events in infants, including seizures, breathing difficulties, muscle weakness, and even death [1.6.1, 1.6.3, 1.6.5].
The Elderly
Older adults are often more sensitive to the anticholinergic effects of belladonna [1.2.1, 1.8.5]. They are more likely to experience side effects such as confusion, memory loss, drowsiness, excitement, and difficult urination [1.3.3, 1.8.5]. The risk of falls and other complications is significantly higher in this population.
Individuals with Pre-Existing Medical Conditions
People with certain health problems should not take belladonna because its anticholinergic effects can worsen their conditions [1.7.4]. These contraindications are extensive and cover multiple body systems.
Cardiovascular and Circulatory Issues
- Heart Disease: Belladonna can cause a rapid heartbeat (tachycardia), which can exacerbate conditions like congestive heart failure (CHF) and other heart diseases [1.2.1, 1.7.4].
- High Blood Pressure (Hypertension): Large amounts of belladonna can increase blood pressure, posing a risk to those who already have hypertension [1.7.4].
- Active Bleeding: It should not be used by individuals with active bleeding accompanied by cardiovascular instability [1.2.3].
Gastrointestinal (GI) Disorders
- GI Obstruction: Belladonna can slow down the intestines, making it dangerous for people with stomach or bowel obstructions, including paralytic ileus [1.2.3, 1.3.5].
- Severe Ulcerative Colitis: The substance can promote complications like toxic megacolon in people with severe ulcerative colitis [1.7.4].
- Acid Reflux and Hiatal Hernia: Belladonna can worsen these conditions [1.7.4].
- Chronic Constipation: The plant's effects can aggravate existing constipation, especially in the elderly or debilitated [1.2.3].
Eye and Urinary Conditions
- Glaucoma: Specifically, narrow-angle glaucoma can be made worse by belladonna [1.2.1, 1.2.5]. The alkaloids can increase pressure inside the eye.
- Urinary Retention: Individuals with bladder obstructions, enlarged prostate, or other problems with urination should avoid belladonna as it can make it more difficult to pass urine [1.2.3, 1.8.6].
Other Conditions
- Respiratory Conditions: People with asthma, emphysema, or other lung diseases should use belladonna with caution, if at all, as it can cause respiratory depression [1.2.1, 1.3.5].
- Myasthenia Gravis: This muscle disorder is a direct contraindication for belladonna use [1.2.3].
- Liver or Kidney Disease: Impaired organ function can slow the removal of belladonna's toxic chemicals from the body, increasing their effects and risks [1.3.2, 1.3.3].
- Down Syndrome: People with Down syndrome may be especially sensitive to the harmful effects of belladonna's chemicals [1.2.5, 1.7.4].
Drug Interactions
Belladonna can interact negatively with several types of medications.
- Anticholinergic Drugs: Combining belladonna with other drugs that have anticholinergic effects (like some antihistamines for allergies and tricyclic antidepressants) can increase the risk of side effects like confusion, blurred vision, and rapid heart rate [1.4.1, 1.4.3].
- Alcohol: Using belladonna with alcohol can significantly increase drowsiness and dizziness and may lead to unsafe or deadly effects [1.2.2, 1.4.6].
- Opioids and Sedatives: When combined with other central nervous system depressants, including opioids, there is a heightened risk of severe drowsiness, respiratory depression, and death [1.2.2].
- MAOIs: Taking belladonna within 14 days of monoamine oxidase inhibitors (MAOIs), used for depression or Parkinson's disease, can cause a dangerous spike in blood pressure [1.2.2].
| Contraindication Category | Specific Conditions or Populations | Primary Risk | Source(s) |
|---|---|---|---|
| High-Risk Populations | Pregnant or breastfeeding women, children, infants, elderly adults | Toxicity, severe side effects, developmental harm, death | [1.2.5], [1.5.1], [1.6.1] |
| Ocular (Eye) Conditions | Narrow-angle glaucoma | Increased eye pressure, worsening of glaucoma | [1.2.1], [1.2.5] |
| Gastrointestinal Issues | GI obstruction, severe ulcerative colitis, reflux, chronic constipation | Worsening of blockage, risk of toxic megacolon | [1.2.3], [1.7.4] |
| Cardiovascular Issues | Heart disease, congestive heart failure, high blood pressure | Rapid heartbeat (tachycardia), increased blood pressure | [1.2.1], [1.7.4] |
| Urological Issues | Enlarged prostate, bladder obstruction, urinary retention | Increased difficulty urinating | [1.2.3], [1.8.6] |
| Neurological/Muscular | Myasthenia gravis, history of seizures, Down syndrome | Worsening of muscle weakness, increased seizure risk, hypersensitivity | [1.2.3], [1.2.5] |
| Drug Interactions | Anticholinergics, alcohol, sedatives, MAOIs | Increased side effects, severe drowsiness, respiratory depression | [1.4.1], [1.4.6], [1.2.2] |
Conclusion
Belladonna is a powerfully toxic plant that is unsafe for oral consumption for most people and is particularly dangerous for specific vulnerable groups [1.8.4]. Individuals who are pregnant, breastfeeding, children, and the elderly must avoid it entirely [1.5.1, 1.8.5]. Furthermore, anyone with a history of glaucoma, heart disease, high blood pressure, gastrointestinal blockages, or urinary problems should not take belladonna, as it can severely worsen these conditions [1.7.1, 1.7.4]. Given the high risk of poisoning, the lack of regulation in supplements, and the potential for fatal interactions, any use of products containing belladonna should only occur under the strict supervision of a qualified healthcare professional who can weigh the substantial risks. For safer alternatives, always consult a doctor or pharmacist.
Authoritative Link: FDA warns consumers about homeopathic teething products [1.6.1]
