Group of chemical compounds
Grayanotoxins are a group of closely related neurotoxins named after Leucothoe grayana, a plant native to Japan and named for 19th-century American botanist Asa Gray. Grayanotoxin I (grayanotoxane-3,5,6,10,14,16-hexol 14-acetate) is also known as andromedotoxin, acetylandromedol, rhodotoxin and asebotoxin. Grayanotoxins are produced by Rhododendron species and other plants in the family Ericaceae. Honey made from the nectar and so containing pollen of these plants also contains grayanotoxins and is commonly referred to as mad honey.
Consumption of the plant or any of its secondary products, including mad honey, can cause a rare poisonous reaction called grayanotoxin poisoning, mad honey disease, honey intoxication, or rhododendron poisoning. It is most frequently produced and consumed in regions of Turkey and Nepal as a recreational drug and traditional medicine.
Safety at a Glance
High Risk- Cholinergics - Because grayanotoxins potentiate the effects of acetylcholine, cholinergic substances such as nicotine...
- Depressants - Combining grayanotoxins with other depressants increase the risk of a sudden loss of consciousness.
- Toxicity: It is strongly recommended that one use harm reduction practices when using this substance. Lethal dosage Tolerance a...
- Dangerous with: Atropa belladonna, Cake, Datura, Deschloroetizolam (+23 more)
- Overdose risk: Depressant overdose from Grayanotoxin is a life-threatening medical emergency. The primary mechan...
If someone is in crisis, call 911 or Poison Control: 1-800-222-1222
Duration
How It Feels
The experience of grayanotoxin, historically encountered through "mad honey" harvested from rhododendron-feeding bees, is unlike any other depressant. The onset takes thirty minutes to two hours and begins with a sensation that something is subtly wrong with the body's calibration. A dizziness appears, not the spinning vertigo of alcohol but a lighter, more floating variety, as though the inner ear has been gently confused about which way is up. There is a tingling in the lips and mouth that spreads to the face and extremities, a characteristic pins-and-needles sensation that announces the toxin's interaction with sodium channels throughout the nervous system.
As the effects develop, the dizziness intensifies and is joined by a noticeable drop in blood pressure and heart rate. The body feels strange -- simultaneously light-headed and heavy-limbed, as though the upper and lower halves were subject to different gravitational rules. There is a warmth that spreads from the stomach, and many users report a mild euphoria, a dreamy sense of contentment that sits oddly alongside the physical discomfort. Vision may blur slightly, and there is a sense of the world being viewed through a gentle haze. Nausea is common, a queasy reminder that this is a toxin the body is working to process, and sweating may occur despite a subjective feeling of coldness.
At what might be called the peak, the experience is a strange mixture of euphoria and malaise. The dizziness is pronounced, and coordination is significantly impaired. There is a perceptual quality that is genuinely unique -- a dreamy, slightly hallucinatory softness to the world, as though reality were being experienced through a thin membrane. The body feels weak, and exertion becomes difficult; the heart beats slowly, and the blood pressure remains low, producing lightheadedness with any change in position. Despite these uncomfortable physical effects, there is often a persistent sense of peace, a calm that seems to belong to a different substance entirely.
The offset is gradual, the dizziness and weakness slowly receding over several hours. The nausea typically resolves before the cardiovascular effects normalize, and a lingering lightheadedness may persist for half a day. The overall experience is more curiosity than pleasure -- a strange, ancient intoxication that feels like it belongs to a different era of human drug use.
Subjective Effects
The effects listed below are based on the Subjective Effect Index (SEI), an open research literature based on anecdotal reports and personal analyses. They should be viewed with a healthy degree of skepticism. These effects will not necessarily occur in a predictable or reliable manner, although higher doses are more liable to induce the full spectrum of effects.
Physical Effects
Physical(18)
- Appetite suppression— A distinct decrease in hunger and desire to eat, ranging from reduced interest in food to complete d...
- Decreased blood pressure— Decreased blood pressure (hypotension) is a drop in arterial blood pressure below normal levels, com...
- Decreased heart rate— Decreased heart rate (bradycardia) is a slowing of the heart's rhythm below the normal resting range...
