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Strychnine Poisoning: Literature Review

Ashish Nair

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Indian Journal of Anesthesia and Analgesia 10(3):p 107-114, July-September 2023. | DOI: 10.21088/ijaa.2349.8471.10323.3

How Cite This Article:

Ashish Nair/Strychnine Poisoning: Literature Review/Indian J Anesth Analg. 2023;10(3) 107-114.

Timeline

Received : June 14, 2023         Accepted : July 18, 2023          Published : August 30, 2023

Abstract

Strychnine poisoning is an quite unusual but a serious poisoning in which convulsions are the major threat to life. Convulsions are predominantly noted at the spinal level, and the key to recognizing this poison is observation of convulsive activity in the awake patient without a postictal phase. Successful treatment requires aggressive airway control and treatment of seizures with benzodiazepines or barbiturates. Neuromuscular blockade may be required. Gastrointestinal decontamination is usually indicated in recent acute ingestions but may precipitate convulsions. Recovery from strychnine poisoning is usually complete and rapid if treatment is aggressive.


References

  • 1.   Gupta RC, Patocka J. Handbook of Toxicology of Chemical Warfare Agents. London: Academic Press; 2009. p. 199.
  • 2.   Inglis-Arkell E. Rat poison strychnine was an early performance-enhancing drug. io9. Gawker Media. 2013 Jun 11 [cited 2015 Nov 23]. Killed by Agatha Christie: Strychnine and the detective novel. Open university. [cited 2017 Jul 27].
  • 3.   Singhapricha T, Pomerleau AC. A case of strychnine poisoning from a southeast Asian herbal remedy. J Emerg Med. 2017 Apr;52(4):493–5.
  • 4.   Smith BA. Strychnine poisoning. J Emerg Med. 1990 May-Jun;8(3):321–5.
  • 5.   Cole C, Jones L, McVeigh J, Kicman A, Syed Q, Bellis M. Adulterants in illicit drugs: a review of empirical evidence. Drug Test Anal. 2011 Feb;3(2):89–96.
  • 6.   Jackson G, Diggle G. Strychnine-containing tonics. Br Med J. 1973 Apr;2(5859):176–7.
  • 7.   Young AB, Snyder SH. Strychnine binding associated with glycine receptors of the central nervous system. Proc Natl Acad Sci U S A. 1973 Oct;70(10):2832–6.
  • 8.   Sgaraglio GP, Mannaioni PF. Pharmacokinetic observations on a case of massive strychnine poisoning. J Toxicol Clin Toxicol. 1973;6(4):533–40.
  • 9.   Mishima M, Tanimoto Y, Oguri K, Yoshimura H. Metabolism of strychnine in vitro. Drug Metab Dispos. 1985 Nov-Dec;13(6):716–21.
  • 10.   Wood DM, Webster E, Martinez D, Dargan PI, Jones AL. Case report: survival after deliberate strychnine self-poisoning, with toxicokinetic data. Crit Care. 2002 Oct;6(5):456–9.
  • 11.   Palatnick W, Meatherall R, Sitar D, Tenebein M. Toxicokinetics of acute strychnine poisoning. J Toxicol Clin Toxicol. 1997;35(6):617–20.
  • 12.   Flood RG. Strychnine poisoning. Pediatr Emerg Care. 1999 Aug;15(4):286.
  • 13.   Boyd RE, Brennan PT, Deng JF, Kelly MT, Espy PD. Strychnine poisoning. Am J Med. 1983 Mar;74(3):507–14.
  • 14.   Polson CJ, Tattersall RN. Clinical toxicology. 2nd ed. London: Pitman Medical and Scientific Publishing Co.; 1969. p. 558–68.
  • 15.   CDC - The Emergency Response Safety and Health Database: Biotoxin: Strychnine-Niosh. Centers for Disease Control and Prevention. [cited 2016 Jan 2].
  • 16.   Makarovsky I, Markel G, Hoffman A, Schein O, Brosh-Nissimov T, Tashma Z, et al. Strychnine—a killer from the past. IMAJ. 2008 Feb;10(2):142–5.
  • 17.   Kempf GF, McCallum JTC, Zerfas LG. A successful treatment for strychnine poisoning: report of eleven cases. JAMA. 1933 Jan;100(1):8.
  • 18.   Leifheit HC, Knopp W. Strychnine poisoning: case report of fatality in a fifteen-month-old child. AMA Am J Dis Child. 1955 Aug;90(2):199–201.
  • 19.   Symons AJC, Boyle AK. Accidental strychnine poisoning—a case report. Br J Anaesth. 1963 Jan;35(1):54–6.
  • 20.   Stannard NW. Child death due to Easton's tablets. Practitioner. 1969 Nov;203(1217):668–9.
  • 21.   Jackson G, Ng SH, Diggle GE, Bourke IG. Strychnine poisoning treated successfully with diazepam. Br Med J. 1971 Aug;3(5773):519–20.
  • 22.   Harden JA, Griggs RC. Diazepam treatment in a case of strychnine poisoning. Lancet. 1971 Aug;2(7719):372–3.
