Scientific Name(s): Anamirta cocculus Wight & Arn.
Common Name(s): Cocculus fructus, Cocculus indicus, Fish killer, Fishberry, Hockle elderberry, Indian berry, Kockel-lian, Levant berry, Levantnut, Louseberry, Poisonberry, Tuba biji
Medically reviewed by Drugs.com. Last updated on Oct 1, 2019.
Levant berry has traditionally been used to relieve malaria, treat lice, stun or kill fish and game, and manage epilepsy. Clinical use of levant berry has largely been abandoned in the United States and Europe because there are no studies supporting its use. The constituent picrotoxin has been evaluated in limited clinical studies for vertigo.
No clinical evidence supports any clinical applications of levant berry. In a small clinical study, picrotoxin suppositories (1 mg 3 times per week) were more effective than betahistine in reducing the frequency and intensity of vertigo attacks.
Toxicity of the constituent picrotoxin has been established.
Avoid use. Adverse effects have been documented.
None well documented.
Picrotoxin stimulates the CNS and is a GI irritant.
High doses can cause salivation, vomiting, purging, rapid shallow respiration, palpitations or heart slowing, stupor, loss of consciousness, and death. Death from doses of 2 to 3 g of the fruit has been reported.
- Menispermaceae (moonseed)
A. cocculus, known as levant berry, is a climbing woody shrub 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.Duke 2002, Morton 1977, USDA 2015
The fruit of levant berry is gathered from the wild and sun dried for export. In India, the leaves have been inhaled as a snuff to relieve malaria, and the leaf juice used in combination with other natural products as a vermifuge.Morton 1977 Extracts of the plant have been applied topically for lice, but the toxic nature of the components (in particular picrotoxin) makes this application dangerous, especially in cases of abraded or irritated skin. For centuries, fishermen in Asia used the seeds to produce a poison to stun fish,Bause 2013 and in some societies, ground whole dried fruit has been used to kill birds or dogs, and to stupefy game as well as fish.Jablonski 2008 Picrotoxin has been used as a stimulant for the management of morphine and barbiturate poisoning and was considered an official remedy for epilepsy at the turn of the 19th century into the 20th in the United States; however, it is no longer used for this condition because of severe toxicity.Duke 2002, Morton 1977 Use as a biological weapon has been suggested for picrotoxin because of the ease of chemical isolation and purification.Jablonski 2008
The fruit flesh and seed shells contain the nontoxic alkaloids menispermine and paramenispermine.Morton 1977, Verpoorte 1981 The seed, however, contains the bitter, toxic principle picrotoxin (1.5% to 5%); this compound can be separated into picrotoxinin and picrotin, which are oxygenated sesquiterpene derivatives.Duke 1992 The tasteless compounds anamirtin and cocculin are also present, along with a fixed oil (11% to 24% of the seed).Morton 1977 The seed is also rich in fatty acids. The stem and roots of the plant contain quaternary alkaloids (eg, berberine, palmatine).Verpoorte 1981
Uses and Pharmacology
Picrotoxin acts as gamma-aminobutyric acid (GABA) receptors, blocking conductance enhancement of agonists such as propofol and barbiturates, hence its historical application as an antidote to barbiturate poisoning.Bause 2013, Belcher 2013 Studies conducted in rodents have shown improved sexual behavior in adult rats and their offspring due to possible action of picrotoxin on GABA receptors.Baso 2003, Bernardi 2013, Teodorov 2005
Clinical studies of picrotoxin use in Meniere disease, as well as in combination with other natural remedies for vertigo, have been limited because of toxicity concerns.Heinle 2010, Weikert 2008 In a small clinical study, picrotoxin suppositories (1 mg 3 times per week) were more effective than betahistine in reducing the frequency and intensity of vertigo attacks.Weikert 2008
Picrotoxin, not levant berry itself, has been studied for effect on acute hypoxic states, potentially via activity on GABA receptors, in ratsSanotskaya 2008 and on cognitive decline in mice.Yoshiike 2008
No clinical evidence supports any clinical applications of levant berry. In a small clinical study, picrotoxin suppositories (1 mg 3 times per week) were more effective than betahistine in reducing the frequency and intensity of vertigo attacks.Weikert 2008
Pregnancy / Lactation
Avoid use. Adverse effects have been documented. Exposure to picrotoxin has been shown to induce demasculinization of male offspring.Baso 2003
None well documented.
Picrotoxin stimulates the CNS and is a GI irritant.Morton 1977
High doses can cause salivation, vomiting, purging, rapid shallow respiration, palpitations or heart slowing, stupor, loss of consciousness, and death.Belcher 2013, Duke 2002 Death from doses of 2 to 3 g of the fruit have been reported.Duke 2002
This information relates to an herbal, vitamin, mineral or other dietary supplement. This product has not been reviewed by the FDA to determine whether it is safe or effective and is not subject to the quality standards and safety information collection standards that are applicable to most prescription drugs. This information should not be used to decide whether or not to take this product. This information does not endorse this product as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about this product. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to this product. This information is not specific medical advice and does not replace information you receive from your health care provider. You should talk with your health care provider for complete information about the risks and benefits of using this product.
This product may adversely interact with certain health and medical conditions, other prescription and over-the-counter drugs, foods, or other dietary supplements. This product may be unsafe when used before surgery or other medical procedures. It is important to fully inform your doctor about the herbal, vitamins, mineral or any other supplements you are taking before any kind of surgery or medical procedure. With the exception of certain products that are generally recognized as safe in normal quantities, including use of folic acid and prenatal vitamins during pregnancy, this product has not been sufficiently studied to determine whether it is safe to use during pregnancy or nursing or by persons younger than 2 years of age.
Copyright © 2019 Wolters Kluwer Health