- Diarrhea— Diarrhea is the occurrence of frequent, loose, or watery bowel movements as a side effect of certain...
- Dizziness— A sensation of spinning, swaying, or lightheadedness that impairs balance and spatial orientation, o...
- Headache— A painful sensation of pressure, throbbing, or aching in the head that can range from a dull backgro...
- Increased libido— A marked enhancement of sexual desire, arousal, and sensitivity to erotic stimuli that can range fro...
- Increased salivation— Increased salivation (hypersalivation or sialorrhea) is the excessive production of saliva beyond wh...
- Motor control loss— A distinct decrease in the ability to control one's physical body with precision, balance, and coord...
- Mouth numbing— Mouth numbing is a localized loss of sensation in the tongue, gums, cheeks, and surrounding oral tis...
- Muscle relaxation— The experience of muscles throughout the body losing their rigidity and tension, becoming noticeably...
- Nausea— An uncomfortable sensation of queasiness and stomach discomfort that may or may not lead to vomiting...
- Pain relief— A suppression of negative physical sensations such as aches and pains, ranging from dulled awareness...
- Physical euphoria— An intensely pleasurable bodily sensation that can manifest as waves of warmth, tingling electricity...
- Physical fatigue— Physical fatigue is a state of bodily exhaustion characterized by reduced energy, diminished capacit...
- Respiratory depression— A dangerous slowing and shallowing of breathing that can progress from barely noticeable reductions ...
- Sedation— A state of deep physical and mental calming that manifests as a progressive desire to remain still, ...
- Temperature regulation disruption— Impaired thermoregulation causing unpredictable fluctuations between feeling hot and cold, with risk...
Cognitive & Perceptual Effects
Visual(7)
- Brightness alteration— Perceived increase or decrease in environmental brightness beyond actual illumination levels, common...
- Double vision— The visual experience of seeing a single object as two separate, overlapping images, similar to cros...
- Drifting— The visual experience of perceiving stationary objects, textures, and surfaces as appearing to flow,...
- External hallucination— A visual hallucination that manifests within the external environment as though it were physically r...
- Internal hallucination— Vivid, detailed visual experiences perceived within an imagined mental landscape that can only be se...
- Visual acuity suppression— Vision becomes blurred, indistinct, and out of focus, as though looking through a smudged lens. Fine...
- Visual haze— A translucent fog or haze overlays the visual field, softening the environment and reducing clarity....
Cognitive(9)
- Anxiety— Intense feelings of apprehension, worry, and dread that can range from a subtle background unease to...
- Anxiety suppression— A partial to complete suppression of anxiety and general unease, producing a calm, relaxed mental st...
- Cognitive dysphoria— A cognitive and emotional state of intense dissatisfaction, discomfort, and malaise encompassing fee...
- Cognitive euphoria— A cognitive and emotional state of intense well-being, elation, happiness, and joy that manifests as...
- Cognitive fatigue— Mental exhaustion and difficulty sustaining thought after intense cognitive experiences, common duri...
- Confusion— An impairment of abstract thinking marked by a persistent inability to grasp or comprehend concepts ...
- Depression— A persistent state of low mood, emotional numbness, hopelessness, and diminished interest or pleasur...
- Irritability— Irritability is a sustained state of emotional reactivity in which the threshold for annoyance, frus...
- Sleepiness— A progressive onset of drowsiness, heaviness, and the desire to sleep that pulls the individual towa...
Pharmacology
The toxicity of grayanotoxin is derived from its ability to interfere with voltage-gated sodium channels located in the cell membrane of neurons. The Nav1.x channels consist of four homologous domains (I-IV), each containing six transmembrane alpha-helical segments (S1-S6). Grayanotoxin has a binding affinity (IC50) of approximately 10 μM and binds the group II receptor site located on segment 6 of domains I and IV (IS6 and IVS6). Other toxins that bind to this region include the alkaloids veratridine, batrachotoxin and aconitine.