  • 23.   O'Callaghan WG, Joyce N, Counihan HE, Ward M, Lavelle P, O'Brien E. Unusual strychnine poisoning and its treatment: report of eight cases. Br Med J (Clin Res Ed). 1982 Aug;285(6340):478.
  • 24.   Dittrich K, Bayer MJ, Wanke LA. A case of fatal strychnine poisoning. J Emerg Med. 1984;1(4):327–30.
  • 25.   Edmunds M, Sheehan TMT, Van't Hoff W. Strychnine poisoning: clinical and toxicological observations on a non-fatal case. J Toxicol Clin Toxicol. 1986;24(3):245–55.
  • 26.   Burn DJ, Tomson CR, Seviour J, Dale G. Strychnine poisoning as an unusual cause of convulsions. Postgrad Med J. 1989 Aug;65(766):563–4.
  • 27.   Sarvesvaran R. Strychnine poisoning: a case report. Mal J Pathol. 1992 Jun;14(1):35–9.
  • 28.   Hernandez AF, Pomares J, Schiaffno S, Pla A, Villanueva E. Acute chemical pancreatitis associated with nonfatal strychnine poisoning. J Toxicol Clin Toxicol. 1998;36(1-2):67–71.
  • 29.   Shadnia S, Moiensadat M, Abdollahi M. A case of acute strychnine poisoning. Vet Hum Toxicol. 2004 Apr;46(2):76–9.
  • 30.   Scheffold N, Heinz B, Albrecht H, Pickert A, Cyran J. Strychninvergiftung [Strychnine poisoning]. Dtsch Med Wochenschr. 2004 Oct;129(42):2236–8.
  • 31.   Parker AJ, Lee JB, Redman J, Jolliffe L. Strychnine poisoning: gone but not forgotten. Emerg Med J. 2011 Jan;28(1):84.
  • 32.   Lages A, Pinho J, Alves R, Capela C, Lourenço E, Lencastre L. Strychnine intoxication: a case report. J Med Cases. 2013 Jun;4(6):385–8.
  • 33.   Van Berlo-van de Laar IR, Arbouw ME, Bles CM. Strychnine-intoxicatie: zeldzaam maar niet verdwenen [Strychnine poisoning: uncommon, but does still happen]. Ned Tijdschr Geneeskd. 2015;159:A8877.
  • 34.   Rao NK, Nayak VC, James RI, Patil N, Rao R, Jaunky C, et al. Survival after strychnine poisoning: a case report. Res J Pharm Biol Chem Sci. 2016 Jan;7(1):1769–71.
  • 35.   Kidiyoor Y, Rai S, Bakkannavar M, Nayak CV, James IR, Saravu K. Rhabdomyolysis and strychnine poisoning: A case report. Res J Pharm Biol Chem Sci. 2016;7(4):45–7.
  • 36.   Ponraj L, Mishra AK, Koshy M, Carey RA. A rare case report of Strychnos nuxvomica poisoning with bradycardia. J Family Med Prim Care. 2017 Jul-Aug;6(4):663–5.
  • 37.   Aghabiklooei A, Abolmaali M. Serial seizures due to the pesticide poison strychnine, refractory to high doses of benzodiazepines. Int J Med Toxicol Forensic Med. 2018;8(4):157–60.
  • 38.   Radosavljevic J, Jeffries WS, Peter JV. Intentional strychnine use and overdose – an entity of the past? Crit Care Resusc. 2006 Sep;8(3):260–1.
  • 39.   Chan YC. Strychnine. In: Goldfrank LR, Flomenbaum M, Hoffman RJ, Howland MA, Lewin NA, Nelson LS, editors. Goldfrank’s Toxicologic Emergencies. 8th ed. New York: McGraw-Hill; 2006. p. 1492–6.
  • 40.   Otter J, D’Orazio JL. Strychnine toxicity. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan [cited 2025 Nov 27.

Data Sharing Statement

There are no additional data available. All raw data and code are available upon request.

Funding

This research received no funding.

Author Contributions

I am single author contributed significantly to the work and approve its publication.

Ethics Declaration

This article does not involve any human or animal subjects, and therefore does not require ethics approval.


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Cite this article

Ashish Nair/Strychnine Poisoning: Literature Review/Indian J Anesth Analg. 2023;10(3) 107-114.


Licence:

Attribution-Non-commercial 4.0 International (CC BY-NC 4.0)

This license enables reusers to distribute, remix, adapt, and build upon the material in any medium or format for noncommercial purposes only, and only so long as attribution is given to the creator.


Received Accepted Published
June 14, 2023 July 18, 2023 August 30, 2023

DOI: 10.21088/ijaa.2349.8471.10323.3

Keywords

StrychninePoisoningConvulsions

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Received June 14, 2023
Accepted July 18, 2023
Published August 30, 2023

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Attribution-Non-commercial 4.0 International (CC BY-NC 4.0)

This license enables reusers to distribute, remix, adapt, and build upon the material in any medium or format for noncommercial purposes only, and only so long as attribution is given to the creator.


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