Medical Today

Preparations

Belladonna leaf is harvested between May and July and dried at temperatures no warmer than 140°F (60° C). The roots of Atropa belladonna plants that have reached two to four year old maturity are also harvested for herbal preparations in early fall between mid-October and mid-November. The roots are then cleaned and dried at temperatures no warmer than 122°F (50°C). After drying, the leaves and roots are crushed for use in a number of forms, including decoctions, tinctures, infusions, plasters, pills, suppositories, liquid solutions or suspensions, and powders. They can be used both alone and in combination with other herbs and medications.

It is extremely dangerous to self-prescribe belladonna, and it should always be taken under the direction of a doctor or other qualified healthcare professional. The frequency and quantity of dosage will depend on both the patient and the illness the herb is prescribed for, but the doses are always extremely small. For example the Physicians’ Desk Reference (PDR) for Herbal Medicines recommends an average single dose of 0.05-0.10 g. Each patient’s illness is different and some patients experience toxicity at unusually low doses.

For homeopathic remedies, the plant is broken apart and juice is extracted through a pressing process. The extract is then mixed with a water/alcohol solution by a ratio of either 1:10 or 1:100, and this process is repeated up to 30 times to form an extremely diluted dose of the extract. Homeopathic belladonna remedy is generally added to pellets of sugar for easier administration. The dilution and dosage frequency depend on the symptoms being treated, but homeopathic remedies are typically administered only until the patient starts to show signs of improvement so that the body’s natural healing response can take over.

Belladonna is available by prescription both alone (in high concentration strength) and in combination with other drugs. Currently available prescription combinations include belladonna with opium (for uterine pain), kaolin and pectin (for diarrhea), Phenobarbital (for menopausal symptoms and migraine prophylactic), other barbiturates (for insomnia and for cramping and muscle spasms in the digestive tract), or belladonna and opium suppositories (for severe intestinal cramping).

Belladonna preparations should be stored in air-tight containers away from direct light. Under these conditions, most preparations will remain potent for up to three years.

Precautions

Ingestion of high concentrations of atropine, a potent alkaloid found in belladonna, can cause severe illness and death. Atropine is fatal in doses as small as 100 mg, which equals 5-50 g of belladonna herb, depending on the potency of the particular plant. For children, a fatal dose is even significantly less. For this reason, belladonna should never be used unless prescribed by a trained practitioner.

Individuals suffering from kidney disease, intestinal blockage, glaucoma, enlarged prostate, urinary blockage, severe ulcerative colitis, or myasthenia gravis are advised not to take belladonna, as are those patients with a known allergy to belladonna. Patients with any chronic health conditions should never take belladonna without a doctor’s prescription.

Pregnant or breastfeeding women should avoid all but homeopathic belladonna, unless prescribed by a doctor.

Because of the sedative qualities of belladonna, individuals taking the herb should use caution when driving or operating machinery. Alcohol and other central nervous system (CNS) depressants should also be avoided, as they may increase drowsiness and dizziness in the patient taking belladonna.

If individuals taking homeopathic dilutions of belladonna experience worsening of their symptoms (known as a homeopathic aggravation), they should contact their healthcare professional. A homeopathic aggravation can be an early indication that a remedy is working properly, but it can also be a sign that a different remedy is called for.

Side effects

Toxic signs of belladonna include dry mouth, drowsiness, dizziness, constipation, and nausea. Some side effects, including pupil dilation, blurred vision, fever (due to the inability to perspire), inability to urinate, arrhythmia, and excessive dry mouth and eyes, can also be early indications of belladonna overdose. Individuals experiencing these side effects should inform their health care practitioner immediately.

Belladonna overdose is also indicated by a burning throat, delirium, restlessness and mania, hallucinations, difficulty breathing, and flushed skin that is hot and dry. Without proper treatment, constriction of the airway can cause suffocation. If any of these symptoms occur, individuals should seek emergency medical attention immediately. Treatment of belladonna overdose is typically gastric lavage, which involves inserting a tube down the patient’s throat and washing out the stomach with a solution of activated charcoal or tannic acid to neutralize the atropine. Oxygen may also be required until breathing is stabilized, and barbiturates may be administered to counteract mania and/or excitation.

Interactions

Certain medications may increase the effects of belladonna. These include central nervous system (CNS) depressants, monoamine oxidase (MAO) inhibitors, tricyclic antidepressants, quinidine, amantadine, antihistamines, and other anticholinergics. Other medications, including anticoagulants (blood thinners) and corticotrophin (ACTH), become less effective when used with belladonna, while some drugs, such as diarrhea medicines containing kaolin and attapulgite, may decrease the therapeutic response to belladonna when they are taken with the herb. If you are taking these or any other medications or herbal remedies, let your healthcare professional know.

Alcohol, a CNS depressant, can also enhance the sedative effect of belladonna, and should be avoided during belladonna treatment.

Individuals considering treatment with homeopathic dilutions of belladonna should consult their healthcare professional about possible interactions with certain foods, beverages, prescription medications, aromatic compounds, and other environmental elements that could counteract the efficacy of belladonna treatment.