Experiments using squid axonal membranes indicate that sodium channel binding likely occurs on the internal face of the neuron. Additionally, grayanotoxin only binds to the activated conformation of sodium channels. Normally, voltage gated sodium channels are activated (opened) only when the cell membrane potential reaches a specific threshold voltage. This activated conformation allows for an influx of sodium ions resulting in cell depolarization, followed by the firing of an action potential. At the peak of the action potential, voltage-gated sodium channels are quickly inactivated and are only reset once the cell has repolarized to resting potential. When grayanotoxin is present, binding induces further conformational changes that prevent sodium channel inactivation and lead to a prolonged depolarization. Owing to its transient ability to activate channels and increase membrane permeability to sodium ions, grayanotoxin is classified as a reversible Nav1.x agonist.
Detection Methods
Standard Drug Panel Inclusion
Grayanotoxin is NOT included on any standard drug screening panel. It is a naturally occurring diterpene toxin found in Rhododendron and Ericaceae family plants and in certain honeys ("mad honey"). No immunoassay exists for grayanotoxin, and it is not tested for on any routine clinical or forensic panel.
Urine Detection
Very limited data exists on the urinary pharmacokinetics of grayanotoxin in humans. Based on animal studies and case reports of mad honey poisoning, the compound and its metabolites are likely detectable in urine for approximately 24 to 48 hours after exposure. The metabolic pathways in humans are not fully characterized. Detection would require specialized LC-MS/MS methods with grayanotoxin reference standards, which are available from natural product chemistry suppliers but not routinely stocked by clinical laboratories.
Blood and Serum Detection
Blood detection is estimated at 12 to 24 hours based on the clinical course of mad honey poisoning, which typically resolves within 24 hours. Serum concentrations associated with toxicity have been reported in the range of 0.1 to 10 mcg/mL in case reports, though systematic pharmacokinetic studies are lacking. Blood testing for grayanotoxin is performed only in research or specialized forensic contexts.
Hair Follicle Detection
No hair testing methods exist for grayanotoxin. The compound is not a substance of abuse in conventional contexts and is not targeted in forensic hair analysis.
Confirmatory Methods
LC-MS/MS with electrospray ionization is the preferred analytical method for grayanotoxin identification. Multiple grayanotoxin isomers exist (GTX-I through GTX-XVIII), and the analytical method should target the most pharmacologically active forms, primarily GTX-I and GTX-III. Analysis of the honey itself using LC-MS/MS or HPLC-UV provides a more practical approach to confirming exposure than biological specimen testing.
Reagent Testing
No reagent testing protocols exist for grayanotoxin. Identification of contaminated honey or plant material requires analytical chemistry methods.
Interactions
| Substance | Status | Note |
|---|---|---|
| Atropa belladonna | Dangerous | Compounding CNS depression with anticholinergic effects; risk of cardiac events and respiratory failure |
| Cake | Dangerous | Combined CNS depression; risk of respiratory failure |
| Datura | Dangerous | Compounding CNS depression with anticholinergic effects; risk of cardiac events and respiratory failure |
| Deschloroetizolam | Dangerous | Combined CNS depression; risk of respiratory failure |
| Desomorphine | Dangerous | Severe respiratory depression risk; leading cause of polydrug overdose |
| Diclazepam | Dangerous | Combined CNS depression; risk of respiratory failure |
| Diphenhydramine | Dangerous | Compounding CNS depression with anticholinergic effects; risk of cardiac events and respiratory failure |
| Eszopiclone | Dangerous | Combined CNS depression; risk of respiratory failure |
| Etizolam | Dangerous | Combined CNS depression; risk of respiratory failure |
| Flubromazepam | Dangerous | Combined CNS depression; risk of respiratory failure |
| Flubromazolam | Dangerous | Combined CNS depression; risk of respiratory failure |
| Flunitrazepam | Dangerous | Combined CNS depression; risk of respiratory failure |
| Flunitrazolam | Dangerous | Combined CNS depression; risk of respiratory failure |
| Gaboxadol | Dangerous | Combined CNS depression; risk of respiratory failure |
| Harmala alkaloid | Dangerous | Unpredictable potentiation of CNS depression; risk of respiratory failure |
