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Levant Berry

Scientific Name(s): Anamirta cocculus Wight & Arn. Family: Menispermaceae (moonseeds)

Common Name(s): The levant berry goes by a large number of synonyms including fish killer , fishberry , hockle elderberry , Indian berry , louseberry and poisonberry . The dried fruit is called “cocculus fructus” or “cocculus indicus” in commercial trade. 1

Uses

Levant berry has been used to relieve malaria, treat lice, stun, or kill fish and game, and manage epilepsy. Its use in medicine has largely been abandoned in the United States and Europe.

Dosing

No clinical evidence supports specific doses in the use of levant berry. The active ingredient, picrotoxin, has been administered for dizziness at 1 to 5 mg intravenous or 1 mg in a suppository.

Contraindications

No longer considered safe.

Pregnancy/Lactation

Documented adverse effects. Avoid use.

Interactions

None well documented.

Adverse Reactions

Central nervous system stimulation and gastrointestinal irritation may occur.

Toxicology

Levant berry should not be used on abraded skin or ingested. It is potentially lethal.

Botany

The levant berry is a climbing woody shrub that is native to India, Burma and other parts of Malaysia. It has wide thick leaves and rootlets that ooze a white milky latex. The fragrant flowers produce U-shaped seeds. The fruit dries to a bitter, nearly black wrinkled shape. 1

History

The fruits are gathered from the wild and sun-dried for export. In India, the leaves are inhaled as a snuff to relieve malaria, and the leaf juice is used in combination with other natural products as a vermifuge. 1 Extracts of the plant are applied topically for lice, but the toxic nature of the components (in particular picrotoxin) make this a dangerous use, especially when the skin is abraded or irritated. Although picrotoxin had been considered an official remedy for epilepsy at the turn of the century in the United States, it is no longer used for this treatment because of severe toxicity. It had found use as a stimulant for the management of morphine poisoning. 1

Chemistry

The fruit flesh contains the nontoxic alkaloids menispermine and paramenispermine. 1 The seed, however, contains the bitter, toxic principle picrotoxin (1.5% to 5%). 2 , 3 This compound can be separated into picrotoxinin and picrotin, oxygenated sesquiterpene derivatives. The tasteless compounds anamirtin and cocculin are also present along with a fixed oil (11% to 24% of the seed). 1 The seed is also rich in fatty acids.

Uses and Pharmacology

Uses

Picrotoxin in doses of 0.3 to 0.6 mg has been used to manage epilepsy and in slightly higher doses to manage night sweating. 1 Picrotoxin continues to find use in experimental models of central nervous system stimulation, but its use in medicine has largely been abandoned in the United States and Europe.

Dosage

No clinical evidence supports specific doses in the use of levant berry. The active ingredient, picrotoxin, has been administered for dizziness at 1 to 5 mg intravenous or 1 mg in a suppository. 4

Pregnancy/Lactation

Documented adverse effects. Avoid use. 5

Interactions

None well documented.

Adverse Reactions

Picrotoxin stimulates the central nervous system and is a gastrointestinal irritant. 1

Toxicology

High doses can cause salivation, vomiting, purging, rapid shallow respiration, palpitations or heart slowing, stupor, loss of consciousness and death. The lethal dose is approximately 30 mg/kg body weight.

In some societies, ground whole dried fruits have been used to kill birds or dogs and to stupefy fish and game. A seed paste is applied to arrow tips by some jungle tribes. 1

Bibliography

1. Morton JF. Major Medicinal Plants . Springfield, IL: Charles C. Thomas, 1977.
2. Evans WC. Trease and Evans' Pharmacognosy . 13th ed. London: Balliere Tindall, 1989.
3. Osol A, Farrar GE Jr, eds. The Dispensatory of the United States of America. 25th ed. Philadelphia: J.B. Lippincott. 1955, 1642.
4. Gruenwald, J, ed. PDR for Herbal Medicine . 2nd ed. Montvale, NJ: Thomson Medical Economics; 2000.
5. Wickersham RM, Novak KK, managing eds. Drug Facts and Comparisons . St. Louis, MO: Wolters Kluwer Heath, Inc.; 2003.

Copyright © 2009 Wolters Kluwer Health

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