Datura Dosage Guide

## Datura Overdose Is a Medical Emergency Unlike most psychoactive substances covered on this site, there is no meaningful distinction between "a datura experience" and "datura poisoning." Every recreational use of datura is, pharmacologically speaking, a case of anticholinergic poisoning of varying severity. The question is not whether you have been poisoned, but how badly. ## Signs of Severe Anticholinergic Poisoning Seek emergency medical attention immediately for any of the following: - **Body temperature above 39 degrees C (102 degrees F)** -- hyperthermia is the primary killer and requires immediate active cooling - **Heart rate above 150 bpm or any irregular rhythm** -- cardiac arrhythmias can be fatal - **Seizures** -- more common in children and with higher doses - **Inability to urinate** (urinary retention) -- painful and potentially dangerous if prolonged - **Complete unresponsiveness** or loss of consciousness - **Violent agitation** that poses danger to the person or others - **Signs of rhabdomyolysis** -- dark brown urine, severe muscle pain, muscle rigidity ## What To Do **Call 911 immediately.** Tell them it was datura, jimsonweed, or an anticholinergic plant poisoning. This single piece of information will immediately orient emergency treatment. While waiting for paramedics: - **Cool the person** -- remove excess clothing, apply cold water or ice packs to neck, armpits, and groin, move to air conditioning. Hyperthermia kills and every minute counts - **Place in recovery position** if consciousness is impaired, to prevent aspiration of vomit - **Do not attempt to induce vomiting** -- the person may aspirate - **Do not give activated charcoal** unless directed by poison control or EMS -- aspiration risk is too high in a delirious patient - **Do not restrain violently** -- agitated patients can develop fatal excited delirium. Use the minimum restraint necessary for safety - **Remove environmental hazards** -- the person is delirious and cannot assess danger. Remove access to heights, water, roads, sharp objects, and vehicles ## Hospital Treatment **Physostigmine** is the specific antidote for anticholinergic poisoning. It is a cholinesterase inhibitor that crosses the blood-brain barrier, reversing both peripheral and central anticholinergic effects. It must be administered slowly IV with cardiac monitoring, as rapid administration or use in patients with cardiac conduction abnormalities can cause bradycardia or asystole. Not all emergency physicians are comfortable using it, but current toxicology guidance supports its use in pure anticholinergic poisoning with severe agitation or delirium. Supportive care includes IV fluid resuscitation, active cooling for hyperthermia, benzodiazepines for seizures and agitation, continuous cardiac monitoring, and bladder catheterization for urinary retention. ICU admission is common for severe cases. The prolonged duration of tropane alkaloid effects (24-72+ hours) means patients may require extended observation. ## After Discharge Residual cognitive effects -- particularly memory impairment, difficulty concentrating, and blurred vision -- may persist for days to weeks. This is normal recovery from anticholinergic insult and typically resolves completely. If visual disturbances (mydriasis) persist beyond a week, see an ophthalmologist.