| Lorazepam | Dangerous | Combined CNS depression; risk of respiratory failure |
| Mephenaqualone | Dangerous | Combined CNS depression; risk of respiratory failure |
| Metizolam | Dangerous | Combined CNS depression; risk of respiratory failure |
| Midazolam | Dangerous | Combined CNS depression; risk of respiratory failure |
| Naloxone | Dangerous | Severe respiratory depression risk; leading cause of polydrug overdose |
| Nicotine | Dangerous | Combined CNS depression; risk of respiratory failure |
| Nifoxipam | Dangerous | Combined CNS depression; risk of respiratory failure |
| Opioids | Dangerous | — |
| Peganum harmala | Dangerous | Unpredictable potentiation of CNS depression; risk of respiratory failure |
| Pentobarbital | Dangerous | Combined CNS depression; risk of respiratory failure |
| Phenobarbital | Dangerous | Combined CNS depression; risk of respiratory failure |
| SAMe | Dangerous | Combined CNS depression; risk of respiratory failure |
| 3-Cl-PCP | Caution | Both cause CNS depression; increased risk of vomiting, unconsciousness, and respiratory depression |
| 3-FMA | Caution | Masks the effects of each drug; risk of overdosing when one wears off before the other |
| 3-HO-PCE | Caution | Both cause CNS depression; increased risk of vomiting, unconsciousness, and respiratory depression |
| 3-HO-PCP | Caution | Both cause CNS depression; increased risk of vomiting, unconsciousness, and respiratory depression |
| 3-MeO-PCE | Caution | Both cause CNS depression; increased risk of vomiting, unconsciousness, and respiratory depression |
| 1,3-Butanediol | Low Risk & Decrease | Depressants dull psychedelic effects; benzodiazepines are commonly used as trip-killers |
| 25E-NBOH | Low Risk & Decrease | Depressants dull psychedelic effects; benzodiazepines are commonly used as trip-killers |
| 2C-T | Low Risk & Decrease | Depressants dull psychedelic effects; benzodiazepines are commonly used as trip-killers |
| 2C-T-2 | Low Risk & Decrease | Depressants dull psychedelic effects; benzodiazepines are commonly used as trip-killers |
| 2C-T-21 | Low Risk & Decrease | Depressants dull psychedelic effects; benzodiazepines are commonly used as trip-killers |
History
There are currently experience reports which describe the effects of this substance in our experience index.
It is strongly recommended that one use harm reduction practices when using this substance. -Cholinergics** - Because grayanotoxins potentiate the effects of acetylcholine, cholinergic substances such as nicotine, caffeine, and galantamine may carry an increased risk of cholinergic crisis. -Depressants** - Combining grayanotoxins with other depressants increase the risk of a sudden loss of consciousness. -Opioids** - Grayanotoxins and opioids potentiate the sedation, hypotension, and decreased heart rate caused by each other, increasing the risk of sudden loss of consciousness or respiratory depression.
- Responsible use
(List along order below)
Grayanotoxin (Wikipedia)
Grayanotoxin (Erowid Vault)
APA formatted reference
Please see the citation formatting guide if you need assistance properly formatting citations.
Harm Reduction
-Cholinergics** - Because grayanotoxins potentiate the effects of acetylcholine, cholinergic substances such as nicotine, caffeine, and galantamine may carry an increased risk of cholinergic crisis. -Depressants** - Combining grayanotoxins with other depressants increase the risk of a sudden loss of consciousness. -Opioids** - Grayanotoxins and opioids potentiate the sedation, hypotension, and decreased heart rate caused by each other, increasing the risk of sudden loss of consciousness or respiratory depression.
- Responsible use
(List along order below)
Grayanotoxin (Wikipedia)
Grayanotoxin (Erowid Vault)
APA formatted reference
Please see the citation formatting guide if you need assistance properly formatting citations.
Toxicity & Safety
It is strongly recommended that one use harm reduction practices when using this substance.
Lethal dosage
Tolerance and addiction potential
Dangerous interactions
Warning: Many psychoactive substances that are reasonably safe to use on their own can suddenly become dangerous and even life-threatening when combined with certain other substances. The following list provides some known dangerous interactions (although it is not guaranteed to include all of them).
Always conduct independent research (e.g. Google, DuckDuckGo, PubMed) to ensure that a combination of two or more substances is safe to consume. Some of the listed interactions have been sourced from TripSit.
Cholinergics - Because grayanotoxins potentiate the effects of acetylcholine, cholinergic substances such as nicotine, caffeine, and galantamine may carry an increased risk of cholinergic crisis.
Depressants - Combining grayanotoxins with other depressants increase the risk of a sudden loss of consciousness.
Opioids - Grayanotoxins and opioids potentiate the sedation, hypotension, and decreased heart rate caused by each other, increasing the risk of sudden loss of consciousness or respiratory depression.
Overdose Information
Depressant overdose from Grayanotoxin is a life-threatening medical emergency. The primary mechanism of death is respiratory depression leading to respiratory arrest.
Signs of overdose: Extremely slow or stopped breathing, blue lips or fingertips (cyanosis), pinpoint pupils, unresponsiveness, cold/clammy skin, gurgling or snoring sounds (may indicate airway obstruction), very slow heart rate.
Emergency response:
- Call emergency services immediately
- If the person is not breathing, begin rescue breathing or CPR
- Place unconscious but breathing person in the recovery position
- Administer naloxone if opioid involvement is suspected
- Stay with the person until help arrives
- Be honest with emergency responders about all substances consumed
Critical combination risk: The combination of Grayanotoxin with other depressants (alcohol, benzodiazepines, opioids) is the most common scenario for fatal depressant overdose. The respiratory depression from multiple depressants is synergistic (greater than the sum of individual effects).
Dangerous Interactions
The combinations listed below may be life-threatening. Independent research should always be conducted to ensure safety when combining substances.
Compounding CNS depression with anticholinergic effects; risk of cardiac events and respiratory failure
Combined CNS depression; risk of respiratory failure
Compounding CNS depression with anticholinergic effects; risk of cardiac events and respiratory failure
Combined CNS depression; risk of respiratory failure
Severe respiratory depression risk; leading cause of polydrug overdose
Combined CNS depression; risk of respiratory failure
Compounding CNS depression with anticholinergic effects; risk of cardiac events and respiratory failure
Combined CNS depression; risk of respiratory failure
Combined CNS depression; risk of respiratory failure
Combined CNS depression; risk of respiratory failure
Combined CNS depression; risk of respiratory failure
Combined CNS depression; risk of respiratory failure
Combined CNS depression; risk of respiratory failure
Combined CNS depression; risk of respiratory failure
Unpredictable potentiation of CNS depression; risk of respiratory failure
Combined CNS depression; risk of respiratory failure
Combined CNS depression; risk of respiratory failure
Combined CNS depression; risk of respiratory failure
Combined CNS depression; risk of respiratory failure
Severe respiratory depression risk; leading cause of polydrug overdose
Combined CNS depression; risk of respiratory failure
Combined CNS depression; risk of respiratory failure
Unpredictable potentiation of CNS depression; risk of respiratory failure
Combined CNS depression; risk of respiratory failure
Combined CNS depression; risk of respiratory failure
Combined CNS depression; risk of respiratory failure
Tolerance
| Full | Limited data — may develop with repeated exposure |
| Half | Unknown |
| Zero | Unknown |
Cross-tolerances
Legal Status
- Responsible use
(List along order below)
Grayanotoxin (Wikipedia)
Grayanotoxin (Erowid Vault)
APA formatted reference
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Experience Reports (1)
Tips (3)
Start with a low dose of Grayanotoxin and wait for full onset before considering more. Depressants have a narrow margin between recreational and dangerous doses. Redosing while already impaired leads to accidental overdose.
Never combine Grayanotoxin with other CNS depressants (alcohol, opioids, benzodiazepines, GHB). Respiratory depression stacks multiplicatively, not additively. This is the most common cause of depressant-related deaths.
Inform a trusted person when using Grayanotoxin, especially if alone. Depressant overdoses can cause you to lose consciousness before you can call for help. Someone should be able to check on you.
See Also
References (3)
- PubChem: Grayanotoxin
PubChem compound page for Grayanotoxin (CID: 433104)
pubchem - Grayanotoxin - TripSit Factsheet
TripSit factsheet for Grayanotoxin
tripsit - Grayanotoxin - Wikipedia
Wikipedia article on Grayanotoxin
wikipedia